Journal
EUROPEAN HEART JOURNAL
Volume 43, Issue 11, Pages 1104-+Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehab656
Keywords
COVID-19; SARS-CoV-2; Epidemiology; Patient registry; Comorbidity; Cardiovascular disease
Categories
Funding
- Dutch Heart Foundation [2020B006 CAPACITY]
- EuroQol Research Foundation
- Novartis Global
- Sanofi Genzyme Europe
- Novo Nordisk Nederland
- Servier Nederland
- Daiichi Sankyo Nederland
- German Centre for Infection Research (DZIF)
- Willy Robert Pitzer Foundation
- Alexandre Suerman Stipend of the University Medical Center Utrecht
- CardioVasculair Onderzoek Nederland [2015-12 eDETECT]
- National Institute of Health Research (NIHR) University College London Hospitals Biomedical Research Centre
- NIHR Exeter Clinical Research facility
- United Kingdom Research and Innovation (UKRI)
- UKRI
- Ministry of Science and Higher Education of the Russian Federation [075-152020-926]
- King Abdulaziz City for Science Technology [10-BIO1342-46]
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Patients with heart disease have a higher mortality rate when hospitalized with COVID-19, but there is considerable heterogeneity in the association between different heart disease subtypes and in-hospital mortality. Patients with heart failure are at greatest risk of death during hospitalization with COVID-19.
Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n= 1545 vs. 15.9%; n= 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P <0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization. [GRAPHICS] .
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