tetano
Editor, Senior Moderator
Eur J Heart Fail
. 2020 Nov 12.
doi: 10.1002/ejhf.2052. Online ahead of print.
Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. Results of the Cardio-COVID-Italy multicentre study
Daniela Tomasoni[SUP] #[/SUP][SUP] 1 [/SUP], Riccardo M Inciardi[SUP] #[/SUP][SUP] 1 [/SUP], Carlo Mario Lombardi[SUP] 1 [/SUP], Chiara Tedino[SUP] 1 [/SUP], Piergiuseppe Agostoni[SUP] 2 [/SUP], Pietro Ameri[SUP] 3 [/SUP], Lucia Barbieri[SUP] 4 [/SUP], Antonio Bellasi[SUP] 5 [/SUP], Rita Camporotondo[SUP] 6 [/SUP], Claudia Canale[SUP] 3 [/SUP], Valentina Carubelli[SUP] 1 [/SUP], Stefano Carugo[SUP] 4 [/SUP], Francesco Catagnano[SUP] 6 7 [/SUP], Laura A Dalla Vecchia[SUP] 8 [/SUP], Giambattista Danzi[SUP] 9 [/SUP], Mattia Di Pasquale[SUP] 1 [/SUP], Margherita Gaudenzi[SUP] 2 [/SUP], Stefano Giovinazzo[SUP] 3 [/SUP], Massimiliano Gnecchi[SUP] 6 [/SUP], Annamaria Iorio[SUP] 10 [/SUP], Maria Teresa La Rovere[SUP] 11 [/SUP], Sergio Leonardi[SUP] 6 [/SUP], Gloria Maccagni[SUP] 9 [/SUP], Massimo Mapelli[SUP] 2 [/SUP], Davide Margonato[SUP] 6 7 [/SUP], Marco Merlo[SUP] 12 [/SUP], Luca Monzo[SUP] 13 [/SUP], Andrea Mortara[SUP] 7 [/SUP], Vincenzo Nuzzi[SUP] 12 [/SUP], Massimo Piepoli[SUP] 14 15 [/SUP], Italo Porto[SUP] 3 [/SUP], Andrea Pozzi[SUP] 10 [/SUP], Filippo Sarullo[SUP] 16 [/SUP], Gianfranco Sinagra[SUP] 12 [/SUP], Maurizio Volterrani[SUP] 17 [/SUP], Gregorio Zaccone[SUP] 1 [/SUP], Marco Guazzi[SUP] 18 [/SUP], Michele Senni[SUP] 10 [/SUP], Marco Metra[SUP] 1 [/SUP]
Affiliations
Abstract
Background: To assess the prognostic value of a history of heart failure (HF) in patients with coronavirus disease 2019 (COVID-19).
Methods and results: We enrolled 692 consecutive patients admitted for COVID-19 in 13 Italian cardiology centres between 1st March and 9th April, 2020. Mean age was 67.4 ? 13.2 years, 69.5% patients were males, 90 (13.0%) had a history of HF, median hospitalization length was 14 days, interquartile range, 9-24. In-hospital death occurred in 37 of 90 patients (41.1%) with HF history versus 126 of those with no HF history (20.9%). The increased risk of death associated with HF history remained significant after adjustment for clinical variables related to COVID-19 and HF severity, including comorbidities, oxygen saturation, lymphocyte count and plasma troponin (adjusted hazard ratio (HR) for death, 2.25; 95% confidence intervals (CI), 1.26-4.02; p=0.006 at multivariable Cox regression model including 404 patients). Patients with a history of HF also had more in-hospital complications including acute HF (33.3% vs 5.1%, p<0.001), acute renal failure (28.1% vs 12.9%, p<0.001), multiorgan failure (15.9% vs 5.8%, p=0.004) and sepsis (18.4% vs 8.9%, p=0.006). Other independent predictors of outcome were age, sex, oxygen saturation and oxygen partial pressure at arterial gas analysis/fraction of inspired oxygen ratio (PaO2/FiO2). In hospital treatment with corticosteroids and heparin had beneficial effects (adjusted HR for death, 0.46; 95% CI, 0.29-0.74; p=0.001; N=404 for corticosteroids and adjusted HR, 0.41; 95%CI, 0.25-0.67; p< 0.001; N=364 for heparin).
Conclusions: Hospitalized patients with COVID-19 and a history of HF have an extremely poor outcome with higher mortality and in-hospital complications. HF history is an independent predictor of increased in-hospital mortality. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2 infection; heart failure; outcome.
