Key result
Decompensated CHF linked to ~472% greater in-hospital mortality risk in COVID-19 pneumonia versus compensated CHF.
Why the study?
Patients with chronic heart failure are vulnerable to COVID-19, motivating investigation into risk factors for unfavorable prognosis and progression of heart failure in those hospitalized with COVID-19 pneumonia.
What are the risk factors for unfavorable prognosis and progression of chronic heart failure in hospitalized patients with COVID-19 pneumonia?
Cohort (n=555)
No
What are the risk factors for unfavorable prognosis and progression of chronic heart failure in hospitalized patients with COVID-19 pneumonia?
Odds Ratio: 5.72 (95% CI 1.84–17.81)
Absolute Event Rate: 42.86% vs 11.59%
p-value: p=0.0026
Chronic heart failure is highly prevalent in patients hospitalized with COVID-19 pneumonia and is associated with significantly increased mortality, particularly when decompensated.
Highlights decompensated HF as mortality marker in COVID-19 pneumonia; hypothesis-generating for targeted management trials.
Introduction. Patients with chronic heart failure are vulnerable to coronavirus disease (COVID-19). Objectives. To investigate risk factors for unfavorable prognosis and progression of heart failure in hospitalized patients with chronic heart failure and COVID-19 pneumonia. Methods. A retrospective analysis of the medical records of 555 hospitalized patients diagnosed with COVID-19 was conducted. Subsequently, the data of 90 patients with chronic heart failure (CHF) and COVID-19 pneumonia from January – February 2021 were collected at Lviv Clinical Hospital of Emergency Medical Care. The following indices were evaluated: anthropometric and demographic data, complications, treatment results, results of clinical, laboratory, and instrumental examinations, and dynamic NT-proBNP. Results. CHF is recorded in 42.9% of hospitalized patients with COVID-19 and is accompanied by lower values of blood oxygen level (p=0.0474), hemoglobin (p=0.0090), prothrombin time (p=0.0196), prothrombin index (p=0.0196) and higher indicators of glucose (p=0.0032), creatinine (p=0.00001), interleukin-6 (p=0.0041). CHF decompensation is associated with lower values of body temperature (p=0.0047) and blood oxygen saturation (p=0.0076), while hemoglobin level (p=0.0026), higher creatinine values (p=0.0034), interleukin-6 (p=0.0300), aspartate aminotransferase (p=0.0035), troponin I (p=0.0061); are associated with the development of myocardial infarction (p=0.0014), acute arrhythmias (p=0.0011), hypertensive crisis (p=0.0096) and increased mortality (OR=5.72; 95). % CI: 1.84, 17.81; p=0.0026). Conclusions. CHF is common and often fatal in patients with COVID-19, especially in decompensated CHF. Low blood oxygen saturation, myocardial infarction, arrhythmia, hypertensive crisis, increased cardio cytolysis markers and pro-inflammatory cytokines preceding adverse cardiovascular risk factors contribute to CHF decompensation in patients with COVID-19.
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О.О. Samchuk (2023) conducted a cohort in COVID-19 pneumonia and Chronic Heart Failure (n=555). Decompensated chronic heart failure vs. Compensated chronic heart failure was evaluated on In-hospital mortality (OR 5.72, 95% CI 1.84-17.81, p=0.0026). Decompensated chronic heart failure in patients with COVID-19 pneumonia was associated with a significantly increased risk of in-hospital mortality (42.86% vs 11.59%, OR 5.72) compared to compensated heart failure.
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