Higher Incidence of Cardiovascular Events in a Large Real-World Database in the Triennium 2020-2022 Compared to a Pre-Covid Triennium Is Independent of Cardiovascular Risk Factors

Objective: We evaluated the incidence and relative risk of major cardiovascular events in a large real-world population from a primary care database in a region at moderate cardiovascular risk in the period 2020-2022 (e.g. during COVID-19 pandemic). Design and method: This is a retrospective cohort analysis using the whole database of a cooperative of general practitioners in the city of Naples, Italy (COMEGEN). All individuals aged >18 were followed up to three years. These data were compared with those derived from the same database in the years 2017-2019, considered as a pre-COVID 19 period. Results: Anonymized data from of 228,266 patients in the period 2020-2022 were considered for statistical analysis (these included 31,764 subjects with a molecular diagnosis of COVID 19). In the 2020-2022 population demographic features and the prevalence of major cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia and smoking) did not differ from those reported in the 2017-2019 cohort (Table 1). On the contrary, the incidence of individuals with a new diagnosis of major adverse cardiovascular and cerebrovascular events was significantly higher in the 2020-2022 compared to the 2017-2019 triennium (Table 1). Conclusions: We report a substantial increase of cardiovascular events during the COVID-19 triennium which is independent of risk factors. Whether this is caused to direct cardiovascular consequences of SARS-CoV-2 (diagnosed or undiagnosed) infection or to other factors such as the reduced access to healthcare facilities cannot be clarified by our present study.