Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19
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‐...
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Wiley
2022-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13854 |
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| author | Raphael Romano Bruno Bernhard Wernly Georg Wolff Jesper Fjølner Antonio Artigas Bernardo Bollen Pinto Joerg C. Schefold Detlef Kindgen‐Milles Philipp Heinrich Baldia Malte Kelm Michael Beil Sigal Sviri Peter Vernon vanHeerden Wojciech Szczeklik Arzu Topeli Muhammed Elhadi Michael Joannidis Sandra Oeyen Eumorfia Kondili Brian Marsh Finn H. Andersen Rui Moreno Susannah Leaver Ariane Boumendil Dylan W. De Lange Bertrand Guidet Hans Flaatten Christian Jung COVIP study group |
| author_facet | Raphael Romano Bruno Bernhard Wernly Georg Wolff Jesper Fjølner Antonio Artigas Bernardo Bollen Pinto Joerg C. Schefold Detlef Kindgen‐Milles Philipp Heinrich Baldia Malte Kelm Michael Beil Sigal Sviri Peter Vernon vanHeerden Wojciech Szczeklik Arzu Topeli Muhammed Elhadi Michael Joannidis Sandra Oeyen Eumorfia Kondili Brian Marsh Finn H. Andersen Rui Moreno Susannah Leaver Ariane Boumendil Dylan W. De Lange Bertrand Guidet Hans Flaatten Christian Jung COVIP study group |
| author_sort | Raphael Romano Bruno |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-186d2796dc964a2498683610b042eb25 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-186d2796dc964a2498683610b042eb252025-02-05T05:22:10ZengWileyESC Heart Failure2055-58222022-06-01931756176510.1002/ehf2.13854Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19Raphael Romano Bruno0Bernhard Wernly1Georg Wolff2Jesper Fjølner3Antonio Artigas4Bernardo Bollen Pinto5Joerg C. Schefold6Detlef Kindgen‐Milles7Philipp Heinrich Baldia8Malte Kelm9Michael Beil10Sigal Sviri11Peter Vernon vanHeerden12Wojciech Szczeklik13Arzu Topeli14Muhammed Elhadi15Michael Joannidis16Sandra Oeyen17Eumorfia Kondili18Brian Marsh19Finn H. Andersen20Rui Moreno21Susannah Leaver22Ariane Boumendil23Dylan W. De Lange24Bertrand Guidet25Hans Flaatten26Christian Jung27COVIP study groupDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich Heine University Düsseldorf Düsseldorf GermanyCenter for Public Health and Healthcare Research Paracelsus Medical University Salzburg Salzburg AustriaDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich Heine University Düsseldorf Düsseldorf GermanyDepartment of Intensive Care Aarhus University Hospital Aarhus DenmarkDepartment of Intensive Care Medicine CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona Sabadell SpainDepartment of Acute Medicine Geneva University Hospitals Geneva SwitzerlandDepartment of Intensive Care Medicine, Inselspital, Universitätsspital Bern University of Bern Bern SwitzerlandDepartment of Anesthesiology Heinrich Heine University Düsseldorf Düsseldorf GermanyDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich Heine University Düsseldorf Düsseldorf GermanyDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich Heine University Düsseldorf Düsseldorf GermanyDepartment of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelDepartment of Medical Intensive Care, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelGeneral Intensive Care Unit, Department of Anaesthesiology, Critical Care and Pain Medicine, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelCenter for Intensive Care and Perioperative Medicine Jagiellonian University Medical College Kraków PolandDivision of Intensive Care, Department of Internal Medicine Hacettepe University Faculty of Medicine Ankara TurkeyFaculty of Medicine University of Tripoli Tripoli LibyaDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine Medical University Innsbruck Innsbruck AustriaDepartment of Intensive Care 1K12IC Ghent University Hospital Ghent BelgiumIntensive Care Unit, Department of Intensive Care Medicine University Hospital of Heraklion Heraklion GreeceMater Misericordiae University Hospital Dublin IrelandDepartment of Anaesthesia and Intensive Care Ålesund Hospital Ålesund NorwayUnidade de Cuidados Intensivos Neurocríticos e Trauma, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Faculdade de Ciências Médicas de Lisboa Nova Medical School Lisbon PortugalGeneral Intensive Care St George's University Hospitals NHS Foundation Trust London UKSorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe: épidémiologie hospitalière qualité et organisation des soins Paris FranceDepartment of Intensive Care Medicine University Medical Center Utrecht, Utrecht University Utrecht The NetherlandsSorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe: épidémiologie hospitalière qualité et organisation des soins Paris FranceDepartment of Clinical Medicine University of Bergen Bergen NorwayDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich Heine University Düsseldorf Düsseldorf GermanyAbstract 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.https://doi.org/10.1002/ehf2.13854COVID‐19Heart failureElderly |
| spellingShingle | Raphael Romano Bruno Bernhard Wernly Georg Wolff Jesper Fjølner Antonio Artigas Bernardo Bollen Pinto Joerg C. Schefold Detlef Kindgen‐Milles Philipp Heinrich Baldia Malte Kelm Michael Beil Sigal Sviri Peter Vernon vanHeerden Wojciech Szczeklik Arzu Topeli Muhammed Elhadi Michael Joannidis Sandra Oeyen Eumorfia Kondili Brian Marsh Finn H. Andersen Rui Moreno Susannah Leaver Ariane Boumendil Dylan W. De Lange Bertrand Guidet Hans Flaatten Christian Jung COVIP study group Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19 ESC Heart Failure COVID‐19 Heart failure Elderly |
| title | Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19 |
| title_full | Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19 |
| title_fullStr | Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19 |
| title_full_unstemmed | Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19 |
| title_short | Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19 |
| title_sort | association of chronic heart failure with mortality in old intensive care patients suffering from covid 19 |
| topic | COVID‐19 Heart failure Elderly |
| url | https://doi.org/10.1002/ehf2.13854 |
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