tetano
Editor, Senior Moderator
ESC Heart Fail
. 2022 Mar 10.
doi: 10.1002/ehf2.13854. Online ahead of print.
Association of chronic heart failure with mortality in old intensive care patients suffering from Covid-19
Raphael Romano Bruno[SUP] 1 [/SUP], Bernhard Wernly[SUP] 2 [/SUP], Georg Wolff[SUP] 1 [/SUP], Jesper Fjølner[SUP] 3 [/SUP], Antonio Artigas[SUP] 4 [/SUP], Bernardo Bollen Pinto[SUP] 5 [/SUP], Joerg C Schefold[SUP] 6 [/SUP], Detlef Kindgen-Milles[SUP] 7 [/SUP], Philipp Heinrich Baldia[SUP] 1 [/SUP], Malte Kelm[SUP] 1 8 [/SUP], Michael Beil[SUP] 9 [/SUP], Sigal Sviri[SUP] 9 [/SUP], Peter Vernon van Heerden[SUP] 10 [/SUP], Wojciech Szczeklik[SUP] 11 [/SUP], Arzu Topeli[SUP] 12 [/SUP], Muhammed Elhadi[SUP] 13 [/SUP], Michael Joannidis[SUP] 14 [/SUP], Sandra Oeyen[SUP] 15 [/SUP], Eumorfia Kondili[SUP] 16 [/SUP], Brian Marsh[SUP] 17 [/SUP], Finn H Andersen[SUP] 18 19 [/SUP], Rui Moreno[SUP] 20 [/SUP], Susannah Leaver[SUP] 21 [/SUP], Ariane Boumendil[SUP] 22 23 [/SUP], Dylan W De Lange[SUP] 24 [/SUP], Bertrand Guidet[SUP] 22 23 [/SUP], Hans Flaatten[SUP] 25 26 [/SUP], Christian Jung[SUP] 1 [/SUP], COVIP study group
Affiliations
Abstract
Aims: Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID-19). This prospective international multicentre study investigates the role of pre-existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID-19.
Methods and results: Patients with pre-existing CHF were subclassified as having ischaemic or non-ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre-existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P < 0.001; odds ratio 1.87, 95% confidence interval (CI) 1.5-2.3] and 3 month mortality (69% vs. 56%, P < 0.001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1.2, 95% CI 0.5-1.5; P = 0.137]. More patients suffered from pre-existing ischaemic than from non-ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non-ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0.042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0.98, 95% CI 0.9-1.0; P = 0.128).
Conclusions: In critically ill older COVID-19 patients, pre-existing CHF was not independently associated with 30 day mortality.
. 2022 Mar 10.
doi: 10.1002/ehf2.13854. Online ahead of print.
Association of chronic heart failure with mortality in old intensive care patients suffering from Covid-19
Raphael Romano Bruno[SUP] 1 [/SUP], Bernhard Wernly[SUP] 2 [/SUP], Georg Wolff[SUP] 1 [/SUP], Jesper Fjølner[SUP] 3 [/SUP], Antonio Artigas[SUP] 4 [/SUP], Bernardo Bollen Pinto[SUP] 5 [/SUP], Joerg C Schefold[SUP] 6 [/SUP], Detlef Kindgen-Milles[SUP] 7 [/SUP], Philipp Heinrich Baldia[SUP] 1 [/SUP], Malte Kelm[SUP] 1 8 [/SUP], Michael Beil[SUP] 9 [/SUP], Sigal Sviri[SUP] 9 [/SUP], Peter Vernon van Heerden[SUP] 10 [/SUP], Wojciech Szczeklik[SUP] 11 [/SUP], Arzu Topeli[SUP] 12 [/SUP], Muhammed Elhadi[SUP] 13 [/SUP], Michael Joannidis[SUP] 14 [/SUP], Sandra Oeyen[SUP] 15 [/SUP], Eumorfia Kondili[SUP] 16 [/SUP], Brian Marsh[SUP] 17 [/SUP], Finn H Andersen[SUP] 18 19 [/SUP], Rui Moreno[SUP] 20 [/SUP], Susannah Leaver[SUP] 21 [/SUP], Ariane Boumendil[SUP] 22 23 [/SUP], Dylan W De Lange[SUP] 24 [/SUP], Bertrand Guidet[SUP] 22 23 [/SUP], Hans Flaatten[SUP] 25 26 [/SUP], Christian Jung[SUP] 1 [/SUP], COVIP study group
Affiliations
- PMID: 35274490
- DOI: 10.1002/ehf2.13854
Abstract
Aims: Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID-19). This prospective international multicentre study investigates the role of pre-existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID-19.
Methods and results: Patients with pre-existing CHF were subclassified as having ischaemic or non-ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre-existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P < 0.001; odds ratio 1.87, 95% confidence interval (CI) 1.5-2.3] and 3 month mortality (69% vs. 56%, P < 0.001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1.2, 95% CI 0.5-1.5; P = 0.137]. More patients suffered from pre-existing ischaemic than from non-ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non-ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0.042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0.98, 95% CI 0.9-1.0; P = 0.128).
Conclusions: In critically ill older COVID-19 patients, pre-existing CHF was not independently associated with 30 day mortality.