Heart failure in COVID-19 patients: prevalence, incidence and prognostic implications.
Eur J Heart Fail
; 22(12): 2205-2215, 2020 12.
Artículo
en Inglés
| MEDLINE | ID: covidwho-726285
ABSTRACT
AIMS:
Data on the impact of COVID-19 in chronic heart failure (CHF) patients and its potential to trigger acute heart failure (AHF) are lacking. The aim of this work was to study characteristics, cardiovascular outcomes and mortality in patients with confirmed COVID-19 infection and a prior diagnosis of heart failure (HF). Further aims included the identification of predictors and prognostic implications for AHF decompensation during hospital admission and the determination of a potential correlation between the withdrawal of HF guideline-directed medical therapy (GDMT) and worse outcomes during hospitalization. METHODS ANDRESULTS:
Data for a total of 3080 consecutive patients with confirmed COVID-19 infection and follow-up of at least 30 days were analysed. Patients with a previous history of CHF (n = 152, 4.9%) were more prone to the development of AHF (11.2% vs. 2.1%; P < 0.001) and had higher levels of N-terminal pro brain natriuretic peptide. In addition, patients with previous CHF had higher mortality rates (48.7% vs. 19.0%; P < 0.001). In contrast, 77 patients (2.5%) were diagnosed with AHF, which in the vast majority of cases (77.9%) developed in patients without a history of HF. Arrhythmias during hospital admission and CHF were the main predictors of AHF. Patients developing AHF had significantly higher mortality (46.8% vs. 19.7%; P < 0.001). Finally, the withdrawal of beta-blockers, mineralocorticoid receptor antagonists and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was associated with a significant increase in in-hospital mortality.CONCLUSIONS:
Patients with COVID-19 have a significant incidence of AHF, which is associated with very high mortality rates. Moreover, patients with a history of CHF are prone to developing acute decompensation after a COVID-19 diagnosis. The withdrawal of GDMT was associated with higher mortality.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Arritmias Cardíacas
/
Mortalidad Hospitalaria
/
COVID-19
/
Insuficiencia Cardíaca
Tipo de estudio:
Estudio de cohorte
/
Estudio observacional
/
Estudio pronóstico
Tópicos:
Covid persistente
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
País/Región como asunto:
Europa
Idioma:
Inglés
Revista:
Eur J Heart Fail
Asunto de la revista:
Cardiología
Año:
2020
Tipo del documento:
Artículo
País de afiliación:
Ejhf.1990
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