Ivan J. Núñez-Gil, Gisela Feltes, María C. Viana-Llamas, Sergio Raposeiras-Roubin, Rodolfo Romero, Emilio Alfonso-Rodríguez, Aitor Uribarri, Francesco Santoro, Víctor Becerra-Muñoz, Martino Pepe, Alex F. Castro-Mejía, Jaime Signes-Costa, Adelina Gonzalez, Francisco Marín, Javier Lopez-País, Enrico Cerrato, Olalla Vázquez-Cancela, Carolina Espejo-Paeres, Álvaro López Masjuan, Lazar Velicki, Ibrahim El-Battrawy, Harish Ramakrishna, Antonio Fernandez-Ortiz, Julián Perez-Villacastín, Institut Català de la Salut, [Núñez-Gil IJ] Cardiology Department, Hospital Clínico San Carlos, Madrid, Spain. Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain. [Feltes G] Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain. Cardiology Department, Hospital Vithas Arturo Soria, Madrid, Spain. [Viana-Llamas MC] Cardiology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain. [Raposeiras-Roubin S] Cardiology Department, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain. [Romero R] Emergency Department, Hospital Isabel Zendal and Hospital Universitario de Getafe, Madrid, Spain. [Alfonso-Rodríguez E] Cardiology Department, Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba. [Uribarri A] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
COVID-19; Heart disease; Persistent COVID 19; Malaltia cardíaca; Persistent COVID-19; Enfermedad cardíaca; Persistente Background: Heart disease is linked to worse acute outcomes after coronavirus disease 2019 (COVID-19), although long-term outcomes and prognostic factor data are lacking. We aim to characterize the outcomes and the impact of underlying heart diseases after surviving COVID-19 hospitalization. Methods: We conducted an analysis of the prospective registry HOPE-2 (Health Outcome Predictive Evaluation for COVID-19-2, NCT04778020). We selected patients discharged alive and considered the primary end-point all-cause mortality during follow-up. As secondary main end-points, we included any readmission or any post-COVID-19 symptom. Clinical features and follow-up events are compared between those with and without cardiovascular disease. Factors with p < 0.05 in the univariate analysis were entered into the multivariate analysis to determine independent prognostic factors. Results: HOPE-2 closed on 31 December 2021, with 9299 patients hospitalized with COVID-19, and 1805 died during this acute phase. Finally, 7014 patients with heart disease data were included in the present analysis, from 56 centers in 8 countries. Heart disease (+) patients were older (73 vs. 58 years old), more frequently male (63 vs. 56%), had more comorbidities than their counterparts, and suffered more frequently from post-COVID-19 complications and higher mortality (OR heart disease: 2.63, 95% CI: 1.81–3.84). Vaccination was found to be an independent protector factor (HR all-cause death: 0.09; 95% CI: 0.04–0.19). Conclusions: After surviving the acute phase, patients with underlying heart disease continue to present a more complex clinical profile and worse outcomes including increased mortality. The COVID-19 vaccine could benefit survival in patients with heart disease during follow-up. Non-conditioned grant (Fundación Interhospitalaria para la Investigación cardiovascular, FIC. Madrid, Spain). This nonprofit institution had no role in the study design; collection, analysis, or interpretation of data; in the writing of the report; nor in the decision to submit the paper for publication.