Association of chronic heart failure with mortality in old intensive care patients suffering from Covid-19
Bruno, Raphael Romano (Heinrich Heine University Düsseldorf)
Wernly, Bernhard (Paracelsus Medical University Salzburg)
Wolff, Georg (Heinrich Heine University Düsseldorf)
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Bollen Pinto, Bernardo (Geneva University Hospitals)
Schefold, Joerg C. (University of Bern)
Kindgen-Milles, Detlef (Heinrich Heine University Düsseldorf)
Baldia, Philipp Heinrich (Heinrich Heine University Düsseldorf)
Kelm, Malte (Medical Faculty of the Heinrich-Heine University)
Beil, Michael (Hebrew University of Jerusalem)
Sviri, Sigal (Hebrew University of Jerusalem)
van Heerden, Peter Vernon (Hebrew University of Jerusalem)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Topeli, Arzu (Hacettepe University Faculty of Medicine)
Elhadi, Muhammed (University of Tripoli)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Kondili, Eumorfia (University Hospital of Heraklion)
Marsh, Brian (Mater Misericordiae University Hospital(Dublín, Irlanda))
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Nova Medical School)
Leaver, Susannah (St George's University Hospitals NHS Foundation Trust)
Boumendil, Ariane (Hôpital Saint-Antoine)
De Lange, Dylan W. (Utrecht University)
Guidet, Bertrand (Hôpital Saint-Antoine)
Flaatten, Hans (Haukeland University Hospital (Bergen, Noruega))
Jung, Christian (Heinrich Heine University Düsseldorf)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID-19). This prospective international multicentre study investigates the role of pre-existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID-19. Patients with pre-existing CHF were subclassified as having ischaemic or non-ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre-existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P < 0. 001; odds ratio 1. 87, 95% confidence interval (CI) 1. 5-2. 3] and 3 month mortality (69% vs. 56%, P < 0. 001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1. 2, 95% CI 0. 5-1. 5; P = 0. 137]. More patients suffered from pre-existing ischaemic than from non-ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non-ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0. 042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0. 98, 95% CI 0. 9-1. 0; P = 0. 128). In critically ill older COVID-19 patients, pre-existing CHF was not independently associated with 30 day mortality. Trial registration number: NCT04321265.
Ajuts:	European Commission. Horizon 2020 831644
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; Elderly ; Heart failure
Publicat a:	ESC Heart Failure, Vol. 9 (march 2022) , p. 1756-1765, ISSN 2055-5822

DOI: 10.1002/ehf2.13854
PMID: 35274490

10 p, 3.2 MB

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