Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

European Heart Journal - Tập 43 Số 11 - Trang 1104-1120 - 2022
Marijke Linschoten, Alicia Uijl, Astrid Schut, C E M Jakob, L R Romão, RM Bell, Ewan McFarlane, Melanie Stecher, Anna G M Zondag, Erik P.A. van Iperen, W Hermans-van Ast, N C Lea, Jeroen Schaap, L. S. D. Jewbali, P C Smits, Riyaz Patel, Avinash Aujayeb, Pim van der Harst1, Hans‐Marc J. Siebelink, Maarten van Smeden1, S. D. Williams, Lisa Pilgram, Wiek H. van Gilst, R. G. Tieleman, Bryan Williams, Folkert W. Asselbergs, Amein K. Al‐Ali2, Fahd A Al-Muhanna, A M Al-Rubaish, Nadea Al-Windy, Mohammad Alkhalil, Y. A. Almubarak, A. N. Alnafie, Mohammed Alshahrani, Abdullah Alshehri, C. C. P. Anning, Rutger L. Anthonio, E A Badings, Claire Ball, Eugène A. van Beek, Jurriën M. ten Berg, Michael von Bergwelt‐Baildon, Matteo Bianco, О. В. Благова, Hidde Bleijendaal, Wilbert Bor, Stefan Borgmann, Anton J.M. van Boxem, Floris S. van den Brink, Chiara Bucciarelli‐Ducci, Bas C. T. van Bussel, R Byrom-Goulthorp1, Gaby Captur, Massimo Caputo, N. Charlotte, Jürgen vom Dahl, Paul Dark, Johan De Sutter, C Degenhardt, Corine E. Delsing, Sebastian Dolff, H. G. R. Dorman, Johanna Drost, Lukas Eberwein, M E Emans3, Ahmet Görkem Er, Janise Braga Barros Ferreira, MJ Forner, Anette Friedrichs, Laurence Gabriël, B. E. Groenemeijer, Albert L. Groenendijk, Beate Grüner, Wolfgang Guggemos, H. E. Haerkens-Arends, Frank Hanses, Behnam Hedayat, David F. Heigener, Dirk J. van der Heijden, Elias Hellou, Kerstin Hellwig, M T H M Henkens, Rik Hermanides, Walther Hermans, Maarten W.J. van Hessen, Stéphane Heymans, Alexander D Hilt, Iwan C.C. van der Horst, Martin Hower, Sabrina H. van Ierssel, Nora Isberner, Björn‐Erik Ole Jensen, Mark T. Kearney, H. A. M. van Kesteren, Jan T. Kielstein, Bas Kietselaer, Matthias Kochanek, MZH Kolk, Aafke M H Koning, P. Y. Kopylov, A F M Kuijper, Johanna M. Kwakkel‐van Erp, Julia Lanznaster, M. M. J. M. van der Linden, Anne‐Lotte C.J. van der Lingen, Gerard C.M. Linssen, David A. Lomas, Moniek Maarse, Rosa Macías‐Ruiz, F. J. H. Magdelijns, Michael Magro, Philipp Markart, Fabrice M.A.C. Martens, S Mazzilli, Gerry P. McCann, Pim van der Meer, Matthijs F.L. Meijs3, Uta Merle4,5, Peter Messiaen, Milena Milovanovic, P. S. Monraats6, Laura Montagna7, A. Moriarty, Alison Moss, Arend Mosterd8, Silvio Nadalin9, Jacob Nattermann10, Marc Neufang11, P.R. Nierop2, J A Offerhaus, Clara E E van Ofwegen-Hanekamp, Emma Parker, A M Persoon, Christiane Piepel, Y M Pinto, Hamidreza Poorhosseini, SK Prasad, Anne G. Raafs, Claudia Raichle, Dominic Rauschning, Josep Redón, Auke C. Reidinga, M. I. A. Ribeiro, Claudia A. Riedel, Siegbert Rieg, David P Ripley, Christoph Römmele, Katja Rothfuss, Jessica Rüddel, Maria Madeleine Rüthrich, Rehab Salah, E Saneei, Manish Saxena, Dirk Schellings, Niels T B Scholte, J. Schubert, Jaap Seelig, Akbar Shafiee, Angela C. Shore, Christoph D. Spinner, Sven Stieglitz, Richard Strauß, Nicole Sturkenboom, Elena Tessitore, Ross J Thomson, Philippe Timmermans, R. A. Tio, Fleur V.Y. Tjong, Lukas Tometten, Janina Trauth, Corstiaan A. den Uil, Emeline M. Van Craenenbroeck, H. P. A. A. van Veen, Maria J. G. T. Vehreschild, L I Veldhuis, Thiemo Veneman, Derk O. Verschure, Ingo