期刊
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
卷 8, 期 7, 页码 -出版社
MDPI
DOI: 10.3390/jcdd8070077
关键词
heart failure; cardiovascular disease; epidemiology; COVID-19; corona virus 2019; risk factor
资金
- National Institute for Health/National Heart, Lung and Blood Institute [K23HL145140]
- National Center for Advancing Translational Science (NCATS) Clinical and Translational Science Award at Einstein-Montefiore [UL1TR001073]
- McAdam Family Foundation
The presence of heart failure in patients admitted with COVID-19 is associated with a higher risk of in-hospital mortality, even after adjusting for age, body mass index, and comorbidities. No significant difference in outcomes was observed between heart failure patients with preserved or reduced ejection fraction.
Aims: The association between cardiovascular diseases, such as coronary artery disease and hypertension, and worse outcomes in COVID-19 patients has been previously demonstrated. However, the effect of a prior diagnosis of heart failure (HF) with reduced or preserved left ventricular ejection fraction on COVID-19 outcomes has not yet been established. Methods and Results: We retrospectively studied all adult patients with COVID-19 admitted to our institution from March 1st to 2nd May 2020. Patients were grouped based on the presence or absence of HF. We used competing events survival models to examine the association between HF and death, need for intubation, or need for dialysis during hospitalization. Of 4043 patients admitted with COVID-19, 335 patients (8.3%) had a prior diagnosis of HF. Patients with HF were older, had lower body mass index, and a significantly higher burden of co-morbidities compared to patients without HF, yet the two groups presented to the hospital with similar clinical severity and similar markers of systemic inflammation. Patients with HF had a higher cumulative in-hospital mortality compared to patients without HF (49.0% vs. 27.2%, p < 0.001) that remained statistically significant (HR = 1.383, p = 0.001) after adjustment for age, body mass index, and comorbidities, as well as after propensity score matching (HR = 1.528, p = 0.001). Notably, no differences in mortality, need for mechanical ventilation, or renal replacement therapy were observed among HF patients with preserved or reduced ejection fraction. Conclusions: The presence of HF is a risk factor of death, substantially increasing in-hospital mortality in patients admitted with COVID-19.
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