tetano
Editor, Senior Moderator
J Card Fail
. 2022 Jan 17;S1071-9164(22)00007-0.
doi: 10.1016/j.cardfail.2021.12.020. Online ahead of print.
Epidemiology of Acute Heart Failure in Critically Ill Patients with COVID-19: An Analysis from the Critical Care Cardiology Trials Network
David D Berg[SUP] 1 [/SUP], Carlos L Alviar[SUP] 2 [/SUP], Ankeet S Bhatt[SUP] 3 [/SUP], Vivian M Baird-Zars[SUP] 3 [/SUP], Christopher F Barnett[SUP] 4 [/SUP], Lori B Daniels[SUP] 5 [/SUP], Andrew P DeFilippis[SUP] 6 [/SUP], Antonio Fagundes Jr[SUP] 3 [/SUP], Praneeth Katrapati[SUP] 7 [/SUP], Benjamin B Kenigsberg[SUP] 8 [/SUP], Jianping Guo[SUP] 3 [/SUP], Norma Keller[SUP] 2 [/SUP], Mathew S Lopes[SUP] 3 [/SUP], Anika Mody[SUP] 5 [/SUP], Alexander I Papolos[SUP] 8 [/SUP], Nicholas Phreaner[SUP] 5 [/SUP], Romteen Sedighi[SUP] 5 [/SUP], Shashank S Sinha[SUP] 9 [/SUP], Sandeep Toomu[SUP] 5 [/SUP], Anubodh S Varshney[SUP] 3 [/SUP], David A Morrow[SUP] 3 [/SUP], Erin A Bohula[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Acute heart failure (HF) is an important complication of coronavirus disease 2019 (COVID-19) and has been hypothesized to relate to inflammatory activation.
Methods: We evaluated consecutive intensive care unit (ICU) admissions for COVID-19 across 6 centers in the Critical Care Cardiology Trials Network, identifying patients with vs. without acute HF. Acute HF was sub-classified as "de novo" vs. "acute-on-chronic" based on the absence or presence of prior HF. Clinical features, biomarker profiles, and outcomes were compared.
Results: Among 901 COVID-19 ICU admissions, 80 (8.9%) had acute HF, including 18 (2.0%) with classic cardiogenic shock (CS) and 37 (4.1%) with vasodilatory CS. The majority (n=45) were de novo HF presentations. Compared to patients without acute HF, those with acute HF had higher cardiac troponin (cTn) and natriuretic peptides, and similar inflammatory biomarkers; patients with de novo HF had the highest cTn. Notably, among critically ill patients with COVID-19, illness severity (median SOFA, 8 [IQR, 5-10] vs. 6 [4-9]; p=0.025) and mortality (43.8% vs. 32.4%; p=0.040) were modestly higher in patients with vs. without acute HF.
Conclusions: Among critically ill COVID-19 patients, acute HF is distinguished more by biomarkers of myocardial injury and hemodynamic stress than by biomarkers of inflammation.
Keywords: COVID-19; biomarkers; heart failure.
. 2022 Jan 17;S1071-9164(22)00007-0.
doi: 10.1016/j.cardfail.2021.12.020. Online ahead of print.
Epidemiology of Acute Heart Failure in Critically Ill Patients with COVID-19: An Analysis from the Critical Care Cardiology Trials Network
David D Berg[SUP] 1 [/SUP], Carlos L Alviar[SUP] 2 [/SUP], Ankeet S Bhatt[SUP] 3 [/SUP], Vivian M Baird-Zars[SUP] 3 [/SUP], Christopher F Barnett[SUP] 4 [/SUP], Lori B Daniels[SUP] 5 [/SUP], Andrew P DeFilippis[SUP] 6 [/SUP], Antonio Fagundes Jr[SUP] 3 [/SUP], Praneeth Katrapati[SUP] 7 [/SUP], Benjamin B Kenigsberg[SUP] 8 [/SUP], Jianping Guo[SUP] 3 [/SUP], Norma Keller[SUP] 2 [/SUP], Mathew S Lopes[SUP] 3 [/SUP], Anika Mody[SUP] 5 [/SUP], Alexander I Papolos[SUP] 8 [/SUP], Nicholas Phreaner[SUP] 5 [/SUP], Romteen Sedighi[SUP] 5 [/SUP], Shashank S Sinha[SUP] 9 [/SUP], Sandeep Toomu[SUP] 5 [/SUP], Anubodh S Varshney[SUP] 3 [/SUP], David A Morrow[SUP] 3 [/SUP], Erin A Bohula[SUP] 3 [/SUP]
Affiliations
- PMID: 35051622
- DOI: 10.1016/j.cardfail.2021.12.020
Abstract
Background: Acute heart failure (HF) is an important complication of coronavirus disease 2019 (COVID-19) and has been hypothesized to relate to inflammatory activation.
Methods: We evaluated consecutive intensive care unit (ICU) admissions for COVID-19 across 6 centers in the Critical Care Cardiology Trials Network, identifying patients with vs. without acute HF. Acute HF was sub-classified as "de novo" vs. "acute-on-chronic" based on the absence or presence of prior HF. Clinical features, biomarker profiles, and outcomes were compared.
Results: Among 901 COVID-19 ICU admissions, 80 (8.9%) had acute HF, including 18 (2.0%) with classic cardiogenic shock (CS) and 37 (4.1%) with vasodilatory CS. The majority (n=45) were de novo HF presentations. Compared to patients without acute HF, those with acute HF had higher cardiac troponin (cTn) and natriuretic peptides, and similar inflammatory biomarkers; patients with de novo HF had the highest cTn. Notably, among critically ill patients with COVID-19, illness severity (median SOFA, 8 [IQR, 5-10] vs. 6 [4-9]; p=0.025) and mortality (43.8% vs. 32.4%; p=0.040) were modestly higher in patients with vs. without acute HF.
Conclusions: Among critically ill COVID-19 patients, acute HF is distinguished more by biomarkers of myocardial injury and hemodynamic stress than by biomarkers of inflammation.
Keywords: COVID-19; biomarkers; heart failure.