Association of Functional Characteristics and Physiotherapy with COVID-19 Mortality in Intensive Care Unit in Inpatients with Cardiovascular Diseases.

Background and Objectives: To estimate the association between admission functional outcomes and exposure to physiotherapy interventions with mortality rate in intensive care unit (ICU) inpatients with cardiovascular diseases and new coronavirus disease (COVID-19). Materials and Methods: Retrospective cohort including 100 ICU inpatients (mean (standard deviation), age 75 (16) years) split into COVID-19+ or COVID-19-. The association of in-ICU death with admission functional outcomes and physiotherapy interventions was investigated using univariable and multivariable regression models. Results: In total, 42 (42%) patients tested positive for COVID-19. In-ICU mortality rate was 37%, being higher for the COVID-19+ group (odds ratio, OR (95% CI): 3.15 (1.37-7.47), p = 0.008). In-ICU death was associated with lower admission ICU Mobility Scale score (0.81 (0.71-0.91), p = 0.001). Restricted mobility (24.90 (6.77-161.94), p < 0.001) and passive kinesiotherapy (30.67 (9.49-139.52), p < 0.001) were associated with in-ICU death, whereas active kinesiotherapy (0.13 (0.05-0.32), p < 0.001), standing (0.12 (0.05-0.30), p < 0.001), or walking (0.10 (0.03-0.27), p < 0.001) were associated with in-ICU discharge. Conclusions: In-ICU mortality was higher for inpatients with cardiovascular diseases who had COVID-19+, were exposed to invasive mechanical ventilation, or presented with low admission mobility scores. Restricted mobility or passive kinesiotherapy were associated with in-ICU death, whereas active mobilizations (kinesiotherapy, standing, or walking) were associated with in-ICU discharge in this population.

Increased cardiovascular death rates in a COVID-19 low prevalence area.

The province of L'Aquila (Central Italy) was marginally affected by COVID-19 pandemic, but changes in health care seeking behaviors were noticed. The authors retrospectively analyzed de-identified data concerning all-cause and cardiovascular hospitalizations, cardiovascular acute phase treatments, and in-hospital cardiovascular deaths in the province of L'Aquila from January 1 to March 31, in 2020 and 2019. Incidence rate ratios (IRR) comparing 2020 and 2019 for admissions/procedures were calculated through Poisson regression. All-cause and cardiovascular mortality in the examined time windows was also assessed. Less all-cause (IRR 0.85, P < .001) and cardiovascular (IRR 0.73, P < .001) hospitalizations occurred in 2020 than in 2019. Less daily cardiovascular procedures were also performed (IRR: 0.74, P = .009). A disproportionate decrease in the number of procedures was observed in relation to cardiovascular hospitalizations in 2020 (-5.5%, P = .001). Unlike all-cause mortality, more in-hospital cardiovascular deaths occurred in March 2020 compared with March 2019 (+6.8%, P = .048).