Cardiac Complications in Patients Hospitalised with COVID-19

Aims: To determine the frequency and pattern of cardiac complications in patients hospitalised with coronavirus disease (COVID-19).

Methods And Results: CAPACITY-COVID is an international patient registry established to determine the role of cardiovascular disease in the COVID-19 pandemic. In this registry, data generated during routine clinical practice are collected in a standardised manner for patients with a (highly suspected) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requiring hospitalisation. For the current analysis, consecutive patients with laboratory confirmed COVID-19 registered between 28 March and 3 July 2020 were included. Patients were followed for the occurrence of cardiac complications and pulmonary embolism from admission to discharge. In total, 3011 patients were included, of which 1890 (62.8%) were men. The median age was 67 years (interquartile range 56-76); 937 (31.0%) patients had a history of cardiac disease, with pre-existent coronary artery disease being most common (=463, 15.4%). During hospitalisation, 595 (19.8%) patients died, including 16 patients (2.7%) with cardiac causes. Cardiac complications were diagnosed in 349 (11.6%) patients, with atrial fibrillation (=142, 4.7%) being most common. The incidence of other cardiac complications was 1.8% for heart failure (=55), 0.5% for acute coronary syndrome (=15), 0.5% for ventricular arrhythmia (=14), 0.1% for bacterial endocarditis (=4) and myocarditis (=3), respectively, and 0.03% for pericarditis (=1). Pulmonary embolism was diagnosed in 198 (6.6%) patients.

Conclusion: This large study among 3011 hospitalised patients with COVID-19 shows that the incidence of cardiac complications during hospital admission is low, despite a frequent history of cardiovascular disease. Long-term cardiac outcomes and the role of pre-existing cardiovascular disease in COVID-19 outcome warrants further investigation.