tetano
Editor, Senior Moderator
Diseases
. 2024 Dec 21;12(12):337.
doi: 10.3390/diseases12120337. Outcomes of Patients with Heart Failure Hospitalized for COVID-19-A Study in a Tertiary Italian Center
Rossella Cianci[SUP] 1 2 [/SUP], Mario Caldarelli[SUP] 1 2 [/SUP], Pierluigi Rio[SUP] 1 2 [/SUP], Giulia Pignataro[SUP] 2 3 [/SUP], Marta Sacco Fernandez[SUP] 2 3 [/SUP], Francesca Ocarino[SUP] 1 2 [/SUP], Davide Antonio Della Polla[SUP] 2 3 [/SUP], Francesco Franceschi[SUP] 2 3 [/SUP], Antonio Gasbarrini[SUP] 1 2 [/SUP], Giovanni Gambassi[SUP] 1 2 [/SUP], Marcello Candelli[SUP] 2 3 [/SUP]
Affiliations
Background: Coronavirus Disease 2019 (COVID-19), triggered by SARS-CoV-2, has represented a global pandemic associated with an elevated rate of mortality, mainly among older individuals. The extensive pulmonary involvement by the viral infection might have precipitated pre-existing chronic conditions in this vulnerable population, including heart failure (HF). Materials and Methods: The aim of this retrospective, observational study was to assess the impact of COVID-19 in patients with a prior diagnosis of HF referred to the Emergency Department of the Agostino Gemelli University Hospital between March 2020 and January 2023. A total of 886 HF patients (444 men and 442 women, mean age of 80 ± 10 years) were identified. Patients were matched in a 1:1 ratio by gender, age, number of comorbidities (excluding HF), and vaccination status, using a propensity score matching (PSM) procedure. We compared the outcomes of 189 patients with a concomitant diagnosis of HF with those of 189 matched controls without HF. Results: Among patients with HF, there was a significantly higher prevalence of valvular disease (p = 0.004), atrial fibrillation (p = 0.003), use of anticoagulants (p = 0.001), chronic obstructive pulmonary diseases (p = 0.03), and chronic kidney disease (p = 0.001). In contrast, hypertension was more prevalent among controls than HF patients (p = 0.04). In addition, controls exhibited higher lymphocytes counts and a higher PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio compared to HF patients. During hospitalization, patients with HF were more frequently treated with high-flow nasal cannulas (p = 0.01), required more frequent admission to an intensive care unit (ICU) (p = 0.04), and showed a significantly higher mortality rate (p 0.0001) than controls. Conclusions: HF is an independent risk factor for ICU admission and death in COVID-19 patients.
Keywords: COVID-19; heart failure; sex differences; vaccination.
. 2024 Dec 21;12(12):337.
doi: 10.3390/diseases12120337. Outcomes of Patients with Heart Failure Hospitalized for COVID-19-A Study in a Tertiary Italian Center
Rossella Cianci[SUP] 1 2 [/SUP], Mario Caldarelli[SUP] 1 2 [/SUP], Pierluigi Rio[SUP] 1 2 [/SUP], Giulia Pignataro[SUP] 2 3 [/SUP], Marta Sacco Fernandez[SUP] 2 3 [/SUP], Francesca Ocarino[SUP] 1 2 [/SUP], Davide Antonio Della Polla[SUP] 2 3 [/SUP], Francesco Franceschi[SUP] 2 3 [/SUP], Antonio Gasbarrini[SUP] 1 2 [/SUP], Giovanni Gambassi[SUP] 1 2 [/SUP], Marcello Candelli[SUP] 2 3 [/SUP]
Affiliations
- PMID: 39727667
- DOI: 10.3390/diseases12120337
Background: Coronavirus Disease 2019 (COVID-19), triggered by SARS-CoV-2, has represented a global pandemic associated with an elevated rate of mortality, mainly among older individuals. The extensive pulmonary involvement by the viral infection might have precipitated pre-existing chronic conditions in this vulnerable population, including heart failure (HF). Materials and Methods: The aim of this retrospective, observational study was to assess the impact of COVID-19 in patients with a prior diagnosis of HF referred to the Emergency Department of the Agostino Gemelli University Hospital between March 2020 and January 2023. A total of 886 HF patients (444 men and 442 women, mean age of 80 ± 10 years) were identified. Patients were matched in a 1:1 ratio by gender, age, number of comorbidities (excluding HF), and vaccination status, using a propensity score matching (PSM) procedure. We compared the outcomes of 189 patients with a concomitant diagnosis of HF with those of 189 matched controls without HF. Results: Among patients with HF, there was a significantly higher prevalence of valvular disease (p = 0.004), atrial fibrillation (p = 0.003), use of anticoagulants (p = 0.001), chronic obstructive pulmonary diseases (p = 0.03), and chronic kidney disease (p = 0.001). In contrast, hypertension was more prevalent among controls than HF patients (p = 0.04). In addition, controls exhibited higher lymphocytes counts and a higher PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio compared to HF patients. During hospitalization, patients with HF were more frequently treated with high-flow nasal cannulas (p = 0.01), required more frequent admission to an intensive care unit (ICU) (p = 0.04), and showed a significantly higher mortality rate (p 0.0001) than controls. Conclusions: HF is an independent risk factor for ICU admission and death in COVID-19 patients.
Keywords: COVID-19; heart failure; sex differences; vaccination.