Adjudicated Cardiovascular Events in Patients With COVID-19: Association With Vaccination Status and Changes over Time.

Publication date: Dec 11, 2025

Patients with COVID-19 are at risk of thrombotic and cardiovascular complications. Existing risk estimates derive from early COVID-19 experiences. More recent event rates, temporal trends, and the association between vaccination status and cardiovascular outcomes remain unclear. The CORONA-VTE Network (COVID-19 Registry to Assess Frequency, Risk Factors, Management, and Outcomes of Arterial and Venous Thromboembolic Complications) multicenter registry included patients with COVID-19 from March 2020 to February 2024. A composite of venous and arterial thrombotic events and a composite of adjudicated cardiovascular events were assessed at 90 days after COVID-19 diagnosis. Time-to-first-event analyses were stratified by inpatients and outpatients and adjusted for competing risks. Outcomes were adjudicated by independent physicians. Of 11 165 patients, 4451 were inpatients (mean age, 65 years; 47% women) and 462 of 4451 were admitted to the intensive care unit. Among inpatients, the 90-day cumulative incidences of thrombotic and cardiovascular events were 8. 9% (95% CI, 8. 0%-9. 8%) and 15. 6% (95% CI, 14. 5%-16. 7%), respectively. Corresponding estimates for patients in the intensive care unit were 20. 0% (95% CI, 16. 6%-24. 0%) and 30. 7% (95% CI, 26. 8%-35. 3%), while event rates were low among outpatients. There was an initial decline in cardiovascular events (adjusted hazard ratio [HR], 0. 84; P=0. 001) after the first COVID-19 wave, with a subsequent catch-up, with no significant linear change in cardiovascular events (adjusted P=0. 634). Vaccination was associated with a reduced risk of cardiovascular events (adjusted HR, 0. 75 [95% CI, 0. 62-0. 92]; P=0. 005). Thrombotic and cardiovascular events are common in hospitalized patients with COVID-19, especially those in the intensive care unit, without a persistent decline over time. COVID-19 vaccination was associated with a reduced risk of cardiovascular events.

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