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Eur Heart J ; 41(19): 1821-1829, 2020 05 14.
Article in English | MEDLINE | ID: mdl-32383763

ABSTRACT

AIMS: To compare demographic characteristics, clinical presentation, and outcomes of patients with and without concomitant cardiac disease, hospitalized for COVID-19 in Brescia, Lombardy, Italy. METHODS AND RESULTS: The study population includes 99 consecutive patients with COVID-19 pneumonia admitted to our hospital between 4 March and 25 March 2020. Fifty-three patients with a history of cardiac disease were compared with 46 without cardiac disease. Among cardiac patients, 40% had a history of heart failure, 36% had atrial fibrillation, and 30% had coronary artery disease. Mean age was 67 ± 12 years, and 80 (81%) patients were males. No differences were found between cardiac and non-cardiac patients except for higher values of serum creatinine, N-terminal probrain natriuretic peptide, and high sensitivity troponin T in cardiac patients. During hospitalization, 26% patients died, 15% developed thrombo-embolic events, 19% had acute respiratory distress syndrome, and 6% had septic shock. Mortality was higher in patients with cardiac disease compared with the others (36% vs. 15%, log-rank P = 0.019; relative risk 2.35; 95% confidence interval 1.08-5.09). The rate of thrombo-embolic events and septic shock during the hospitalization was also higher in cardiac patients (23% vs. 6% and 11% vs. 0%, respectively). CONCLUSIONS: Hospitalized patients with concomitant cardiac disease and COVID-19 have an extremely poor prognosis compared with subjects without a history of cardiac disease, with higher mortality, thrombo-embolic events, and septic shock rates.


Subject(s)
Coronavirus Infections/mortality , Heart Diseases/mortality , Hospitalization , Pneumonia, Viral/mortality , Aged , Aged, 80 and over , Atrial Fibrillation , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Creatinine/blood , Female , Heart Diseases/complications , Heart Failure , Humans , Italy/epidemiology , Male , Middle Aged , Natriuretic Peptide, Brain/blood , Pandemics , Peptide Fragments/blood , Pneumonia, Viral/complications , Prognosis , Respiratory Distress Syndrome , Risk Factors , SARS-CoV-2 , Shock, Septic , Thromboembolism , Troponin T/blood
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