. 2020 Nov 12.
doi: 10.1002/ejhf.2052. Online ahead of print.
Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. Results of the Cardio-COVID-Italy multicentre study
Daniela Tomasoni[SUP] #[/SUP][SUP] 1 [/SUP], Riccardo M Inciardi[SUP] #[/SUP][SUP] 1 [/SUP], Carlo Mario Lombardi[SUP] 1 [/SUP], Chiara Tedino[SUP] 1 [/SUP], Piergiuseppe Agostoni[SUP] 2 [/SUP], Pietro Ameri[SUP] 3 [/SUP], Lucia Barbieri[SUP] 4 [/SUP], Antonio Bellasi[SUP] 5 [/SUP], Rita Camporotondo[SUP] 6 [/SUP], Claudia Canale[SUP] 3 [/SUP], Valentina Carubelli[SUP] 1 [/SUP], Stefano Carugo[SUP] 4 [/SUP], Francesco Catagnano[SUP] 6 7 [/SUP], Laura A Dalla Vecchia[SUP] 8 [/SUP], Giambattista Danzi[SUP] 9 [/SUP], Mattia Di Pasquale[SUP] 1 [/SUP], Margherita Gaudenzi[SUP] 2 [/SUP], Stefano Giovinazzo[SUP] 3 [/SUP], Massimiliano Gnecchi[SUP] 6 [/SUP], Annamaria Iorio[SUP] 10 [/SUP], Maria Teresa La Rovere[SUP] 11 [/SUP], Sergio Leonardi[SUP] 6 [/SUP], Gloria Maccagni[SUP] 9 [/SUP], Massimo Mapelli[SUP] 2 [/SUP], Davide Margonato[SUP] 6 7 [/SUP], Marco Merlo[SUP] 12 [/SUP], Luca Monzo[SUP] 13 [/SUP], Andrea Mortara[SUP] 7 [/SUP], Vincenzo Nuzzi[SUP] 12 [/SUP], Massimo Piepoli[SUP] 14 15 [/SUP], Italo Porto[SUP] 3 [/SUP], Andrea Pozzi[SUP] 10 [/SUP], Filippo Sarullo[SUP] 16 [/SUP], Gianfranco Sinagra[SUP] 12 [/SUP], Maurizio Volterrani[SUP] 17 [/SUP], Gregorio Zaccone[SUP] 1 [/SUP], Marco Guazzi[SUP] 18 [/SUP], Michele Senni[SUP] 10 [/SUP], Marco Metra[SUP] 1 [/SUP]
Affiliations
- PMID: 33179839
- DOI: 10.1002/ejhf.2052
Abstract
Background: To assess the prognostic value of a history of heart failure (HF) in patients with coronavirus disease 2019 (COVID-19).
Methods and results: We enrolled 692 consecutive patients admitted for COVID-19 in 13 Italian cardiology centres between 1st March and 9th April, 2020. Mean age was 67.4 ? 13.2 years, 69.5% patients were males, 90 (13.0%) had a history of HF, median hospitalization length was 14 days, interquartile range, 9-24. In-hospital death occurred in 37 of 90 patients (41.1%) with HF history versus 126 of those with no HF history (20.9%). The increased risk of death associated with HF history remained significant after adjustment for clinical variables related to COVID-19 and HF severity, including comorbidities, oxygen saturation, lymphocyte count and plasma troponin (adjusted hazard ratio (HR) for death, 2.25; 95% confidence intervals (CI), 1.26-4.02; p=0.006 at multivariable Cox regression model including 404 patients). Patients with a history of HF also had more in-hospital complications including acute HF (33.3% vs 5.1%, p<0.001), acute renal failure (28.1% vs 12.9%, p<0.001), multiorgan failure (15.9% vs 5.8%, p=0.004) and sepsis (18.4% vs 8.9%, p=0.006). Other independent predictors of outcome were age, sex, oxygen saturation and oxygen partial pressure at arterial gas analysis/fraction of inspired oxygen ratio (PaO2/FiO2). In hospital treatment with corticosteroids and heparin had beneficial effects (adjusted HR for death, 0.46; 95% CI, 0.29-0.74; p=0.001; N=404 for corticosteroids and adjusted HR, 0.41; 95%CI, 0.25-0.67; p< 0.001; N=364 for heparin).
Conclusions: Hospitalized patients with COVID-19 and a history of HF have an extremely poor outcome with higher mortality and in-hospital complications. HF history is an independent predictor of increased in-hospital mortality. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; SARS-CoV-2 infection; heart failure; outcome.