Prevalence and characteristics of newly diagnosed heart failure in patients with shortness of breath after coronavirus infection.
Russian Journal of Cardiology
; 28(3):27-37, 2023.
Artigo
em Russo
| EMBASE | ID: covidwho-20239408
ABSTRACT
Aim. To determine the prevalence and show the features of the development of newly diagnosed heart failure (HF) in patients with dyspnea after a coronavirus disease 2019 (COVID-19). Material and methods. This clinical prospective observational study was conducted during 2020-2022. The study consecutively included 368 outpatients with shortness of breath, who applied to the clinic. Depending on the presence of prior COVID-19, the patients were divided into 2 groups the first group consisted of 205 patients with shortness of breath after COVID-19, the second group - 163 patients without prior COVID-19. All patients underwent a clinical examination within 3 days after presentation with an assessment of outpatient records and other medical documents for the differential diagnosis of dyspnea. The severity of dyspnea was determined using the Modified Medical Research Council Dyspnoea Scale (mMRC). The diagnosis of HF was verified in accordance with the 2020 Russian Society of Cardiology guidelines and in some cases reclassified in accordance with the 2021European Society of Cardiology guidelines. For further analysis, 2 subgroups of patients with HF were identified depending on the presence and absence of prior COVID-19. The subgroup analysis excluded patients with acute heart failure, acute illness, and conditions requiring hospitalization and/or intensive care. Results. Among 368 patients who presented to the clinic with dyspnea during 2020-2022, 205 patients (55,7%) had COVID-19. The average period of treatment after COVID-19 was 3,5 [1,5;22,4] months. Patients after COVID-19 applied earlier after the onset of dyspnea, which is associated with higher mMRC score. The prevalence of HF among patients with shortness of breath after COVID-19 was significantly higher than in patients without this pathology in history, and amounted to 19,0% vs 9,8% (p=0,021). Prior COVID-19 increased the relative risk (RR) of HF in patients with shortness of breath by 1,7 times. RR for HF in systolic blood pressure >140 mm Hg increased by 1,9 times, while in diastolic blood pressure >90 mm Hg - by 1,9 times, with the development of a hypertensive crisis - by 28%, with a heart rate >80 bpm at rest - by 1,4 times, with the development of type 2 diabetes - by 31%, in the presence of pulmonary fibrosis - by 2,3 times. Patients with shortness of breath after COVID-19 had more severe HF, both according to clinical tests and according to the blood concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP), mainly with the preserved ejection fraction (EF) with a higher prevalence of left atrial (LA) enlargement in combination with a decrease in right ventricular (RV) systolic function and its dilatation. In patients after COVID-19 in the presence of chronic kidney disease, the RR for HF increased by 4,5 times;in the presence of C-reactive protein >4 mg/l - by 1,6 times. Conclusion. Every fifth patient with shortness of breath 3,5 months after COVID-19 had more severe HF, both according to clinical tests and according to blood NT-proBNP concentration, mainly with preserved EF with a higher prevalence of LA increase in combination with a decrease in RV systolic function and its dilatation. The risk of HF is interrelated with the female sex and multiple comorbidities.Copyright © 2023, Silicea-Poligraf. All rights reserved.
newly diagnosed heart failure; post-COVID syndrome; shortness of breath; acute disease; acute heart failure; adult; article; blood pressure monitoring; cardiology; chronic kidney failure; clinical examination; comorbidity; controlled study; coronavirus disease 2019; diagnosis; diastolic blood pressure; differential diagnosis; dilatation; dyspnea; female; heart ejection fraction; heart failure; heart left atrium; heart rate; heart right ventricle; hospitalization; human; human tissue; hypertensive crisis; intensive care; left atrial enlargement; long COVID; lung fibrosis; major clinical study; Modified Medical Research Council Dyspnea Scale; non insulin dependent diabetes mellitus; observational study; outpatient; practice guideline; prevalence; prospective study; protein blood level; risk assessment; risk factor; systolic blood pressure; systolic heart failure; amino terminal pro brain natriuretic peptide; C reactive protein; endogenous compound
Texto completo:
Disponível
Coleções:
Bases de dados de organismos internacionais
Base de dados:
EMBASE
Tipo de estudo:
Estudo diagnóstico
/
Estudo experimental
/
Estudo observacional
/
Estudo prognóstico
/
Ensaios controlados aleatorizados
Idioma:
Russo
Revista:
Russian Journal of Cardiology
Ano de publicação:
2023
Tipo de documento:
Artigo
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