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Multicenter Study
. 2022 Aug;9(4):2189-2198.
doi: 10.1002/ehf2.13964. Epub 2022 Jun 3.

Impact of SARS-Cov-2 infection in patients with hypertrophic cardiomyopathy: results of an international multicentre registry

Juan R Gimeno  1   2   3 , Iacopo Olivotto  4 , Ana Isabel Rodríguez  1   2 , Carolyn Y Ho  5 , Adrián Fernández  6 , Alejandro Quiroga  6 , Mari Angeles Espinosa  3   7 , Cristina Gómez-González  3   7 , María Robledo  8 , Lucas Tojal-Sierra  8 , Sharlene M Day  9 , Anjali Owens  9 , Roberto Barriales-Villa  3   10 , Jose María Larrañaga  3   10 , Jose Rodríguez-Palomares  3   11   12 , Maribel González-Del-Hoyo  3   11   12 , Jesús Piqueras-Flores  13 , Nosheen Reza  9 , Olga Chumakova  14 , Euan A Ashley  15 , Victoria Parikh  15 , Matthew Wheeler  15 , Daniel Jacoby  16 , Alexandre C Pereira  17 , Sara Saberi  18 , Adam S Helms  18 , Eduardo Villacorta  3   19   20   21 , María Gallego-Delgado  3   19   20   21 , Daniel de Castro  2   3   22 , Fernando Domínguez  2   3   22 , Tomás Ripoll-Vera  23 , Esther Zorio-Grima  3   24 , José Carlos Sánchez-Martínez  3   24 , Ana García-Álvarez  3   25   26 , Elena Arbelo  3   25   26 , María Victoria Mogollón  27 , María Eugenia Fuentes-Cañamero  28 , Elias Grande  29 , Carlos Peña  29 , Lorenzo Monserrat  29 , Neal K Lakdawala  5 ; Dilema International Cardiomyopathy and Heart Failure Registry and international SHaRe (Sarcomeric Human Cardiomyopathy Registry) Investigators group
Collaborators, Affiliations
Multicenter Study

Impact of SARS-Cov-2 infection in patients with hypertrophic cardiomyopathy: results of an international multicentre registry

Juan R Gimeno et al. ESC Heart Fail. 2022 Aug.

Abstract

Aims: To describe the natural history of SARS-CoV-2 infection in patients with hypertrophic cardiomyopathy (HCM) compared with a control group and to identify predictors of adverse events.

Methods and results: Three hundred and five patients [age 56.6 ± 16.9 years old, 191 (62.6%) male patients] with HCM and SARS-Cov-2 infection were enrolled. The control group consisted of 91 131 infected individuals. Endpoints were (i) SARS-CoV-2 related mortality and (ii) severe clinical course [death or intensive care unit (ICU) admission]. New onset of atrial fibrillation, ventricular arrhythmias, shock, stroke, and cardiac arrest were also recorded. Sixty-nine (22.9%) HCM patients were hospitalized for non-ICU level care, and 21 (7.0%) required ICU care. Seventeen (5.6%) died: eight (2.6%) of respiratory failure, four (1.3%) of heart failure, two (0.7%) suddenly, and three (1.0%) due to other SARS-CoV-2-related complications. Covariates associated with mortality in the multivariable were age {odds ratio (OR) per 10 year increase 2.25 [95% confidence interval (CI): 1.12-4.51], P = 0.0229}, baseline New York Heart Association class [OR per one-unit increase 4.01 (95%CI: 1.75-9.20), P = 0.0011], presence of left ventricular outflow tract obstruction [OR 5.59 (95%CI: 1.16-26.92), P = 0.0317], and left ventricular systolic impairment [OR 7.72 (95%CI: 1.20-49.79), P = 0.0316]. Controlling for age and sex and comparing HCM patients with a community-based SARS-CoV-2 cohort, the presence of HCM was associated with a borderline significant increased risk of mortality OR 1.70 (95%CI: 0.98-2.91, P = 0.0600).

Conclusions: Over one-fourth of HCM patients infected with SARS-Cov-2 required hospitalization, including 6% in an ICU setting. Age and cardiac features related to HCM, including baseline functional class, left ventricular outflow tract obstruction, and systolic impairment, conveyed increased risk of mortality.

Keywords: COVID‐19; Heart failure; Hypertrophic cardiomyopathy; Prognosis; Registry; SARS‐CoV‐2 infection.

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Conflict of interest statement

Elias Grande, Carlos Peña, and Lorenzo Monserrat work for a Dilemma SL company and made substantial contributions to the study. They participated in development of the eCRF, in the revision, and in the approval of the manuscript. The rest of the authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of the percentage of hypertrophic cardiomyopathy patients with SARS‐Cov‐2 regarding care setting (upper chart) and proportion of sex by care setting (lower chart). ICU, intensive care unit.
Figure 2
Figure 2
Distribution of the number of patients with hypertrophic cardiomyopathy‐related and SARS‐CoV‐2‐related death by age interval and sex.
Figure 3
Figure 3
Percentage of SARS‐CoV‐2‐related death by age interval for patients with HCM and controls. HCM, hypertrophic cardiomyopathy.
See this image and copyright information in PMC

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