TY - JOUR
T1 - Association of chronic heart failure with mortality in old intensive care patients suffering from Covid-19
AU - Bruno, Raphael Romano
AU - Wernly, Bernhard
AU - Wolff, Georg
AU - Fjølner, Jesper
AU - Artigas, Antonio
AU - Bollen Pinto, Bernardo
AU - Schefold, Joerg C
AU - Kindgen-Milles, Detlef
AU - Baldia, Philipp Heinrich
AU - Kelm, Malte
AU - Beil, Michael
AU - Sviri, Sigal
AU - van Heerden, Peter Vernon
AU - Szczeklik, Wojciech
AU - Topeli, Arzu
AU - Elhadi, Muhammed
AU - Joannidis, Michael
AU - Oeyen, Sandra
AU - Kondili, Eumorfia
AU - Marsh, Brian
AU - Andersen, Finn H
AU - Moreno, Rui
AU - Leaver, Susannah
AU - Boumendil, Ariane
AU - De Lange, Dylan W
AU - Guidet, Bertrand
AU - Flaatten, Hans
AU - Jung, Christian
N1 - Funding: This study was endorsed by the ESICM. Free support for running the electronic database was granted from the Department of Epidemiology, Aarhus University, Denmark. The support of the study in France by a grant from ‘Fondation Assistance Publique-Hôpitaux de Paris pour la recherche’ is greatly appreciated. In Norway, the study was supported by a grant from the Health Region West. In addition, the study was supported by a grant from the European Open Science Cloud (EOSC). EOSCsecretariat.eu has received funding from the European Union’s Horizon 2020 Framework Programme called H2020-INFRAEOSC-05-2018-2019, Grant Agreement Number 831644. This work was supported by the Forschungskommission of the Medical Faculty of the Heinrich Heine University Düsseldorf, No. 2018-32 to G.W. and No. 2020-21 to R.R.B. for a Clinician Scientist Track. Open access funding was enabled and organized by Projekt DEAL. No (industry) sponsorship has been received for this investigator-initiated study.
PY - 2022/6
Y1 - 2022/6
N2 - 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.
AB - 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.
U2 - 10.1002/ehf2.13854
DO - 10.1002/ehf2.13854
M3 - Article
C2 - 35274490
SN - 2055-5822
VL - 9
SP - 1756
EP - 1765
JO - ESC Heart Failure
JF - ESC Heart Failure
IS - 3
ER -