Aims: 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 1 March and 9 April 2020. Mean age was 67.4 ± 13.2 years, 69.5% of 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 vs. 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 interval (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.

Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. results of the cardio-COVID-Italy multicentre study / Tomasoni, D.; Inciardi, R. M.; Lombardi, C. M.; Tedino, C.; Agostoni, P.; Ameri, P.; Barbieri, L.; Bellasi, A.; Camporotondo, R.; Canale, C.; Carubelli, V.; Carugo, S.; Catagnano, F.; Dalla Vecchia, L. A.; Danzi, G. B.; Di Pasquale, M.; Gaudenzi, M.; Giovinazzo, S.; Gnecchi, M.; Iorio, A.; La Rovere, M. T.; Leonardi, S.; Maccagni, G.; Mapelli, M.; Margonato, D.; Merlo, M.; Monzo, L.; Mortara, A.; Nuzzi, V.; Piepoli, M.; Porto, I.; Pozzi, A.; Sarullo, F.; Sinagra, G.; Volterrani, M.; Zaccone, G.; Guazzi, M.; Senni, M.; Metra, M.. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 22:12(2020), pp. 2238-2247. [10.1002/ejhf.2052]

Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. results of the cardio-COVID-Italy multicentre study

Monzo L.;Nuzzi V.;
2020

Abstract

Aims: 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 1 March and 9 April 2020. Mean age was 67.4 ± 13.2 years, 69.5% of 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 vs. 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 interval (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.
2020
COVID-19; heart failure; outcome; SARS-CoV-2 Infection; acute disease; adrenal cortex hormones; age factors; aged; aged, 80 and over; anticoagulants; blood gas analysis; chronic disease; comorbidity; disease progression; female; heart failure; heparin; humans; italy; length of stay; male; middle aged; multiple organ failure; multivariate analysis; partial pressure; prognosis; proportional hazards models; protective factors; sepsis; severity of illness index; hospital mortality
01 Pubblicazione su rivista::01a Articolo in rivista
Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. results of the cardio-COVID-Italy multicentre study / Tomasoni, D.; Inciardi, R. M.; Lombardi, C. M.; Tedino, C.; Agostoni, P.; Ameri, P.; Barbieri, L.; Bellasi, A.; Camporotondo, R.; Canale, C.; Carubelli, V.; Carugo, S.; Catagnano, F.; Dalla Vecchia, L. A.; Danzi, G. B.; Di Pasquale, M.; Gaudenzi, M.; Giovinazzo, S.; Gnecchi, M.; Iorio, A.; La Rovere, M. T.; Leonardi, S.; Maccagni, G.; Mapelli, M.; Margonato, D.; Merlo, M.; Monzo, L.; Mortara, A.; Nuzzi, V.; Piepoli, M.; Porto, I.; Pozzi, A.; Sarullo, F.; Sinagra, G.; Volterrani, M.; Zaccone, G.; Guazzi, M.; Senni, M.; Metra, M.. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 22:12(2020), pp. 2238-2247. [10.1002/ejhf.2052]
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