Association of chronic heart failure with mortality in old intensive care patients suffering from Covid-19.
Publisher DOI
PubMed ID
35274490
Abstract
AIMS
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.
METHODS AND RESULTS
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).
CONCLUSIONS
In critically ill older COVID-19 patients, pre-existing CHF was not independently associated with 30 day mortality.
TRIAL REGISTRATION NUMBER
NCT04321265.
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.
METHODS AND RESULTS
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).
CONCLUSIONS
In critically ill older COVID-19 patients, pre-existing CHF was not independently associated with 30 day mortality.
TRIAL REGISTRATION NUMBER
NCT04321265.
Date Issued
2022-06
Publication Type
Article
Subject(s)
Subjects
COVID-19 Elderly Heart failure
Language(s)
en
Author(s)
Bruno, Raphael Romano | |
Wernly, Bernhard | |
Wolff, Georg | |
Fjølner, Jesper | |
Artigas, Antonio | |
Bollen Pinto, Bernardo | |
Kindgen-Milles, Detlef | |
Baldia, Philipp Heinrich | |
Kelm, Malte | |
Beil, Michael | |
Sviri, Sigal | |
van Heerden, Peter Vernon | |
Szczeklik, Wojciech | |
Topeli, Arzu | |
Elhadi, Muhammed | |
Joannidis, Michael | |
Oeyen, Sandra | |
Kondili, Eumorfia | |
Marsh, Brian | |
Andersen, Finn H | |
Moreno, Rui | |
Leaver, Susannah | |
Boumendil, Ariane | |
De Lange, Dylan W | |
Guidet, Bertrand | |
Flaatten, Hans | |
Jung, Christian |
Additional Credits
Journal
ESC Heart Failure
Publisher
Wiley
ISSN
2055-5822
Access(Rights)
open.access