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. 2025 Oct 29;15(1):37900.
doi: 10.1038/s41598-025-21711-1.

Long-term cardiovascular complications in COVID-19 survivors according to disease severity

Anaïs Curtiaud  1   2 , Antonin Trimaille  3   4 , François Severac  5 , Amandine Granier  3 , Julien Demiselle  1   2 , Rayane Lakehal  1 , Julie Helms  1   2 , Olivier Morel  3   4 , Ferhat Meziani  1   2 , Hamid Merdji  6   7
Affiliations

Long-term cardiovascular complications in COVID-19 survivors according to disease severity

Anaïs Curtiaud et al. Sci Rep. .

Abstract

Post-sepsis syndrome is a major concern affecting sepsis survivors. COVID-19 increases the risk of long-term complications, but existing data lack detail on patient-specific factors and long-term cardiovascular complications, namely major adverse cardiovascular events (MACE). Our objective was to analyze and compare the MACE occurrence, among COVID-19 survivors, according to the severity of infection. Adults aged ≥ 18 years infected during the first waves of COVID-19 pandemic hospitalized in Strasbourg University Hospital were included. Follow-up began immediately after COVID-19 diagnosis and continued for up to 12 months. Inverse probability of treatment weighting was used to balance baseline patient characteristics between the two groups (i.e. intensive care unit patients and medical ward patients). A total of 332 patients, i.e.132 in intensive care unit (ICU) and 200 in medical ward were included in the final analysis. The ICU population experienced a significantly higher risk of MACE during the first year (HR 16.2 [5.7-45.8] p < 0.001). Smoking status, history of peripheral arterial obstructive disease, and hospitalization in ICU remained independently associated with the occurrence of MACE in multivariable analysis. Severity of COVID-19 appears as an independent risk factor for MACE at one year among intensive care unit patients compared to those hospitalized in medical ward.

Keywords: COVID-19; Cardiovascular outcomes; MACE; Post-intensive care syndrome (PICS); SARS-CoV-2.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The local ethics committee of the University Hospital of Strasbourg approved the study (reference NCE-2020-51) and approval from the institutional review board for the research, the ethical principles stated by the Declaration of Helsinki, as well as all national legal and regulatory requirements. Consent for publication: All authors hereby consent to the publication. Competing interests: The authors declare no competing interests. Informed consent: has been obtained from all participants or their legal representatives.

Figures

Fig. 1
Fig. 1
Study flow-chart. ICU, intensive care unit; MW, Medical ward.
Fig. 2
Fig. 2
MACE-free survival probability between ICU patients and MW patients. ICU, intensive care unit; MW, Medical ward.
Fig. 3
Fig. 3
Forest plot of the multivariate analysis showing factors independently associated with the occurrence of MACE. Covariates included in the multivariate analysis represent preexisting medical history prior to index hospitalization for COVID-19. AF, atrial fibrillation; AMI, myocardial infarction; ICU, intensive care unit; MACE, major adverse cardiovascular event; PAOD, peripheral artery occlusive disease.
See this image and copyright information in PMC

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