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


Tài liệu tham khảo

Johns Hopkins Coronavirus Resource Center. COVID-19 Dashboard, 2021

Gudbjartsson, 2020, Spread of SARS-CoV-2 in the Icelandic population, N Engl J Med, 382, 2302, 10.1056/NEJMoa2006100

Petersen, 2020, Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics, Lancet Infect Dis, 20, e238, 10.1016/S1473-3099(20)30484-9

World Health Organization.Middle East respiratory syndrome coronavirus (MERS-CoV): key facts, 2020

WHO Update 49—SARS case fatality ratio, incubation period, 2020

Ruan, 2020, Likelihood of survival of coronavirus disease 2019, Lancet Infect Dis, 20, 630, 10.1016/S1473-3099(20)30257-7

Piroth, 2021, Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study, Lancet Respir Med, 9, 251, 10.1016/S2213-2600(20)30527-0

Docherty, 2020, Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study, BMJ, 369, m1985, 10.1136/bmj.m1985

Linschoten, 2020, Cardiac complications in patients hospitalised with COVID-19, Eur Heart J Acute Cardiovasc Care, 9, 817, 10.1177/2048872620974605

Yehia, 2020, Association of race with mortality among patients hospitalized with coronavirus disease 2019 (COVID-19) at 92 US Hospitals, JAMA Netw Open, 3, e2018039, 10.1001/jamanetworkopen.2020.18039

Fried, 2021, Patient characteristics and outcomes of 11,721 patients with COVID19 hospitalized across the United States, Clin Infect Dis, 72, e558, 10.1093/cid/ciaa1268

Williamson, 2020, Factors associated with COVID-19-related death using OpenSAFELY, Nature, 584, 430, 10.1038/s41586-020-2521-4

Wu, 2020, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, JAMA, 323, 1239, 10.1001/jama.2020.2648

Weng, 2019, National retrospective cohort study to identify age-specific fatality risks of comorbidities among hospitalised patients with influenza-like illness in Taiwan, BMJ Open, 9, e025276, 10.1136/bmjopen-2018-025276

Mertz, 2013, Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis, BMJ, 347, f5061, 10.1136/bmj.f5061

Siropaides, 2020, Crucial conversations with patients in the era of COVID-19, Circulation, 142, 191, 10.1161/CIRCULATIONAHA.120.047374

Mafham, 2020, COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England, Lancet, 396, 381, 10.1016/S0140-6736(20)31356-8

Linschoten, 2020, CAPACITY-COVID: a European Registry to determine the role of cardiovascular disease in the COVID-19 pandemic, Eur Heart J, 41, 1795, 10.1093/eurheartj/ehaa280

ISARIC. COVID-19 CRF. Clinical Data Collection –, 2021

Caforio, 2013, Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases, Eur Heart J, 34, 2636, 10.1093/eurheartj/eht210

Adler, 2015, 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC). Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS), Eur Heart J, 36, 2921, 10.1093/eurheartj/ehv318

Habib, 2015, 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM), Eur Heart J, 36, 3075, 10.1093/eurheartj/ehv319

Roffi, 2016, 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC), Eur Heart J, 37, 267, 10.1093/eurheartj/ehv320

Buxton, 2006, ACC/AHA/HRS 2006 key data elements and definitions for electrophysiological studies and procedures: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (ACC/AHA/HRS Writing Committee to Develop Data Standards on Electrophysiology), J Am Coll Cardiol, 48, 2360, 10.1016/j.jacc.2006.09.020

Jakob, 2021, First results of the ‘Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS)’, Infection, 49, 63, 10.1007/s15010-020-01499-0

Jakob, 2020, Design and evaluation of a data anonymization pipeline to promote Open Science on COVID-19, Sci Data, 7, 435, 10.1038/s41597-020-00773-y

European Centre for Disease Prevention and Control, 2020

ISARIC Clinical Characterisation Group, 2021, COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study, Infection, 10.1007/s15010-021-01599-5

Michelen, 2020, Characterising long-term covid-19: a rapid living systematic review, medRxiv

Carfì, 2020, Persistent symptoms in patients after acute COVID-19, JAMA, 324, 603, 10.1001/jama.2020.12603

Goërtz, 2020, Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?, ERJ Open Res, 6, 00542, 10.1183/23120541.00542-2020

Puntmann, 2020, Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19), JAMA Cardiol, 5, 1265, 10.1001/jamacardio.2020.3557

Nicin, 2020, Cell type-specific expression of the putative SARS-CoV-2 receptor ACE2 in human hearts, Eur Heart J, 41, 1804, 10.1093/eurheartj/ehaa311

The Human Protein Atlas. ACE2, 2021

Richardson, 2020, Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area, JAMA, 323, 2052, 10.1001/jama.2020.6775

Lala, 2020, Prevalence and impact of myocardial injury in patients hospitalized with COVID-19 infection, J Am Coll Cardiol, 76, 533, 10.1016/j.jacc.2020.06.007

Halushka, 2021, Myocarditis is rare in COVID-19 autopsies: cardiovascular findings across 277 postmortem examinations, Cardiovasc Pathol, 50, 107300, 10.1016/j.carpath.2020.107300

Huang, 2020, Cardiac involvement in patients recovered from COVID-2019 identified using magnetic resonance imaging, JACC Cardiovasc Imaging, 13, 2330, 10.1016/j.jcmg.2020.05.004

Kotecha, 2021, Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance, Eur Heart J, 42, 1866, 10.1093/eurheartj/ehab075

Rajpal, 2021, Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19 infection, JAMA Cardiol, 6, 116

Klok, 2020, Incidence of thrombotic complications in critically ill ICU patients with COVID-19, Thromb Res, 191, 145, 10.1016/j.thromres.2020.04.013

Poissy, 2020, Pulmonary embolism in patients with COVID-19: awareness of an increased prevalence, Circulation, 142, 184, 10.1161/CIRCULATIONAHA.120.047430

Cuker, 2021, American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19, Blood Adv, 5, 872, 10.1182/bloodadvances.2020003763

Chalmers, 2021, Management of hospitalised adults with coronavirus disease 2019 (COVID-19): a European Respiratory Society living guideline, Eur Respir J, 57, 2100048, 10.1183/13993003.00048-2021

Alvarez-Garcia, 2020, Prognostic impact of prior heart failure in patients hospitalized with COVID-19, J Am Coll Cardiol, 76, 2334, 10.1016/j.jacc.2020.09.549

Tomasoni, 2020, Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. Results of the Cardio-COVID-Italy multicentre study, Eur J Heart Fail, 22, 2238, 10.1002/ejhf.2052

Petrilli, 2020, Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study, BMJ, 369, m1966, 10.1136/bmj.m1966

Störk, 2017, Epidemiology of heart failure in Germany: a retrospective database study, Clin Res Cardiol, 106, 913, 10.1007/s00392-017-1137-7

Ammar, 2007, Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community, Circulation, 115, 1563, 10.1161/CIRCULATIONAHA.106.666818

Thông tin
Thông tin xuất bản

European Heart Journal

Tập 43 Số 11

1104-1120

Thông tin tác giả