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Multicenter Study
. 2020 Dec;22(12):2238-2247.
doi: 10.1002/ejhf.2052. Epub 2020 Nov 27.

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

Daniela Tomasoni #  1 , Riccardo M Inciardi #  1 , Carlo M Lombardi  1 , Chiara Tedino  1 , Piergiuseppe Agostoni  2   3 , Pietro Ameri  4 , Lucia Barbieri  5 , Antonio Bellasi  6 , Rita Camporotondo  7 , Claudia Canale  4 , Valentina Carubelli  1 , Stefano Carugo  5 , Francesco Catagnano  7   8 , Laura A Dalla Vecchia  9 , Gian Battista Danzi  10 , Mattia Di Pasquale  1 , Margherita Gaudenzi  2   3 , Stefano Giovinazzo  4 , Massimiliano Gnecchi  7 , Annamaria Iorio  11 , Maria Teresa La Rovere  12 , Sergio Leonardi  7 , Gloria Maccagni  10 , Massimo Mapelli  2 , Davide Margonato  7   8 , Marco Merlo  13 , Luca Monzo  14 , Andrea Mortara  8 , Vincenzo Nuzzi  13 , Massimo Piepoli  15   16 , Italo Porto  4 , Andrea Pozzi  11 , Filippo Sarullo  17 , Gianfranco Sinagra  13 , Maurizio Volterrani  18 , Gregorio Zaccone  1 , Marco Guazzi  19 , Michele Senni  11 , Marco Metra  1
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Free article
Multicenter Study

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

Daniela Tomasoni et al. Eur J Heart Fail. 2020 Dec.
Free article

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.

Keywords: COVID-19; Heart failure; Outcome; SARS-CoV-2 Infection.

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References

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