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Cardiovascular Complications in Patients with Heart Failure and COVID-19: CARDIO COVID 19-20 Registry
Mario Speranza1,2, Juan D López-López3,4, Pedro Schwartzmann5
1Department of Cardiology, Hospital Clínica Bíblica, San José 10104, Costa Rica.
Insights
Patients with a history of heart failure (HF) hospitalized with COVID-19 experienced worse cardiovascular outcomes, including higher rates of complications, intensive care unit (ICU) admission, and mortality. This highlights HF as a significant risk factor for severe COVID-19 cardiovascular events.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Older adults with cardiovascular comorbidities face increased COVID-19 risk.
- Heart failure (HF) is a prevalent cardiovascular comorbidity.
- The impact of HF on COVID-19 prognosis requires further investigation.
Purpose of the Study:
- To assess the impact of pre-existing heart failure (HF) on COVID-19 patients.
- To evaluate HF's effect on cardiovascular complications, ICU admissions, and mortality.
- To analyze in-hospital and post-discharge outcomes in COVID-19 patients with and without HF.
Main Methods:
- Utilized the CARDIO COVID 19-20 registry (May 2020-June 2021).
- Included 3260 hospitalized COVID-19 patients from Latin America.
- Compared outcomes between patients with (n=182) and without previous HF.
Main Results:
- Patients with HF had higher incidence of supraventricular arrhythmia (16.5% vs 6.3%) and acute coronary syndrome (7.1% vs 2.7%).
- HF patients showed increased ICU admission rates (61.5% vs 53.1%) and in-hospital mortality (41.8% vs 24.5%).
- Cardiovascular mortality was significantly higher at discharge (42.1% vs 18.5%) and 30 days post-discharge (66.7% vs 18.0%) for HF patients.
Conclusions:
- A history of heart failure is associated with a more severe cardiovascular profile in COVID-19 patients.
- Pre-existing HF significantly increases the risk of cardiovascular complications and adverse outcomes.
- HF is a critical factor influencing COVID-19 severity and mortality, necessitating targeted management strategies.
Abstract:
Since early 2020, different studies have shown an increased prevalence of COVID-19 and poorer prognosis in older adults with cardiovascular comorbidities. This study aimed to assess the impact of heart failure (HF) on cardiovascular complications, intensive care unit (ICU) admissions, and in-hospital mortality in patients hospitalized with COVID-19. The CARDIO COVID 19-20 registry includes 3260 hospitalized patients with a COVID-19 serological diagnosis between May 2020 and June 2021 from Latin American countries. A history of HF was identified in 182 patients (5.6%). In patients with and without previous HF, the incidence of supraventricular arrhythmia was 16.5% vs. 6.3%, respectively (p = 0.001), and that of acute coronary syndrome was 7.1% vs. 2.7%, respectively (p = 0.001). Patients with a history of HF had higher rates of ICU admission (61.5% vs. 53.1%, respectively; p = 0.031) and in-hospital mortality (41.8% vs. 24.5%, respectively; p = 0.001) than patients without HF. Cardiovascular mortality at discharge (42.1% vs. 18.5%, respectively; p < 0.001) and at 30 days post-discharge (66.7% vs. 18.0%, respectively) was higher for patients with a history of HF than for patients without HF. In patients hospitalized with COVID-19, previous history of HF was associated with a more severe cardiovascular profile, with increased risk of cardiovascular complications, and poor in-hospital and 30-day outcomes.
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