Epidemiology of Acute Heart Failure in Critically Ill Patients With COVID-19: An Analysis From the Critical Care Cardiology Trials Network

Berg, David D.; Alviar, Carlos L.; Bhatt, Ankeet S.; Baird-Zars, Vivian M; Barnett, Christopher F.; Daniels, Lori B.; DeFilippis, Andrew P.; Fagundes, Antônio; Katrapati, Praneeth; Kenigsberg, Benjamin; Guo, Jianping; Keller, Norma; Lopes, Mathew S.; Mody, Anika; Papolos, Alexander; Phreaner, Nicholas; Sedighi, Romteen; Sinha, Shashank S.; Toomu, Sandeep; Varshney, Anubodh; Morrow, David A.; Bohula, Erin A.

doi:10.1016/j.cardfail.2021.12.020

Cited by 10 publications

(14 citation statements)

References 8 publications

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“…Sessenta e seis por cento dos pacientes já apresentavam IC prévia e tiveram seu quadro agudizado pelo processo infeccioso, enquanto 33,8% desenvolveram um quadro novo de IC de forma aguda. Outros estudos encontraram frequência semelhante entre ICCa e ICA (Berg et al 2022;Tomasoni et al 2020). Pacientes com histórico de IC crônica são propensos a desenvolver descompensação aguda após o diagnóstico de COVID-19 (Rey et al 2020).…”

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“…Pacientes com histórico de IC crônica são propensos a desenvolver descompensação aguda após o diagnóstico de COVID-19 (Rey et al 2020). Embora o risco de IC aguda seja maior em pacientes com IC prévia, mais de 50% das síndromes de IC aguda em pacientes criticamente doentes com COVID-19 foram apresentações de uma nova IC aguda (Berg et al 2022).…”

Section: Discussionunclassified

“…Ao avaliar as características clínicas de pacientes hospitalizados com pneumonia, infectados pelo SARS-CoV-2 em Wuhan, na China, Wang et al 2020 viram como complicações frequentes o choque, a insuficiência cardíaca aguda (ICA), arritmia, síndrome do desconforto respiratório agudo (SDRA) e a lesão renal aguda (LRA) (Wang et al 2020). A ICA é uma complicação importante em pacientes criticamente doentes com COVID-19, ocorrendo em, aproximadamente, 1 em cada 11 pacientes, havendo casos de ICA em pacientes com insuficiência cardíaca (IC) prévia, além do surgimento da IC pós infecção viral (Berg et al 2022). Um estudo realizado em pacientes internados por COVID-19 em 169 hospitais da Ásia, Europa e América do Norte demonstrou um risco aumentado de evolução para o óbito de 15,3% naqueles que apresentaram IC versus 5,6% entre aqueles sem esta condição (Mehra et al 2020).…”

Section: Introductionunclassified

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Complicações em pacientes internados por COVID-19 com insuficiência cardíaca descompensada

Santos

Santos²,

Bispo³

et al. 2022

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Objetivo: Analisar o desenvolvimento de complicações durante a internação de pacientes com COVID-19 e IC. Método: Trata-se de um estudo observacional, quantitativo, a partir da revisão dos prontuários dos pacientes internados na Unidade de Doenças Respiratórias (UDR) de um Hospital Universitário do nordeste brasileiro, com RT-PCR reagente para SARS-COV2 e diagnóstico de IC. Resultados: Dos 77 pacientes, 51 (66,2%) apresentavam uma insuficiência cardíaca crônica agudizada (ICCa) enquanto os demais (n = 26; 33,8%) não tinham história de cardiopatia prévia e estavam apresentando o primeiro episódio de insuficiência cardíaca aguda (ICA). Aqueles com a classificação NYHA IV tiveram maior risco de desenvolver choque (p = 0,001), parada cardiorrespiratória (PCR) (p = 0,01), síndrome do desconforto respiratório agudo (SDRA) (p < 0,0001), bacteremia (p = 0,008), hemorragia e dano hepático (p = 0,04) como complicações. A taxa de mortalidade intra-hospitalar foi de 39% (n= 30). Ao analisar a relação entre o tipo de complicação desenvolvida com o desfecho óbito, choque, PCR, SDRA (p < 0,0001), pneumonia (p = 0,009), bacteremia (p = 0,0003), hemorragia, anemia (p = 0,02), arritmia cardíaca (p = 0,03) e dano hepático (p = 0,04) tiveram associação significante. Conclusão: A associação entre IC e COVID-19 na internação leva a uma alta taxa de mortalidade intra-hospitalar. Pacientes com a classe funcional NYHA IV possuem maior risco de desenvolver complicações e óbito durante internação. Além disso, os pacientes com IC e COVID-19 que desenvolvem pneumonia, SDRA, choque, PCR, anemia, hemorragia, arritmia, dano hepático e/ou bacteremia possuem maior taxa de mortalidade.

