Prognostic significance and interplay between heart failure and COVID-19
Circulation
; 144(SUPPL 1), 2021.
Article
in English
| EMBASE | ID: covidwho-1632819
ABSTRACT
Introduction:
COVID-19 may negatively impact prognosis for patients with chronic HFrEF, and vice versa. However, large-scale data characterizing the interplay of COVID-19 and HFrEF on clinical outcomes are scarce.Methods:
We examined the TriNetX health database from January 2020-September 2020 to conduct 2 analyses. Analysis A excluded patients with HFpEF and included patients with a positive inpatient or outpatient test for COVID-19, with a 3-way comparison of patients 1) without prior HF, 2) HFrEF without recent worsening HF event (WHFE) (i.e., no HF hospitalization or outpatient IV diuretic within prior 1 year), and 3) worsening HFrEF (i.e., HF hospitalization or outpatient IV diuretic within prior 1 year). Outcomes included mortality at 30 days and composite all-cause mortality or hospitalization following COVID-19 test. Analysis B included patients with HFrEF who underwent PCR testing for COVID-19, and compared patients with a positive versus negative test. Outcomes were mortality at 30 days and worsening HF (i.e., HF hospitalization or outpatient IV diuretic use).Results:
In analysis A, 98,014 (99%) patients had no prior HF, 524 (0.5%) had HFrEF without WHFE, and 514 (0.5%) had worsening HFrEF. After adjustment for confounders, compared with patients without HF, worsening HFrEF was independently associated with excess mortality (p<0.01), whereas HFrEF without WHFE was not statistically significant (p=0.06) (Table). In analysis B, 1,038 (7%) had a positive test for COVID-19 and 13,800 (93%) had only negative tests. After adjustment, testing positive for COVID-19 was independently associated with mortality and worsening HF (all p<0.01).Conclusions:
In this US population of ambulatory and hospitalized patients, after accounting for confounders, worsening HFrEF was independently associated with excess mortality after COVID-19 infection. Among patients with HFrEF, COVID-19 infection was associated with higher risk of death and worsening HF events.
diuretic, agent; adult; all, cause, mortality; case, report; clinical, article; conference, abstract; confounding, variable; COVID-19, testing; excess, mortality; female; heart, failure, with, reduced, ejection, fraction; hospital, patient; hospitalization; human; male; outpatient; polymerase, chain, reaction
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Circulation
Year:
2021
Document Type:
Article
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