Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID‐19. Results of the Cardio‐COVID‐Italy multicentre study

Abstract

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.

Meta-Analysis of Atrial Fibrillation in Patients With COVID-19

“…Nine hundred and sixteen potentially relevant studies were screened according to the inclusion and exclusion criteria. Finally, 23 studies with 108,745 COVID-19 patients 1 , 2 , 3 , 4 , 5 , 6 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 were eligibly included in the present quantitative meta-analysis. The study characteristics are summarized in Table 1 .…”

C1q Complement/Tumor Necrosis Factor-Associated Proteins in Cardiovascular Disease and COVID-19

“…Treatment for COVID-19 should give particular attention to cardiovascular protection, especially in patients who have obesity or diabetes [104]. The mechanism of cardiovascular injury caused by SARS-CoV-2 infection might be related to ACE2 and inflammatory cytokine storms [105,106]. Numerous adipokines exert imbalanced expressions in the obese or diabetes state, which leads to a series of inflammation response and cardiovascular damage.…”

December 2020 at a glance: focus on COVID‐19, comorbidities and palliative care

“…In a study conducted in Madrid, Spain, including 3080 COVID‐19 patients, those with a previous history of chronic HF were more likely to develop acute HF (11.2% vs. 2.1%; P < 0.001) and had higher mortality rates (48.7% vs. 19.0%; P < 0.001) 3 . In an Italian study including 13 centres and 692 patients, history of HF was an independent predictor of increased in‐hospital mortality [adjusted hazard ratio (HR) 2.25, 95% confidence interval (CI) 1.26–4.02; P = 0.006), along with age, sex, oxygen saturation and oxygen partial pressure/fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio 4 …”