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- Long-term cardiovascular events in individuals hospitalised with COVID-19: a retrospective cohortPublication . Soares, Patricia; Ruivinho, Carolina; Silva, Joana; Lobão, Maria João; Santos, Lelita; Paixão, Joana; Ramalho, Ana Rita; Henriques, Adriana; Simões, Inês; Guimarães, Luísa Eça; Moça, Rita; Costa, Andreia; Atanásio, Gabriel; Nóbrega, Sofia; Brazão, Maria da Luz; Goes, Ana Rita; Leite, Andreia; LOCUS groupBackground: Post-COVID condition encompasses a spectrum of persistent or emerging symptoms affecting multiple organ systems, including a heightened risk of cardiovascular complications. Despite growing recognition of this phenomenon, there remains a lack of comprehensive data regarding the incidence and risk factors associated with cardiovascular events during the post-acute phase in patients previously hospitalised for COVID-19. Thus, we aimed to estimate the incidence of cardiovascular events among patients hospitalised for COVID-19 in Portugal and assess the association between patient and infection characteristics and cardiovascular events in the COVID-19 post-acute phase. Methods: We conducted a registry-based retrospective cohort study from seven hospitals across Portugal. Data was retrospectively collected from the electronic medical record of each patient. We included individuals hospitalised due to COVID-19 between March 2020 and March 2021. Our outcome of interest was cardiovascular events in the post-acute phase of COVID-19, occurring at least 30 days after a positive SARS-CoV-2 test. The variables of interest considered were the severity of the episode, existing cardiovascular risk and vaccination status before the SARS-CoV-2 test. Person-years was estimated for each individual, and incidence rates were estimated. A Cox proportional hazard regression model was employed to assess risk factors. Results: We included 1,803 patients in the analysis, of which 143 (7.9%) experienced at least one cardiovascular event following COVID-19 hospitalisation. The overall incidence rate of having at least one cardiovascular event was 34.65 per 1,000 person-years (95% confidence interval (CI): 29.20; 40.82). We found higher risk of cardiovascular events for individuals with pre-existing cardiovascular risk (adjusted hazard ratio (aHR): 3.76, 95% CI: 1.53; 9.24) and lower risk for individuals with at least one vaccine dose before the SARS-CoV-2 test (partial vaccination - aHR: 0.44, 95%CI: 0.30; 0.64, complete vaccination - aHR: 0.46, 95%CI: 0.2; 0.80). We did not find a significant difference between the severity of the COVID-19 episode and the risk of having cardiovascular events post-COVID-19. Conclusion: Our findings suggest a substantial burden of cardiovascular complications post-COVID-19, underscoring the need for health services to be prepared and commence screening and preventive measures for individuals at higher risk.
- Prevalence and risk factors for post COVID condition 12 months after a test: evidence from a Portuguese regionPublication . Moniz, M.; Ruivinho, Carolina; Goes, Ana Rita; Soares, Patrícia; Leite, Andreia; LOCUS groupBackground/Objectives: PCC prevalence estimates vary widely. Additionally, its development is associated with multiple factors, from individual characteristics to the broader impacts of the pandemic. The aim of this study was to characterise the prevalence of symptoms 12 months after SARS-CoV-2 testing, comparing individuals with positive and negative test results, and to analyse the factors associated with the prevalence of Long COVID symptoms in individuals with a positive test in Lisbon and Tagus Valley. Methods: Cross-sectional study with individuals randomly selected from the National Epidemiological Surveillance System (SINAVE) of Portugal. We included individuals who underwent a SARS-CoV-2 test in August 2022, resided in the Lisbon and Tagus Valley region, were 18 years or older, and consented to participate. PCC was defined as the presence of #1 1 symptom 12 months after testing. Prevalence (Pr) was estimated for participants with positive and negative test results, with the respective 95% confidence interval (95%CI). To study the factors associated with Long COVID, we considered individuals with a positive test and applied a robust Poisson regression to estimate prevalence ratios (PR), with the respective 95%CI. Results: A total of 6,642 individuals were contacted, and the final sample included 699 individuals: 226 with a negative test and 473 with a positive test. PCC symptoms were slightly higher in individuals who tested positive (Pr: 41.65, 95%CI: 37.17; 46.24) than negative (Pr: 35.84, 95%CI: 29.59; 42.47), with confidence interval overlapping. Fatigue was the most prevalent symptom, particularly among positive individuals (Pr: 18.39, 95%CI: 15.00; 22.18 vs. 10.18, 95%CI: 6.56; 14.88). Factors associated with PCC symptoms were female (PR: 1.48 95%CI: 1.13; 1.96), age (PR: 1.01, 95%CI: 1.00; 1.02), number of symptoms during COVID-19 infection (PR: 1.06, 95%CI: 1.03; 1.09) and smoking (PR: 1.39, 95%CI: 1.08; 1.79). Conclusions/Recommendations: Most of the symptoms analysed did not show a higher prevalence in those who tested positive, highlighting the need to distinguish these symptoms from other postviral conditions and the broader effects of the pandemic. Factors associated with higher risk of PCC symptoms, highlight the importance of targeted follow-up and preventive strategies for these individuals. As our sample is predominantly composed of cases that did not require hospital care during the acute infection, the results also emphasise that symptoms can emerge in non-severe cases, representing a wider range of people at risk.