Daniela Tomasoni1, Riccardo M Inciardi1, Carlo M Lombardi1, Chiara Tedino1, Piergiuseppe Agostoni2,3, Pietro Ameri4, Lucia Barbieri5, Antonio Bellasi6, Rita Camporotondo7, Claudia Canale4, Valentina Carubelli1, Stefano Carugo5, Francesco Catagnano7,8, Laura A Dalla Vecchia9, Gian Battista Danzi10, Mattia Di Pasquale1, Margherita Gaudenzi2,3, Stefano Giovinazzo4, Massimiliano Gnecchi7, Annamaria Iorio11, Maria Teresa La Rovere12, Sergio Leonardi7, Gloria Maccagni10, Massimo Mapelli2, Davide Margonato7,8, Marco Merlo13, Luca Monzo14, Andrea Mortara8, Vincenzo Nuzzi13, Massimo Piepoli15,16, Italo Porto4, Andrea Pozzi11, Filippo Sarullo17, Gianfranco Sinagra13, Maurizio Volterrani18, Gregorio Zaccone1, Marco Guazzi19, Michele Senni11, Marco Metra1. 1. Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. 2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 3. Centro Cardiologico Monzino, IRCCS, Milan, Italy. 4. IRCCS Ospedale Policlinico San Martino - IRCCS Italian Cardiovascular Network and Department of Internal Medicine, University of Genova, Genoa, Italy. 5. Division of Cardiology, Ospedale San Paolo, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy. 6. Research, Innovation and Brand Reputation, ASST Papa Giovanni XXIII, Bergamo, Italy. 7. Fondazione IRCCS Policlinico S. Matteo and University of Pavia, Pavia, Italy. 8. Department of Cardiology, Policlinico di Monza, Monza, Italy. 9. Department of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Istituto Scientifico di Milano, Milan, Italy. 10. Division of Cardiology, Ospedale Maggiore di Cremona, Cremona, Italy. 11. Cardiovascular Department and Cardiology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy. 12. Department of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Istituto Scientifico di Montescano, Pavia, Italy. 13. Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, Trieste, Italy. 14. Istituto Clinico Casal Palocco, Policlinico Casilino, Rome, Italy. 15. Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy. 16. Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy. 17. Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy. 18. Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy. 19. Heart Failure Unit, Cardiology Department, University of Milan, IRCCS San Donato Hospital, Milan, Italy.
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.
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.
Authors: Matteo Bassetti; Daniele Roberto Giacobbe; Paolo Bruzzi; Emanuela Barisione; Stefano Centanni; Nadia Castaldo; Silvia Corcione; Francesco Giuseppe De Rosa; Fabiano Di Marco; Andrea Gori; Andrea Gramegna; Guido Granata; Angelo Gratarola; Alberto Enrico Maraolo; Malgorzata Mikulska; Andrea Lombardi; Federico Pea; Nicola Petrosillo; Dejan Radovanovic; Pierachille Santus; Alessio Signori; Emanuela Sozio; Elena Tagliabue; Carlo Tascini; Carlo Vancheri; Antonio Vena; Pierluigi Viale; Francesco Blasi Journal: Infect Dis Ther Date: 2021-07-30
Authors: Max Ruge; Joanne Michelle D Gomez; Jeanne du Fay de Lavallaz; Alexander Hlepas; Annas Rahman; Priya Patel; Clay Hoster; Prutha Lavani; Gatha G Nair; Nusrat Jahan; J Alan Simmons; Anupama K Rao; William Cotts; Kim Williams; Annabelle Santos Volgman; Karolina Marinescu; Tisha Suboc Journal: Am Heart J Plus Date: 2021-06-15