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Impact of COVID-19 Infection on Clinical Outcomes Among Patients With Acute Decompensated Heart Failure: A Nationwide

Michael Fatuyi1, Joseph Amoah2, Henry Egbuchiem2

  • 1Department of Medicine, TriHealth Good Samaritan Hospital Program, Cincinnati, OH.

Current Problems in Cardiology
|July 3, 2023
PubMed

Insights

COVID-19 infection significantly increases mortality risk in patients with heart failure. Those with Acute Decompensated Heart Failure with Reduced Ejection Fraction (AD-HFrEF) faced the highest in-hospital death rates compared to those without heart failure.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Heart Failure (HF) is a prevalent comorbidity in the United States.
  • COVID-19 infection has been linked to worse outcomes in HF patients, but data on specific HF subsets is limited.

Purpose of the Study:

  • To investigate clinical outcomes, specifically in-hospital mortality, among patients hospitalized with COVID-19.
  • To compare outcomes between patients with COVID-19 alone, COVID-19 with Acute Decompensated Heart Failure with Preserved Ejection Fraction (AD-HFpEF), and COVID-19 with Acute Decompensated Heart Failure with Reduced Ejection Fraction (AD-HFrEF).

Main Methods:

  • Retrospective analysis of the National Inpatient Sample (NIS) database for 2020 hospitalizations.
  • Inclusion criteria: adult patients (≥18 years) with COVID-19 as the principal diagnosis.
  • Stratification into three groups: COVID-19 without HF, COVID-19 with AD-HFpEF, and COVID-19 with AD-HFrEF. Primary outcome: in-hospital mortality. Analysis using multivariate regression models.

Main Results:

  • A total of 1,050,045 COVID-19 cases were analyzed.
  • COVID-19 without HF: 10.6% mortality.
  • COVID-19 with AD-HFpEF: 22.5% mortality (aOR 2.4).
  • COVID-19 with AD-HFrEF: 25.4% mortality (aOR 2.9).
  • Patients with COVID-19 and AD-HFrEF exhibited the highest in-hospital mortality.

Conclusions:

  • Concurrent Acute Decompensated Heart Failure (ADHF) with COVID-19 infection is associated with significantly higher in-hospital mortality.
  • The highest mortality risk is observed in patients with COVID-19 and Acute Decompensated Heart Failure with Reduced Ejection Fraction (AD-HFrEF).

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