Published 2020
| Version v1
Publication
Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. Results of the Cardio-COVID-Italy multicentre study
Creators
- Tomasoni, Daniela
- Inciardi, Riccardo M
- Lombardi, Carlo M
- Tedino, Chiara
- Agostoni, Piergiuseppe
- Ameri, Pietro
- Barbieri, Lucia
- Bellasi, Antonio
- Camporotondo, Rita
- Canale, Claudia
- Carubelli, Valentina
- Carugo, Stefano
- Catagnano, Francesco
- Dalla Vecchia, Laura A
- Danzi, Gian Battista
- Di Pasquale, Mattia
- Gaudenzi, Margherita
- Giovinazzo, Stefano
- Gnecchi, Massimiliano
- Iorio, Annamaria
- La Rovere, Maria Teresa
- Leonardi, Sergio
- Maccagni, Gloria
- Mapelli, Massimo
- Margonato, Davide
- Merlo, Marco
- Monzo, Luca
- Mortara, Andrea
- Nuzzi, Vincenzo
- Piepoli, Massimo
- Porto, Italo
- Pozzi, Andrea
- Sarullo, Filippo
- Sinagra, Gianfranco
- Volterrani, Maurizio
- Zaccone, Gregorio
- Guazzi, Marco
- Senni, Michele
- Metra, Marco
Contributors
Others:
- Tomasoni, Daniela
- Inciardi, Riccardo M
- Lombardi, Carlo M
- Tedino, Chiara
- Agostoni, Piergiuseppe
- Ameri, Pietro
- Barbieri, Lucia
- Bellasi, Antonio
- Camporotondo, Rita
- Canale, Claudia
- Carubelli, Valentina
- Carugo, Stefano
- Catagnano, Francesco
- Dalla Vecchia, Laura A
- Danzi, Gian Battista
- Di Pasquale, Mattia
- Gaudenzi, Margherita
- Giovinazzo, Stefano
- Gnecchi, Massimiliano
- Iorio, Annamaria
- La Rovere, Maria Teresa
- Leonardi, Sergio
- Maccagni, Gloria
- Mapelli, Massimo
- Margonato, Davide
- Merlo, Marco
- Monzo, Luca
- Mortara, Andrea
- Nuzzi, Vincenzo
- Piepoli, Massimo
- Porto, Italo
- Pozzi, Andrea
- Sarullo, Filippo
- Sinagra, Gianfranco
- Volterrani, Maurizio
- Zaccone, Gregorio
- Guazzi, Marco
- Senni, Michele
- Metra, Marco
Description
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.
Additional details
Identifiers
- URL
- http://hdl.handle.net/11567/1096397
- URN
- urn:oai:iris.unige.it:11567/1096397
Origin repository
- Origin repository
- UNIGE