ABSTRACT
Objective: Our goal was to characterize a cohort of heart failure patients with and without COVID-19 in terms of demographics, comorbid conditions, treatment regimens, lab test results and outcome. Methods: We performed a retrospective, unicentric, cohort study on consecutive patients admitted to our department between September and December 2021. Results: We enrolled a total of 76 HF patients - 65.3% COVID-19 (+). The median age was 72 years with a female predominance (59.2%). The median length of hospitalization was 13 days, longer for COVID-19 (+). Only 20.7% of all patients were fully vaccinated. COVID-19 (+) patients had higher ICU admission rates and mortality (in-hospital and at follow-up). The most common associated conditions were HTN (78.9%), T2DM (38.2%), cancer (18.4%), CAD (17.1%), late-stage CKD (16.7%), AF (14.5%) and stroke (11.8%). Patients with a history of stroke were more likely to require ICU management. At-home treatment with ACEi/ARB/ARNi made no difference for COVID-19 severity (p = 0.393), mechanical ventilation (p = 0.101) or mortality (in-hospital: p = 0.316;follow-up: p = 0.563);however, ICU admission rates were lower in these patients (p = 0.023). Conclusion: Heart failure with preserved ejection fraction and low symptom severity were common findings among COVID-19 positive patients. However, COVID-19 positive patients were hospitalized for longer, required more ICU care and had higher mortality both in-hospital and at follow-up. © 2022 Ana-Maria Vintilǎ et al.
ABSTRACT
Objective: Our aim was to explore COVID19-related mortality in hypertensive patients as compared to other associated conditions as well as antihypertensive treatment effect. Design and method: We performed a retrospective, unicentric study on COVID19 patients admitted to our department between 1st of September and 1st of December 2021. Collected data included medical history, treatment, echocardiographic data and lab test results. SPSS version 23 was used for descriptive and inferential statistics. Results: The lot consisted of 139 consecutively enrolled patients. The median age was 68 years (range: 18-91) and 48.9% females. Only 14.9% of patients were fully vaccinated (3.9% partially vaccinated, 81.3% unvaccinated). Associated conditions were: arterial hypertension (64.7%), heart failure (41.7%), T2DM (29.5%), stroke (13.7%) and coronary artery disease (12.2%). The inhospital mortality rate was 24.5% without differences between hypertensive and non-hypertensive patients (RR: 1.31 ;0.68 - 2.50). However, T2DM, coronary artery disease and stroke had higher relative risk than hypertension, AF and HF for COVID19 death (T2DM: 2.13 ;1.21 - 3.74;CAD: 2.21 ;1.20 - 4.06;stroke: 7.11 ;4.45 - 11.35). Hypertensive patients underwent treatment with ACEi/ARB (37.8%), diuretics (32.2%), calcium channel blockers (13.3%) and betablockers (40%) prior to admission. There was a statistical trend showing that fewer hypertensive patients receiving ACEi/ARB prior to admission required ICU management (20.6% vs 39.3%, p = 0.052) with no difference of inhospital mortality (23.5% vs 28.6%, p = 0.394). Hypertensive patients undergoing BB treatment had lower ICU admission rates (16.7% vs 42.6%, p = 0.008). Conclusions: Most hospitalised COVID19 patients were not fully vaccinated. Inhospital mortality was higher among patients withT2DM, CAD and history of stroke, but not HTN. Home treatment with ACEi/ARB or BB treatment was associated with lower ICU admission rates.