tetano
Editor, Senior Moderator
Viruses
. 2023 Feb 22;15(3):600.
doi: 10.3390/v15030600.
COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States
Adeel Nasrullah[SUP] 1 [/SUP], Karthik Gangu[SUP] 2 [/SUP], Harmon R Cannon[SUP] 3 [/SUP], Umair A Khan[SUP] 3 [/SUP], Nichole B Shumway[SUP] 3 [/SUP], Aneish Bobba[SUP] 4 [/SUP], Shazib Sagheer[SUP] 3 [/SUP], Prabal Chourasia[SUP] 5 [/SUP], Hina Shuja[SUP] 6 [/SUP], Sindhu Reddy Avula[SUP] 7 [/SUP], Rahul Shekhar[SUP] 3 [/SUP], Abu Baker Sheikh[SUP] 3 [/SUP]
Affiliations
Abstract
Heart failure exacerbations impart significant morbidity and mortality, however, large- scale studies assessing outcomes in the setting of concurrent coronavirus disease-19 (COVID-19) are limited. We utilized National Inpatient Sample (NIS) database to compare clinical outcomes in patients admitted with acute congestive heart failure exacerbation (CHF) with and without COVID-19 infection. A total of 2,101,980 patients (Acute CHF without COVID-19 (n = 2,026,765 (96.4%) and acute CHF with COVID-19 (n = 75,215, 3.6%)) were identified. Multivariate logistic regression analysis was utilized to compared outcomes and were adjusted for age, sex, race, income level, insurance status, discharge quarter, Elixhauser co-morbidities, hospital location, teaching status and bed size. Patients with acute CHF and COVID-19 had higher in-hospital mortality compared to patients with acute CHF alone (25.78% vs. 5.47%, adjust OR (aOR) 6.3 (95% CI 6.05-6.62, p < 0.001)) and higher rates of vasopressor use (4.87% vs. 2.54%, aOR 2.06 (95% CI 1.86-2.27, p < 0.001), mechanical ventilation (31.26% vs. 17.14%, aOR 2.3 (95% CI 2.25-2.44, p < 0.001)), sudden cardiac arrest (5.73% vs. 2.88%, aOR 1.95 (95% CI 1.79-2.12, p < 0.001)), and acute kidney injury requiring hemodialysis (5.56% vs. 2.94%, aOR 1.92 (95% CI 1.77-2.09, p < 0.001)). Moreover, patients with heart failure with reduced ejection fraction had higher rates of in-hospital mortality (26.87% vs. 24.5%, adjusted OR 1.26 (95% CI 1.16-1.36, p < 0.001)) with increased incidence of vasopressor use, sudden cardiac arrest, and cardiogenic shock as compared to patients with heart failure with preserved ejection fraction. Furthermore, elderly patients and patients with African-American and Hispanic descents had higher in-hospital mortality. Acute CHF with COVID-19 is associated with higher in-hospital mortality, vasopressor use, mechanical ventilation, and end organ dysfunction such as kidney failure and cardiac arrest.
Keywords: COVID-19; HFpEF; HFrEF; National Inpatient Sample database; United States; congestive heart failure; mortality.
. 2023 Feb 22;15(3):600.
doi: 10.3390/v15030600.
COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States
Adeel Nasrullah[SUP] 1 [/SUP], Karthik Gangu[SUP] 2 [/SUP], Harmon R Cannon[SUP] 3 [/SUP], Umair A Khan[SUP] 3 [/SUP], Nichole B Shumway[SUP] 3 [/SUP], Aneish Bobba[SUP] 4 [/SUP], Shazib Sagheer[SUP] 3 [/SUP], Prabal Chourasia[SUP] 5 [/SUP], Hina Shuja[SUP] 6 [/SUP], Sindhu Reddy Avula[SUP] 7 [/SUP], Rahul Shekhar[SUP] 3 [/SUP], Abu Baker Sheikh[SUP] 3 [/SUP]
Affiliations
- PMID: 36992309
- DOI: 10.3390/v15030600
Abstract
Heart failure exacerbations impart significant morbidity and mortality, however, large- scale studies assessing outcomes in the setting of concurrent coronavirus disease-19 (COVID-19) are limited. We utilized National Inpatient Sample (NIS) database to compare clinical outcomes in patients admitted with acute congestive heart failure exacerbation (CHF) with and without COVID-19 infection. A total of 2,101,980 patients (Acute CHF without COVID-19 (n = 2,026,765 (96.4%) and acute CHF with COVID-19 (n = 75,215, 3.6%)) were identified. Multivariate logistic regression analysis was utilized to compared outcomes and were adjusted for age, sex, race, income level, insurance status, discharge quarter, Elixhauser co-morbidities, hospital location, teaching status and bed size. Patients with acute CHF and COVID-19 had higher in-hospital mortality compared to patients with acute CHF alone (25.78% vs. 5.47%, adjust OR (aOR) 6.3 (95% CI 6.05-6.62, p < 0.001)) and higher rates of vasopressor use (4.87% vs. 2.54%, aOR 2.06 (95% CI 1.86-2.27, p < 0.001), mechanical ventilation (31.26% vs. 17.14%, aOR 2.3 (95% CI 2.25-2.44, p < 0.001)), sudden cardiac arrest (5.73% vs. 2.88%, aOR 1.95 (95% CI 1.79-2.12, p < 0.001)), and acute kidney injury requiring hemodialysis (5.56% vs. 2.94%, aOR 1.92 (95% CI 1.77-2.09, p < 0.001)). Moreover, patients with heart failure with reduced ejection fraction had higher rates of in-hospital mortality (26.87% vs. 24.5%, adjusted OR 1.26 (95% CI 1.16-1.36, p < 0.001)) with increased incidence of vasopressor use, sudden cardiac arrest, and cardiogenic shock as compared to patients with heart failure with preserved ejection fraction. Furthermore, elderly patients and patients with African-American and Hispanic descents had higher in-hospital mortality. Acute CHF with COVID-19 is associated with higher in-hospital mortality, vasopressor use, mechanical ventilation, and end organ dysfunction such as kidney failure and cardiac arrest.
Keywords: COVID-19; HFpEF; HFrEF; National Inpatient Sample database; United States; congestive heart failure; mortality.