Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries in European Heart Journal
2022
ASL Torino 4
Tipo pubblicazione
Article
Autori/Collaboratori (281)Vedi tutti...
Asselbergs FW
Linschoten M
Uijl A
et alii...
Abstract
Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P < 0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.
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PMID : 34734634
DOI : 10.1093/eurheartj/ehab656
Keywords
NCT04325412; aldosterone antagonist; angiotensin receptor antagonist; antithrombocytic agent; C reactive protein; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; diuretic agent; insulin; oral antidiabetic agent; acute coronary syndrome; adult; aged; anosmia; article; body mass; breathing disorder; cardiovascular risk factor; chronic kidney failure; chronic obstructive lung disease; clinical feature; clinical outcome; cohort analysis; comorbidity; controlled study; coronavirus disease 2019; coughing; diabetes mellitus; diastolic blood pressure; disease association; disease course; disease duration; disease severity; dyspnea; echocardiography; electrocardiogram; endocarditis; faintness; fatigue; female; fever; gastrointestinal symptom; gender; heart arrhythmia; heart disease; heart failure; heart infarction; heart muscle conduction disturbance; heart palpitation; heart rate; heart ventricle arrhythmia; hemoglobin blood level; high risk patient; human; hypertension; image analysis; in-hospital mortality; infection risk; ischemic heart disease; length of stay; leukocyte count; lung embolism; lymphocyte count; major clinical study; male; medical history; myocarditis; New York Heart Association class; orthopnoea; oxygen saturation; pandemic; pericarditis; peripheral edema; platelet count; prevalence; sore throat; systolic blood pressure; thorax pain; valvular heart disease; venous thromboembolism;