Voigt, Jeroen K. de Vries, R. M. A. van de Wal, Lorenz Walter, Dennis Johannes van de Watering, I. C. D. Westendorp, P. H. M. Westendorp, Timm H. Westhoff, Caroline Weytjens, Eric Wierda, Kai Wille, Katja de With, Maximilian Worm, Pier Woudstra, Ka wai Wu, Ruben Zaal, A G Zaman, P. M. van der Zee, Laurien E. Zijlstra, T. E. Alling, Raheel Ahmed, Krista van Aken, Esther Bayraktar-Verver, F J Bermúdez Jiménes, Carloalberto Biolè, Petra Den Boer-Penning, M Bontje, M Bos, Laura Bellver Bosch, Marike L. D. Broekman, F. J. F. Broeyer, E. A. Bruijn, Sophie Bruinsma, Nelson Cardoso, Bernard Cosyns, Dirk H. van Dalen, Emily Dekimpe, J Domange, J L van Doorn, P. van Doorn, Fabien Dormal, I M J Drost, Albert Dunnink, J.W.M. van Eck, K Elshinawy, R. Gevers, Daria Gognieva, Marinette van der Graaf, S Grangeon, Aydın Güçlü, Abdulrazaq G. Habib, N Haenen, Karyn L. Hamilton, Sandra Handgraaf, Hein Heidbüchel, Marjolijn Hendriks-van Woerden, Brigitta Hessels-Linnemeijer, Kaveh Hosseini, Jennifer Huisman, Tammy Jacobs, S E Jansen, Alfred Janssen, K Jourdan, Gerrit L. ten Kate, Masja Kempen, Chris M. Kievit, Pamela W. M. Kleikers, N. M. J. Knufman, Sjarlot Kooi, B A S Koole, M. A. C. Koole, K K Kui, L Kuipers-Elferink, I Lemoine, Elsemieke M Lensink, V van Marrewijk, Jan P. van Meerbeeck, Esther Meijer, A J Melein, D. F. Mesitskaya, C P M van Nes, François Paris, Maria Giulia Perrelli, A Pieterse-Rots, Ron Pisters, B C Pölkerman, A van Poppel, Simone Reinders, M J Reitsma, A H Ruiter, Jasper L. Selder, Aize van der Sluis, A I C Sousa, Masih Tajdini, Luís Tercedor, Caroline M. Van De Heyning, Hubert Vial, Erika Vlieghe, Harald E. Vonkeman, Paul K. Vreugdenhil, Tim A.C. de Vries, Anne‐Marie Willems, Alexandra Wils, S K Zoet-Nugteren
1Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom
2Department of Clinical Biochemistry, King Fahd Hospital of the University, Imam Abdulrahman
3Department of Cardiology, Amphia Hospital, The Netherlands
4Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
5Department of Intensive Care Erasmus MC, University Medical Center Rotterdam The Netherlands
6Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands
7Department of Respiratory and Acute Medicine, Northumbria Healthcare NHS Foundation Trust, Newcastle, United Kingdom
8Barts Life Sciences, Barts Health NHS Trust, London, United Kingdom
9Department of Internal Medicine, Hematology and Oncology, Goethe University, Frankfurt, Frankfurt, Germany
10Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
11Department of Cardiology, Martini Hospital, Groningen, the Netherlands

Tóm tắt

Abstract Aims

Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality.

 Methods and results

We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66–75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02–1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10–1.30; P < 0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20–1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients.

 Conclusion

Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.

Từ khóa


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European Heart Journal

Tập 43 Số 11

1104-1120

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