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Association of chronic heart failure with mortality in old intensive care patients suffering from Covid-19.
Bruno, Raphael Romano; Wernly, Bernhard; Wolff, Georg; Fjølner, Jesper; Artigas, Antonio; Bollen Pinto, Bernardo; Schefold, Joerg C; Kindgen-Milles, Detlef; Baldia, Philipp Heinrich; Kelm, Malte; Beil, Michael; Sviri, Sigal; van Heerden, Peter Vernon; Szczeklik, Wojciech; Topeli, Arzu; Elhadi, Muhammed; Joannidis, Michael; Oeyen, Sandra; Kondili, Eumorfia; Marsh, Brian; Andersen, Finn H; Moreno, Rui; Leaver, Susannah; Boumendil, Ariane; De Lange, Dylan W; Guidet, Bertrand; Flaatten, Hans; Jung, Christian.
  • Bruno RR; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
  • Wernly B; Center for Public Health and Healthcare Research, Paracelsus Medical University Salzburg, Salzburg, Austria.
  • Wolff G; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
  • Fjølner J; Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
  • Artigas A; Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.
  • Bollen Pinto B; Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
  • Schefold JC; Department of Intensive Care Medicine, Inselspital, Universitätsspital Bern, University of Bern, Bern, Switzerland.
  • Kindgen-Milles D; Department of Anesthesiology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
  • Baldia PH; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
  • Kelm M; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
  • Beil M; Cardiovascular Research Institute, Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany.
  • Sviri S; Department of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • van Heerden PV; Department of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Szczeklik W; General Intensive Care Unit, Department of Anaesthesiology, Critical Care and Pain Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Topeli A; Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
  • Elhadi M; Division of Intensive Care, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
  • Joannidis M; Faculty of Medicine, University of Tripoli, Tripoli, Libya.
  • Oeyen S; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria.
  • Kondili E; Department of Intensive Care 1K12IC, Ghent University Hospital, Ghent, Belgium.
  • Marsh B; Intensive Care Unit, Department of Intensive Care Medicine, University Hospital of Heraklion, Heraklion, Greece.
  • Andersen FH; Mater Misericordiae University Hospital, Dublin, Ireland.
  • Moreno R; Department of Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway.
  • Leaver S; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
  • Boumendil A; Unidade de Cuidados Intensivos Neurocríticos e Trauma, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Faculdade de Ciências Médicas de Lisboa, Nova Medical School, Lisbon, Portugal.
  • De Lange DW; General Intensive Care, St George's University Hospitals NHS Foundation Trust, London, UK.
  • Guidet B; Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe: épidémiologie hospitalière qualité et organisation des soins, Paris, France.
  • Flaatten H; Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, service de réanimation médicale, Paris, France.
  • Jung C; Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
ESC Heart Fail ; 9(3): 1756-1765, 2022 06.
Article in English | MEDLINE | ID: covidwho-1739148
ABSTRACT

AIMS:

Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID-19). This prospective international multicentre study investigates the role of pre-existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID-19. METHODS AND

RESULTS:

Patients with pre-existing CHF were subclassified as having ischaemic or non-ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre-existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P < 0.001; odds ratio 1.87, 95% confidence interval (CI) 1.5-2.3] and 3 month mortality (69% vs. 56%, P < 0.001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1.2, 95% CI 0.5-1.5; P = 0.137]. More patients suffered from pre-existing ischaemic than from non-ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non-ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0.042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0.98, 95% CI 0.9-1.0; P = 0.128).

CONCLUSIONS:

In critically ill older COVID-19 patients, pre-existing CHF was not independently associated with 30 day mortality. TRIAL REGISTRATION NUMBER NCT04321265.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Heart Failure Type of study: Cohort study / Etiology study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: ESC Heart Fail Year: 2022 Document Type: Article Affiliation country: Ehf2.13854

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Heart Failure Type of study: Cohort study / Etiology study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: ESC Heart Fail Year: 2022 Document Type: Article Affiliation country: Ehf2.13854