In-hospital mortality more common among COVID-19 patients with heart failure

Hospitalized COVID-19 patients with a history of heart failure may face a greater risk of in-hospital mortality, according to a new analysis in European Heart Journal. However, the same trend doesn’t appear to be true for any other subtypes of cardiovascular disease (CVD).

Researchers from the CAPACITY-COVID Collaborative Consortium and LEOSS Study Group examined data from more than 16,000 adult patients who were hospitalized with COVID-19 from March 2020 to May 2021. Patients came from one of 18 different countries, including France, Russia, Spain, Germany, the United Kingdom and others. A majority of patients were male and white.

Nearly 32% of patients included in the study had a history of CVD—these individuals tended to be older and present with more comorbidities than other patients included in the analysis. Mortality was 29.7% among patients with a history of CVD and 15.9% among patients with no history of CVD. However, after making key adjustments, “this difference was not significant.”

The group looked for associations between different CVD subtypes—including arrhythmias, coronary artery disease, myocardial infarction (MI), heart failure and valvular heart disease—and in-hospital mortality. Heart failure, however, was the only one that had a clear link with in-hospital mortality.

“This finding is of relevance for clinicians in countries with low vaccination rates and limited critical care capacity, that sometimes are forced to employ strict prioritization of the initiation and continuation of critical care treatment during this pandemic,” wrote corresponding author Folkert W. Asselbergs, MD, PhD, a cardiologist at University Medical Center Utrecht in the Netherlands, and colleagues. “Based on the results of this study, a history of cardiac disease, besides severe heart failure, should by itself presumably not be a reason to refrain from critical care treatment.”

The authors also noted that cardiac complications such as myocarditis, MI and new-onset heart failure were rare during hospitalization. These were found in 0.2%, 0.6% and 1.2% of hospitalized COVID-19 patients, respectively.

Read the study group’s full evaluation here.

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