{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T02:50:35Z","timestamp":1773456635568,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Acute myocardial injury (AMJ), assessed by elevated levels of cardiac troponin, is associated with fatal outcome in coronavirus disease 2019 (COVID-19). However, the role of acute cardiovascular (CV) events defined by clinical manifestation rather than sole elevations of biomarkers is unclear in hospitalized COVID-19 patients. Objective: The aim of this study was to investigate acute clinically manifest CV events in hospitalized COVID-19 patients. Methods: From 1 March 2020 to 5 January 2021, we conducted a multicenter, prospective, epidemiological cohort study at six hospitals from Hamburg, Germany (a portion of the state-wide 45-center CORONA Germany cohort study) enrolling all hospitalized COVID-19 patients. Primary endpoint was occurrence of a clinically manifest CV-event. Results: In total, 132 CV-events occurred in 92 of 414 (22.2%) patients in the Hamburg-cohort: cardiogenic shock in 10 (2.4%), cardiopulmonary resuscitation in 12 (2.9%), acute coronary syndrome in 11 (2.7%), de-novo arrhythmia in 31 (7.5%), acute heart-failure in 43 (10.3%), myocarditis in 2 (0.5%), pulmonary-embolism in 11 (2.7%), thrombosis in 9 (2.2%) and stroke in 3 (0.7%). In the Hamburg-cohort, mortality was 46% (42\/92) for patients with a CV-event and 33% (27\/83) for patients with only AMJ without CV-event (OR 1.7, CI: (0.94\u20133.2), p = 0.077). Mortality was higher in patients with CV-events (Odds ratio(OR): 4.8, 95%-confidence-interval(CI): [2.9\u20138]). Age (OR 1.1, CI: (0.66\u20131.86)), atrial fibrillation (AF) on baseline-ECG (OR 3.4, CI: (1.74\u20136.8)), systolic blood-pressure (OR 0.7, CI: (0.53\u20130.96)), potassium (OR 1.3, CI: (0.99\u20131.73)) and C-reactive-protein (1.4, CI (1.04\u20131.76)) were associated with CV-events. Conclusion: Hospitalized COVID-19 patients with clinical manifestation of acute cardiovascular events show an almost five-fold increased mortality. In this regard, the emergence of arrhythmias is a major determinant.<\/jats:p>","DOI":"10.3390\/jcm10173982","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T21:13:36Z","timestamp":1630617216000},"page":"3982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic Impact of Acute Cardiovascular Events in COVID-19 Hospitalized Patients\u2014Results from the CORONA Germany Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Melanie A.","family":"Gunawardene","sequence":"first","affiliation":[{"name":"Department of Cardiology and Internal Intensive Care Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-7749","authenticated-orcid":false,"given":"Nele","family":"Gessler","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Intensive Care Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany"},{"name":"Asklepios Proresearch, Research Institute, 20099 Hamburg, Germany"},{"name":"Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Wohlmuth","sequence":"additional","affiliation":[{"name":"Asklepios Proresearch, Research Institute, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Heitmann","sequence":"additional","affiliation":[{"name":"Asklepios Proresearch, Research Institute, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Anders","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Jaquet","sequence":"additional","affiliation":[{"name":"Asklepios Proresearch, Research Institute, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph U.","family":"Herborn","sequence":"additional","affiliation":[{"name":"Asklepios Proresearch, Research Institute, 20099 Hamburg, Germany"},{"name":"Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Asklepios Hospitals GmbH & Co. KGaA, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology, Palliative Care Medicine and Rheumatology, Asklepios Hospital Altona, 22763 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berthold","family":"Bein","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin W.","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\u2014Cardiology and Pneumology, Asklepios Hospital Wandsbek, 22043 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus R.","family":"Herrlinger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\u2014Gastroenterology, Oncology, Infectious Diseases, Asklepios Hospital Nord-Heidberg, 22417 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Stang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Oncology and Palliative Care Medicine, Asklepios Hospital Barmbek, 22307 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruediger","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Asklepios Hospital West, 22559 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claas","family":"Wesseler","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Asklepios Hospital Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Intensive Care Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1001\/jamacardio.2020.0950","article-title":"Association of Cardiac Injury with Mortality in Hospitalized Patients with COVID-19 in Wuhan, China","volume":"5","author":"Shi","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1161\/CIR.0000000000000617","article-title":"Fourth Universal Definition of Myocardial Infarction","volume":"138","author":"Thygesen","year":"2018","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"446.e5","DOI":"10.1016\/j.amjmed.2015.11.006","article-title":"Clinical Characteristics and Outcomes of Patients with Myocardial Infarction, Myocardial Injury, and Nonelevated Troponins","volume":"129","author":"Sarkisian","year":"2016","journal-title":"Am. 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