Clinical outcomes of COVID-19 infection in patients with pre-existing cardiovascular disease

Kerolos, Mina Medhat; Ruge, Max; Gill, Ahmad; Planek, Maria Isabel Camara; Volgman, Annabelle Santos; Du-Fay-De-Lavallaz, Jeanne M.; Gomez, Joanne Michelle D.; Suboc, Tisha; Williams, Kim A.; Abusin, Salaheldin

doi:10.1016/j.ahjo.2022.100189

Cited by 6 publications

(5 citation statements)

References 33 publications

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“…A meta-analysis by Younas et al reported pooled prevalence of HF in COVID-19 as 9%, which includes studies comprising patients with known HF and new onset HF with COVID-19 [ 19 ]. We report the prevalence of AHF-COVID+ as 3.5% which corresponds to prior reported studies by Rey et al and Kerolos et al as 2.5% and 2.9%, respectively [ 20 , 21 ]. Similarly, AHF-COVID+ predominantly affected African-Americans, Medicare beneficiaries, and the elderly population (mean age > 70 years) with baseline comorbidities such as diabetes and kidney disease, which is consistent with prior reported literature [ 20 , 22 , 23 ].…”

Section: Discussionsupporting

confidence: 89%

COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States

Nasrullah

Gangu

Cannon

et al. 2023

Viruses

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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.

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Section: Discussionsupporting

confidence: 89%

COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States

Nasrullah

Gangu

Cannon

et al. 2023

Viruses

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“…With regard to the clinical profile of patients according to AF status, compared to patients without AF, those patients with new-onset AF were older and had more comorbidities, without relevant differences between patients with preexisting or new-onset AF. Previous studies have shown that patients with cardiovascular disease, including AF, are complex, with many comorbidities, 29 , 30 and this also includes patients with new-onset AF. 27 As a result, our data are consistent with previous publications.…”

Section: Discussionmentioning

confidence: 99%

Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the “ACO-VID” Registry

Cerezo Manchado,

Iturbe Hernández,

Martínez Pacheco

et al. 2023

Clin Appl Thromb Hemost

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Objective To assess the impact of new-onset atrial fibrillation (AF) on patients hospitalized with coronavirus disease 2019 (COVID-19). Methods Multicenter and retrospective study that included subjects >55 years hospitalized with COVID-19 from March to October 2020 in Spanish hospitals. Patients were divided into 3 groups (no AF, new-onset AF, and preexisting AF) and followed-up to 90 days. Results A total of 668 patients were included, of whom 162 (24.3%) had no AF, 107 (16.0%) new-onset AF and 399 (59.7%) preexisting AF. Compared to patients without AF, those patients with new-onset AF were older and had more comorbidities, but without differences with preexisting AF. During hospitalization, in the univariate analysis, compared to patients without AF, major bleeding and cardiovascular mortality were more frequent in patients with new-onset AF (10.3% vs 0.6%; P < .001; 2.8% vs 0.6%; P = .025, respectively), with a trend toward more stroke (1.9% vs 0%; P = .085). Outcomes were similar between AF groups, but the length of stay was greater in preexisting AF patients. Among patients with new-onset AF taking reduced doses of anticoagulant treatment was associated with higher risks of stroke and major bleeding. Conclusions In COVID-19 hospitalized patients, new-onset AF may be associated with worse outcomes, but influenced by the dose of anticoagulants.

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“…Multiple clinical studies have shown that patients with COVID-19 are prone to developing new AF and that new-onset AF predicts a poor prognosis ( 22 – 25 ). Pre-existing AF also exacerbates symptoms as well as the risk of death in patients with COVID-19 ( 26 , 27 ). In addition, the incidence of AF is significantly higher in survivors of COVID-19 ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Comprehensive bioinformatics analysis reveals common potential mechanisms, progression markers, and immune cells of coronary virus disease 2019 and atrial fibrillation

Yang

Zhao

2022

Front. Cardiovasc. Med.

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ObjectivesAtrial fibrillation (AF) is the most common arrhythmia in coronary virus disease 2019 (COVID-19) patients, especially in severe patients. A history of AF can exacerbate COVID-19 symptoms. COVID-19 Patients with new-onset AF have prolonged hospital stays and increased death risk. However, the mechanisms and targets of the interaction between COVID-19 and AF have not been elucidated.Materials and methodsWe used a series of bioinformatics analyses to understand biological pathways, protein-protein interaction (PPI) networks, gene regulatory networks (GRNs), and protein-chemical interactions between COVID-19 and AF and constructed an AF-related gene signature to assess COVID-19 severity and prognosis.ResultsWe found folate and one-carbon metabolism, calcium regulation, and TFG-β signaling pathway as potential mechanisms linking COVID-19 and AF, which may be involved in alterations in neutrophil metabolism, inflammation, and endothelial cell function. We identified hug genes and found that NF-κb, hsa-miR-1-3p, hsa-miR-124-3p, valproic acid, and quercetin may be key regulatory molecules. We constructed a 3-gene signature consisting of ARG1, GIMAP7, and RFX2 models for the assessment of COVID-19 severity and prognosis, and found that they are associated with neutrophils, T cells, and hematopoietic stem cells, respectively.ConclusionOur study reveals a dysregulation of metabolism, inflammation, and immunity between COVID-19 and AF, and identified several therapeutic targets and progression markers. We hope that the results will reveal important insights into the complex interactions between COVID-19 and AF that will drive novel drug development and help in severity assessment.

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Clinical outcomes of COVID-19 infection in patients with pre-existing cardiovascular disease

Cited by 6 publications

References 33 publications

COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States

COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients in the United States

Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the “ACO-VID” Registry

Comprehensive bioinformatics analysis reveals common potential mechanisms, progression markers, and immune cells of coronary virus disease 2019 and atrial fibrillation

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