tetano
Editor, Senior Moderator
Arch Cardiovasc Dis
. 2021 May 24;S1875-2136(21)00087-5.
doi: 10.1016/j.acvd.2021.04.003. Online ahead of print.
History of heart failure in patients with coronavirus disease 2019: Insights from a French registry
Vassili Panagides[SUP] 1 [/SUP], Flavien Vincent[SUP] 2 [/SUP], Orianne Weizman[SUP] 3 [/SUP], Melchior Jonveaux[SUP] 4 [/SUP], Antonin Trimaille[SUP] 5 [/SUP], Thibaut Pommier[SUP] 6 [/SUP], Joffrey Cellier[SUP] 7 [/SUP], Laura Geneste[SUP] 8 [/SUP], Wassima Marsou[SUP] 9 [/SUP], Antoine Deney[SUP] 10 [/SUP], Sabir Attou[SUP] 11 [/SUP], Thomas Delmotte[SUP] 12 [/SUP], Charles Fauvel[SUP] 13 [/SUP], Nacim Ezzouhairi[SUP] 14 [/SUP], Benjamin Perin[SUP] 15 [/SUP], Cyril Zakine[SUP] 16 [/SUP], Thomas Levasseur[SUP] 17 [/SUP], Iris Ma[SUP] 7 [/SUP], Diane Chavignier[SUP] 18 [/SUP], Nathalie Noirclerc[SUP] 19 [/SUP], Arthur Darmon[SUP] 20 [/SUP], Marine Mevelec[SUP] 19 [/SUP], Clément Karsenty[SUP] 10 [/SUP], Baptiste Duceau[SUP] 4 [/SUP], Willy Sutter[SUP] 4 [/SUP], Delphine Mika[SUP] 21 [/SUP], Théo Pezel[SUP] 22 [/SUP], Victor Waldmann[SUP] 4 [/SUP], Julien Ternacle[SUP] 23 [/SUP], Ariel Cohen[SUP] 24 [/SUP], Guillaume Bonnet[SUP] 25 [/SUP], Critical COVID-19 France Investigators
Affiliations
Abstract
Background: Although cardiovascular comorbidities seem to be strongly associated with worse outcomes in patients with coronavirus disease 2019 (COVID-19), data regarding patients with preexisting heart failure are limited.
Aims: To investigate the incidence, characteristics and clinical outcomes of patients with COVID-19 with a history of heart failure with preserved or reduced ejection fraction.
Methods: We performed an observational multicentre study including all patients hospitalized for COVID-19 across 24 centres in France from 26 February to 20 April 2020. The primary endpoint was a composite of in-hospital death or need for orotracheal intubation.
Results: Overall, 2809 patients (mean age 66.4±16.9years) were included. Three hundred and seventeen patients (11.2%) had a history of heart failure; among them, 49.2% had heart failure with reduced ejection fraction and 50.8% had heart failure with preserved ejection fraction. COVID-19 severity at admission, defined by a quick sequential organ failure assessment score>1, was similar in patients with versus without a history of heart failure. Before and after adjustment for age, male sex, cardiovascular comorbidities and quick sequential organ failure assessment score, history of heart failure was associated with the primary endpoint (hazard ratio
: 1.41, 95% confidence interval [CI]: 1.06-1.90; P=0.02). This result seemed to be mainly driven by a history of heart failure with preserved ejection fraction (HR: 1.61, 95% CI: 1.13-2.27; P=0.01) rather than heart failure with reduced ejection fraction (HR: 1.19, 95% CI: 0.79-1.81; P=0.41).
Conclusions: History of heart failure in patients with COVID-19 was associated with a higher risk of in-hospital death or orotracheal intubation. These findings suggest that patients with a history of heart failure, particularly heart failure with preserved ejection fraction, should be considered at high risk of clinical deterioration.
Keywords: COVID-19; Facteurs de risque; Femme; HFpEF; HFrEF; Heart failure; RAAS inhibitors; Résultats; SARS-COV 2.
