TY - JOUR
T1 - Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. Results of the Cardio-COVID-Italy multicentre study
AU - Tomasoni, Daniela
AU - Inciardi, Riccardo M.
AU - Lombardi, Carlo M.
AU - Tedino, Chiara
AU - Agostoni, Piergiuseppe
AU - Ameri, Pietro
AU - Barbieri, Lucia
AU - Bellasi, Antonio
AU - Camporotondo, Rita
AU - Canale, Claudia
AU - Carubelli, Valentina
AU - Carugo, Stefano
AU - Catagnano, Francesco
AU - Dalla Vecchia, Laura A.
AU - Danzi, Gian Battista
AU - Di Pasquale, Mattia
AU - Gaudenzi, Margherita
AU - Giovinazzo, Stefano
AU - Gnecchi, Massimiliano
AU - Iorio, Annamaria
AU - La Rovere, Maria Teresa
AU - Leonardi, Sergio
AU - Maccagni, Gloria
AU - Mapelli, Massimo
AU - Margonato, Davide
AU - Merlo, Marco
AU - Monzo, Luca
AU - Mortara, Andrea
AU - Nuzzi, Vincenzo
AU - Piepoli, Massimo
AU - Porto, Italo
AU - Pozzi, Andrea
AU - Sarullo, Filippo
AU - Sinagra, Gianfranco
AU - Volterrani, Maurizio
AU - Zaccone, Gregorio
AU - Guazzi, Marco
AU - Senni, Michele
AU - Metra, Marco
N1 - Funding Information: P.A. received speaker and advisor honoraria from Novartis, AstraZeneca, Vifor, Daiichi‐Sankyo, Boehringer Ingelheim, Pfizer, GSK and MSD. V.C. received consulting honoraria from CVie Therapeutics Limited, Servier, and Windtree Therapeutics. A.M. reports personal consulting honoraria from Novartis, Servier, AstraZeneca for participation in advisory board meetings and receives grants from Novartis and Niccomo for research trials. M.P. received research grant and speaking fees from Novartis, Servier, Vifor. M.M. reports personal consulting honoraria from Abbott, Actelion, Amgen, Bayer, Servier, Vifor Pharma and Windtree Therapeutics for participation in advisory board meetings and executive committees of clinical trials. All other authors have nothing to disclose. Conflict of interest: Publisher Copyright: © 2020 European Society of Cardiology Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - COVID-19
KW - Heart failure
KW - Outcome
KW - SARS-CoV-2 Infection
U2 - 10.1002/ejhf.2052
DO - 10.1002/ejhf.2052
M3 - Article
JO - Eur. J. Heart Fail.
JF - Eur. J. Heart Fail.
SN - 1388-9842
ER -