Major adverse cardiovascular events (MACE) in patients with severe COVID-19 registered in the ISARIC WHO clinical characterization protocol: A prospective, multinational, observational study.
Reyes LF., Garcia-Gallo E., Murthy S., Fuentes YV., Serrano CC., Ibáñez-Prada ED., Lee J., Rojek A., Citarella BW., Gonçalves BP., Dunning J., Rätsep I., Viñan-Garces AE., Kartsonaki C., Rello J., Martin-Loeches I., Shankar-Hari M., Olliaro PL., Merson L., ISARIC Characterisation Group None.
PurposeTo determine its cumulative incidence, identify the risk factors associated with Major Adverse Cardiovascular Events (MACE) development, and its impact clinical outcomes.Materials and methodsThis multinational, multicentre, prospective cohort study from the ISARIC database. We used bivariate and multivariate logistic regressions to explore the risk factors related to MACE development and determine its impact on 28-day and 90-day mortality.Results49,479 patients were included. Most were male 63.5% (31,441/49,479) and from high-income countries (84.4% [42,774/49,479]); however, >6000 patients were registered in low-and-middle-income countries. MACE cumulative incidence during their hospital stay was 17.8% (8829/49,479). The main risk factors independently associated with the development of MACE were older age, chronic kidney disease or cardiovascular disease, smoking history, and requirement of vasopressors or invasive mechanical ventilation at admission. The overall 28-day and 90-day mortality were higher among patients who developed MACE than those who did not (63.1% [5573/8829] vs. 35.6% [14,487/40,650] p ConclusionsPatients with severe COVID-19 frequently develop MACE, which is independently associated with worse clinical outcomes.