Background: Coronavirus Disease 2019 (COVID-19), triggered by SARS-CoV-2, has represented a global pandemic associated with an elevated rate of mortality, mainly among older individuals. The extensive pulmonary involvement by the viral infection might have precipitated pre-existing chronic conditions in this vulnerable population, including heart failure (HF). Materials and Methods: The aim of this retrospective, observational study was to assess the impact of COVID-19 in patients with a prior diagnosis of HF referred to the Emergency Department of the Agostino Gemelli University Hospital between March 2020 and January 2023. A total of 886 HF patients (444 men and 442 women, mean age of 80 ± 10 years) were identified. Patients were matched in a 1:1 ratio by gender, age, number of comorbidities (excluding HF), and vaccination status, using a propensity score matching (PSM) procedure. We compared the outcomes of 189 patients with a concomitant diagnosis of HF with those of 189 matched controls without HF. Results: Among patients with HF, there was a significantly higher prevalence of valvular disease (p = 0.004), atrial fibrillation (p = 0.003), use of anticoagulants (p = 0.001), chronic obstructive pulmonary diseases (p = 0.03), and chronic kidney disease (p = 0.001). In contrast, hypertension was more prevalent among controls than HF patients (p = 0.04). In addition, controls exhibited higher lymphocytes counts and a higher PaO2/FiO2 ratio compared to HF patients. During hospitalization, patients with HF were more frequently treated with high-flow nasal cannulas (p = 0.01), required more frequent admission to an intensive care unit (ICU) (p = 0.04), and showed a significantly higher mortality rate (p 0.0001) than controls. Conclusions: HF is an independent risk factor for ICU admission and death in COVID-19 patients.

Cianci, R., Caldarelli, M., Ri, P., Pignataro, G., Sacco Fernandez, M., Ocarino, F., Della Polla, D. A., Franceschi, F., Gasbarrini, A., Gambassi, G., Candelli, M., Outcomes of Patients with Heart Failure Hospitalized for COVID-19-A Study in a Tertiary Italian Center, <<DISEASES>>, 2024; 12 (12): N/A-N/A. [doi:10.3390/diseases12120337] [https://hdl.handle.net/10807/303365]

Outcomes of Patients with Heart Failure Hospitalized for COVID-19-A Study in a Tertiary Italian Center

Cianci, Rossella
Primo
Conceptualization
;
Caldarelli, Mario
Secondo
Writing – Original Draft Preparation
;
Pignataro, Giulia
Writing – Original Draft Preparation
;
Ocarino, Francesca
Writing – Original Draft Preparation
;
Della Polla, Davide Antonio
Writing – Original Draft Preparation
;
Franceschi, Francesco
Supervision
;
Gasbarrini, Antonio
Supervision
;
Gambassi, Giovanni
Supervision
;
Candelli, Marcello
Ultimo
Writing – Review & Editing
2024

Abstract

Background: Coronavirus Disease 2019 (COVID-19), triggered by SARS-CoV-2, has represented a global pandemic associated with an elevated rate of mortality, mainly among older individuals. The extensive pulmonary involvement by the viral infection might have precipitated pre-existing chronic conditions in this vulnerable population, including heart failure (HF). Materials and Methods: The aim of this retrospective, observational study was to assess the impact of COVID-19 in patients with a prior diagnosis of HF referred to the Emergency Department of the Agostino Gemelli University Hospital between March 2020 and January 2023. A total of 886 HF patients (444 men and 442 women, mean age of 80 ± 10 years) were identified. Patients were matched in a 1:1 ratio by gender, age, number of comorbidities (excluding HF), and vaccination status, using a propensity score matching (PSM) procedure. We compared the outcomes of 189 patients with a concomitant diagnosis of HF with those of 189 matched controls without HF. Results: Among patients with HF, there was a significantly higher prevalence of valvular disease (p = 0.004), atrial fibrillation (p = 0.003), use of anticoagulants (p = 0.001), chronic obstructive pulmonary diseases (p = 0.03), and chronic kidney disease (p = 0.001). In contrast, hypertension was more prevalent among controls than HF patients (p = 0.04). In addition, controls exhibited higher lymphocytes counts and a higher PaO2/FiO2 ratio compared to HF patients. During hospitalization, patients with HF were more frequently treated with high-flow nasal cannulas (p = 0.01), required more frequent admission to an intensive care unit (ICU) (p = 0.04), and showed a significantly higher mortality rate (p 0.0001) than controls. Conclusions: HF is an independent risk factor for ICU admission and death in COVID-19 patients.
2024
Inglese
Cianci, R., Caldarelli, M., Ri, P., Pignataro, G., Sacco Fernandez, M., Ocarino, F., Della Polla, D. A., Franceschi, F., Gasbarrini, A., Gambassi, G., Candelli, M., Outcomes of Patients with Heart Failure Hospitalized for COVID-19-A Study in a Tertiary Italian Center, <<DISEASES>>, 2024; 12 (12): N/A-N/A. [doi:10.3390/diseases12120337] [https://hdl.handle.net/10807/303365]
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