ArticleBMC cardiovascular disorders2026
High incidence of post-discharge cardiovascular mortality after COVID-19 hospitalization: a data-linkage study in Southern Iran.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe long-term cardiovascular sequelae of SARS-CoV-2 infection, a major component of Post-Acute COVID-19 Syndrome (PACS), is a global health challenge. However, detailed characterization of fatal cardiovascular outcomes following COVID-19 hospitalization, particularly from the Middle East, remains limited.
objectiveWe aimed to investigate the incidence and clinical characteristics of cardiovascular mortality among patients discharged after COVID-19-associated hospitalizations in southern Iran.
methodsWe conducted a retrospective data-linkage study between regional death certificates (N = 25,425) and COVID-19 hospital discharge records (N = 51,346) from teaching hospitals affiliated with Shiraz University of Medical Sciences between March 2020 and March 2021. Cardiovascular death was defined using ICD-10 codes I00-I99 from official death certificates. A multivariable Cox regression analysis was performed on the cohort of cardiovascular deaths to identify factors associated with the time from discharge to death.
resultsThe all-cause mortality rate following discharge from COVID-19 hospitalization was substantially high, comprising 18.54% (N = 4,715) of all regional deaths. A total of 845 post-discharge deaths (3.32% of all regional deaths) were classified as being due to cardiovascular causes. Notably, 71.4% of these patients had elevated troponin levels – indicating acute myocardial injury – during their index COVID-19 hospitalization, which constitutes 2.85% of mortality in discharged COVID-19 patients (1,331 out of 46,705). The median time from discharge to death was 18 days [IQR: 6, 49.5]. The most frequent underlying cardiovascular conditions were unspecified cardiovascular disease (13.4%) and acute myocardial infarction (9.3%). The on-arrival ECG showed a high prevalence of abnormalities, including QT dispersion ≥ 40ms (50.9%), poor R wave progression (44.8%), and ST segment depression (26.8%). Discharge with cardiovascular drugs was independently associated with a longer time to death (aHR: 0.759 [95% CI: 0.588, 0.981]).
conclusionThis study showed a significant burden of cardiovascular mortality during 6–9 months following discharge from COVID-19 hospitalization, associated with a high-risk in-hospital phenotype for rapid post-discharge cardiovascular mortality. These findings suggested the critical need for structured long-term cardiovascular monitoring and risk stratification for high-risk patients after COVID-19 hospitalization.
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