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Cardiol J
. 2020 Dec 21.
doi: 10.5603/CJ.a2020.0183. Online ahead of print.
Underlying heart diseases and acute COVID-19 outcomes
Iv?n Javier J N??ez-Gil 1 , Antonio Fern?ndez-Ortiz 2 , Charbel Maroud Eid 3 , Jia Huang 4 , Rodolfo Romero 5 , Victor Manuel Becerra-Mu?oz 6 , Aitor Uribarri 7 , Gisela Feltes 8 , Daniela Trabatoni 9 , Inmaculada Fernandez-Rozas 10 , Maria C Viana-Llamas 11 , Martino Pepe 12 , Enrico Cerrato 13 , Maurizio Bertaina 14 , Thamar Capel Astrua 15 , Emilio Alfonso 16 , Alex F Castro-Mej?a 17 , Sergio Raposeiras-Roubin 18 , Fabrizio D'Ascenzo 19 , Carolina Espejo Paeres 20 , Jaime Signes-Costa 21 , Alfredo Bardaji 22 , Cristina Fernandez-P?rez 2 , Francisco Marin 23 , Oscar Fabregat-Andres 24 , Ibrahim Akin 25 , Vicente Estrada 2 , Carlos Macaya 2
Affiliations
- PMID: 33346365
- DOI: 10.5603/CJ.a2020.0183
Abstract
Background: The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19).
Methods: The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive.
Results: HOPE enrolled 2798 patients from 35 centers in 7 countries. Median age was 67 years (IQR: 53.0-78.0), and most were male (59.5%). A relevant heart disease was present in 682 (24%) cases. These were older, more frequently male, with higher overall burden of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, smoking habit, obesity) and other comorbidities such renal failure, lung, cerebrovascular disease and oncologic antecedents (p < 0.01, for all). The heart cohort received more corticoids (28.9% vs. 20.4%, p < 0.001), antibiotics, but less hydroxychloroquine, antivirals or tocilizumab. Considering the epidemiologic profile, a previous heart condition was independently related with short-term mortality in the COX multivariate analysis (1.62; 95% CI 1.29-2.03; p < 0.001). Moreover, heart patients needed more respiratory, circulatory support, and presented more in-hospital events, such heart failure, renal failure, respiratory insufficiency, sepsis, SIRS and clinically relevant bleedings (all, p < 0.001), and mortality (39.7% vs. 15.5%; p < 0.001).
Conclusions: An underlying heart disease is an adverse prognostic factor for patients suffering COVID-19. Its presence could be related with different clinical drug management and would benefit from maintaining treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers during in-hospital stay. Trial Numbers: NCT04334291/ EUPAS34399.
Keywords: COVID-19; cardiology; heart disease; mortality; prognosis; registry.