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Joint effect of heart failure and coronary artery disease on the risk of death during hospitalization for COVID-19.
Angeli, Fabio; Marazzato, Jacopo; Verdecchia, Paolo; Balestrino, Antonella; Bruschi, Claudio; Ceriana, Piero; Chiovato, Luca; Dalla Vecchia, Laura Adelaide; De Ponti, Roberto; Fanfulla, Francesco; La Rovere, Maria Teresa; Perego, Francesca; Scalvini, Simonetta; Spanevello, Antonio; Traversi, Egidio; Visca, Dina; Vitacca, Michele; Bachetti, Tiziana.
  • Angeli F; Department of Medicine and Surgery, University of Insubria, Varese, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Italy. Electronic address: angeli.internet@gmail.com.
  • Marazzato J; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
  • Verdecchia P; Fondazione Umbra Cuore e Ipertensione-ONLUS and Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy.
  • Balestrino A; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Bruschi C; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Ceriana P; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Chiovato L; Istituti Clinici Scientifici Maugeri IRCCS, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Italy.
  • Dalla Vecchia LA; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • De Ponti R; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
  • Fanfulla F; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • La Rovere MT; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Perego F; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Scalvini S; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Spanevello A; Department of Medicine and Surgery, University of Insubria, Varese, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Traversi E; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Visca D; Department of Medicine and Surgery, University of Insubria, Varese, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Vitacca M; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
  • Bachetti T; Istituti Clinici Scientifici Maugeri IRCCS, Italy.
Eur J Intern Med ; 89: 81-86, 2021 07.
Article in English | MEDLINE | ID: covidwho-1209445
ABSTRACT

AIMS:

heart failure (HF) and coronary artery disease (CAD) are independent predictors of death in patients with COVID-19. The adverse prognostic impact of the combination of HF and CAD in these patients is unclear. METHODS AND

RESULTS:

we analysed data from 954 consecutive patients hospitalized for SARS-CoV-2 in five Italian Hospitals from February 23 to May 22, 2020. The study was a systematic prospective data collection according to a pre-specified protocol. All-cause mortality during hospitalization was the outcome measure. Mean duration of hospitalization was 33 days. Mortality was 11% in the total population and 7.4% in the group without evidence of HF or CAD (reference group). Mortality was 11.6% in the group with CAD and without HF (odds ratio [OR] 1.6, p = 0.120), 15.5% in the group with HF and without CAD (OR 2.3, p = 0.032), and 35.6% in the group with CAD and HF (OR 6.9, p<0.0001). The risk of mortality in patients with CAD and HF combined was consistently higher than the sum of risks related to either disorder, resulting in a significant synergistic effect (p<0.0001) of the two conditions. Age-adjusted attributable proportion due to interaction was 64%. Adjusting for the simultaneous effects of age, hypotension, and lymphocyte count did not significantly lower attributable proportion which persisted statistically significant (p = 0.0360).

CONCLUSION:

The combination of HF and CAD exerts a marked detrimental impact on the risk of mortality in hospitalized patients with COVID-19, which is independent on other adverse prognostic markers.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronary Artery Disease / COVID-19 / Heart Failure Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur J Intern Med Journal subject: Internal Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronary Artery Disease / COVID-19 / Heart Failure Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur J Intern Med Journal subject: Internal Medicine Year: 2021 Document Type: Article