. 2021 May 24;S1875-2136(21)00087-5.
doi: 10.1016/j.acvd.2021.04.003. Online ahead of print.
History of heart failure in patients with coronavirus disease 2019: Insights from a French registry
Vassili Panagides[SUP] 1 [/SUP], Flavien Vincent[SUP] 2 [/SUP], Orianne Weizman[SUP] 3 [/SUP], Melchior Jonveaux[SUP] 4 [/SUP], Antonin Trimaille[SUP] 5 [/SUP], Thibaut Pommier[SUP] 6 [/SUP], Joffrey Cellier[SUP] 7 [/SUP], Laura Geneste[SUP] 8 [/SUP], Wassima Marsou[SUP] 9 [/SUP], Antoine Deney[SUP] 10 [/SUP], Sabir Attou[SUP] 11 [/SUP], Thomas Delmotte[SUP] 12 [/SUP], Charles Fauvel[SUP] 13 [/SUP], Nacim Ezzouhairi[SUP] 14 [/SUP], Benjamin Perin[SUP] 15 [/SUP], Cyril Zakine[SUP] 16 [/SUP], Thomas Levasseur[SUP] 17 [/SUP], Iris Ma[SUP] 7 [/SUP], Diane Chavignier[SUP] 18 [/SUP], Nathalie Noirclerc[SUP] 19 [/SUP], Arthur Darmon[SUP] 20 [/SUP], Marine Mevelec[SUP] 19 [/SUP], Clément Karsenty[SUP] 10 [/SUP], Baptiste Duceau[SUP] 4 [/SUP], Willy Sutter[SUP] 4 [/SUP], Delphine Mika[SUP] 21 [/SUP], Théo Pezel[SUP] 22 [/SUP], Victor Waldmann[SUP] 4 [/SUP], Julien Ternacle[SUP] 23 [/SUP], Ariel Cohen[SUP] 24 [/SUP], Guillaume Bonnet[SUP] 25 [/SUP], Critical COVID-19 France Investigators
Affiliations
- PMID: 34099379
- DOI: 10.1016/j.acvd.2021.04.003
Abstract
Background: Although cardiovascular comorbidities seem to be strongly associated with worse outcomes in patients with coronavirus disease 2019 (COVID-19), data regarding patients with preexisting heart failure are limited.
Aims: To investigate the incidence, characteristics and clinical outcomes of patients with COVID-19 with a history of heart failure with preserved or reduced ejection fraction.
Methods: We performed an observational multicentre study including all patients hospitalized for COVID-19 across 24 centres in France from 26 February to 20 April 2020. The primary endpoint was a composite of in-hospital death or need for orotracheal intubation.
Results: Overall, 2809 patients (mean age 66.4±16.9years) were included. Three hundred and seventeen patients (11.2%) had a history of heart failure; among them, 49.2% had heart failure with reduced ejection fraction and 50.8% had heart failure with preserved ejection fraction. COVID-19 severity at admission, defined by a quick sequential organ failure assessment score>1, was similar in patients with versus without a history of heart failure. Before and after adjustment for age, male sex, cardiovascular comorbidities and quick sequential organ failure assessment score, history of heart failure was associated with the primary endpoint (hazard ratio
: 1.41, 95% confidence interval [CI]: 1.06-1.90; P=0.02). This result seemed to be mainly driven by a history of heart failure with preserved ejection fraction (HR: 1.61, 95% CI: 1.13-2.27; P=0.01) rather than heart failure with reduced ejection fraction (HR: 1.19, 95% CI: 0.79-1.81; P=0.41).
Conclusions: History of heart failure in patients with COVID-19 was associated with a higher risk of in-hospital death or orotracheal intubation. These findings suggest that patients with a history of heart failure, particularly heart failure with preserved ejection fraction, should be considered at high risk of clinical deterioration.
Keywords: COVID-19; Facteurs de risque; Femme; HFpEF; HFrEF; Heart failure; RAAS inhibitors; Résultats; SARS-COV 2.