RESUMO
BackgroundPrior diagnosis of heart failure (HF) is associated with increased length of hospital stay (LOS) and mortality from Coronavirus disease-2019 (COVID-19). Associations between substance use, venous thromboembolism (VTE), or peripheral arterial disease (PAD) and its effects on LOS or mortality in patients with HF hospitalized with COVID-19 remains unknown. ObjectiveThis study identified risk factors associated with poor in-hospital outcomes among patients with HF hospitalized with COVID-19. MethodsCase control study was conducted of patients with prior diagnosis of HF hospitalized with COVID-19 at an academic tertiary care center from January 1, 2020 to February 28, 2021. Patients with HF hospitalized with COVID-19 with risk factors were compared with those without risk factors for clinical characteristics, length of stay (LOS), and mortality. Multivariate regression was conducted to identify multiple predictors of increased LOS and in-hospital mortality in patients with HF hospitalized with COVID-19. ResultsTotal of 211 HF patients were hospitalized with COVID-19. Females had longer LOS than males (9 days vs. 7 days; p < 0.001). Compared with patients without peripheral arterial disease (PAD) or ischemic stroke, patients with PAD or ischemic stroke had longer LOS (7 days vs. 9 days; p = 0.012 and 7 days vs. 11 days, p < 0.001; respectively). Older patients (aged 65 and above) had increased in-hospital mortality compared to younger patients (Adjusted OR: 1.04; 95% CI: 1.00 - 1.07; p = 0.036). VTE increased mortality more than three-fold in patients with HF hospitalized with COVID-19 (Adjusted OR: 3.33; 95% CI: 1.29 - 8.43; p = 0.011). ConclusionVascular diseases increase LOS and mortality in patients with HF hospitalized with COVID-19. KEY QUESTIONSO_ST_ABSWhat is already known about this subject?C_ST_ABS- Prior diagnosis of heart failure (HF) increases LOS and mortality in patients admitted to the hospital for COVID-19 - Antiplatelet, anticoagulation, and statin therapy decreased venous thromboembolism (VTE) in patients admitted for COVID-19 What does this study add?- This study showed that patients with COVID-19, HF, and VTE had a higher mortality rate than patients with COVID-19 and either HF or VTE, or patients with HF and/or VTE who did not have COVID-19. - This study showed that patients with HF hospitalized with COVID-19 had greater length of stay with prior diagnosis of peripheral arterial disease (PAD) or ischemic stroke How might this impact on clinical practice?- Our findings demonstrate clinical relevance by showing supportive evidence for antiplatelet, anticoagulation, and statin therapy in HF patients hospitalized with COVID-19