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Complicações em pacientes internados por COVID-19 com insuficiência cardíaca descompensada

Santos

Santos²,

Bispo³

et al. 2022

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“…Patients with CVD risk factors were identified as more likely to develop severe illness leading to hospitalization and death, [18][19][20][21] while CVD complications have been recognized as important contributors to the morbidity and mortality associated with COVID-19 infection. [22][23][24][25] Myocardial injury commonly occurs and is associated with more severe illness. 26,27 Multiple studies have described myocardial inflammatory changes with cardiac magnetic resonance imaging among some survivors of COVID-19 infection.…”

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confidence: 99%

Longitudinal Trends in Cardiovascular Risk Factor Profiles and Complications Among Patients Hospitalized for COVID-19 Infection: Results From the American Heart Association COVID-19 Cardiovascular Disease Registry

Hall

Ayers

Kolkailah

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND: The COVID-19 pandemic has evolved through multiple phases characterized by new viral variants, vaccine development, and changes in therapies. It is unknown whether rates of cardiovascular disease (CVD) risk factor profiles and complications have changed over time. METHODS: We analyzed the American Heart Association COVID-19 CVD registry, a national multicenter registry of hospitalized adults with active COVID-19 infection. The time period from April 2020 to December 2021 was divided into 3-month epochs, with March 2020 analyzed separately as a potential outlier. Participating centers varied over the study period. Trends in all-cause in-hospital mortality, CVD risk factors, and in-hospital CVD outcomes, including a composite primary outcome of cardiovascular death, cardiogenic shock, new heart failure, stroke, and myocardial infarction, were evaluated across time epochs. Risk-adjusted analyses were performed using generalized linear mixed-effects models. RESULTS: A total of 46 007 patient admissions from 134 hospitals were included (mean patient age 61.8 years, 53% male, 22% Black race). Patients admitted later in the pandemic were younger, more likely obese, and less likely to have existing CVD ( P trend ≤0.001 for each). The incidence of the primary outcome increased from 7.0% in March 2020 to 9.8% in October to December 2021 (risk-adjusted P trend =0.006). This was driven by an increase in the diagnosis of myocardial infarction and stroke ( P trend <0.0001 for each). The overall rate of in-hospital mortality was 14.2%, which declined over time (20.8% in March 2020 versus 10.8% in the last epoch; adjusted P trend <0.0001). When the analysis was restricted to July 2020 to December 2021, no temporal change in all-cause mortality was seen (adjusted P trend =0.63). CONCLUSIONS: Despite a shifting risk factor profile toward a younger population with lower rates of established CVD, the incidence of diagnosed cardiovascular complications of COVID increased from the onset of the pandemic through December 2021. All-cause mortality decreased during the initial months of the pandemic and thereafter remained consistently high through December 2021.

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“…The following features are considered specific signs in the diagnosis of myocarditis: a significant increase in the D-dimer, ferritin, and C-reactive protein; a high level of troponin in the absence of other markers of myocardial necrosis; and an increased level of NT-proBNP. In addition, characteristic are the presence of global and/or regional disturbances of myocardial contractility; thickening of the wall of the left ventricle; and criteria for inflammation, detected using magnetic resonance imaging and data from an endomyocardial biopsy [ 10 ]. Today, many Russian researchers are actively studying the morphological changes in the heart of patients who have died of coronavirus infection.…”

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COVID-19 Pandemic and Cardiovascular Diseases: Lessons and Prospects

Shlyakhto

Konradi

Karonova

et al. 2022

Her. Russ. Acad. Sci.

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This article is focused on the topicality of assessing complications and mortality from diseases of the circulatory system during the COVID-19 pandemic. The main variants of damage to the cardiovascular system, the mechanisms of their development, and risk factors are given. The long-term consequences of the new coronavirus infection for the heart and blood vessels are considered. In addition, the necessary measures to reduce the burden of disease after the pandemic are discussed.

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Epidemiology of Acute Heart Failure in Critically Ill Patients With COVID-19: An Analysis From the Critical Care Cardiology Trials Network

Cited by 10 publications

References 8 publications

Complicações em pacientes internados por COVID-19 com insuficiência cardíaca descompensada

Complicações em pacientes internados por COVID-19 com insuficiência cardíaca descompensada

Longitudinal Trends in Cardiovascular Risk Factor Profiles and Complications Among Patients Hospitalized for COVID-19 Infection: Results From the American Heart Association COVID-19 Cardiovascular Disease Registry

COVID-19 Pandemic and Cardiovascular Diseases: Lessons and Prospects

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