Infectious Disease

Virtually one in 4 hospitalized sufferers with HF, COVID-19, dies

January 15, 2021

2 min read

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Disclosure:
Solomon reports that he has received grants from Alnylam, Amgen, AstraZeneca, Bellrophon, Bayer, Bristol Myers Squibb, Celladon, Cytokinetics, Eidos, Gilead, GlaxoSmithKline, Ionis, Lone Star Heart, Mesoblast, MyoKardia, Neurotronik, NIH / NHLBI Respardia, Novartis, had received. Sanofi and Theracos. In the study you will find all relevant financial information from all other authors. The editorial authors do not report any relevant financial information.

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Patients with HF and COVID-19 were at high risk for complications. Almost one in four died while in hospital, researchers reported.

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“Patients with heart failure generally have lower reserves than people without severe cardiovascular disease and are at increased risk of many respiratory infections, including influenza.” Scott D.. Solomon, MD, Professor of medicine at Harvard Medical School and senior physician at Brigham and Women’s Hospital, Healio said. “In addition, patients with cardiovascular disease generally appear to be at greater risk of COVID-19-related complications.”

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Researchers rated the Premier Healthcare database to identify patients who had at least one HF hospital stay or two associated outpatient visits from 2019 to March 2020, who were then hospitalized from April to September 2020. In patients with HF who were hospitalized with COVID, predictors of in-hospital mortality have been identified -19. The researchers also compared this population to those who were hospitalized for other factors.

From April to September 2020, 132,312 patients with a history of HF were hospitalized, 23,843 with acute HF, 8,383 with COVID-19 and 100,068 for alternative reasons.

Mortality in hospital

COVID-19 hospital stays were associated with a higher likelihood of in-hospital mortality compared to acute HF hospital stays (24.2% versus 2.6%). The researchers observed the strongest associations in April 2020 (adjusted OR = 14.48; 95% CI, 12.25-17.12) compared to other months (aOR = 10.11; 95% CI, 8.95-11 , 42; P for interaction <0.001).

Male sex (aOR = 1.26; 95% CI, 1.13-1.4) and morbid obesity (aOR = 1.25; 95% CI, 1.07-1.46) were in patients with HF who hospitalized with COVID-19 was associated with a higher chance of hospital mortality. The age (aOR per 10 years = 1.35; 95% CI, 1.29-1.42) and admission at the onset of the pandemic (aOR range from May to September versus April 0.35 to 0.64) were also associated with hospital mortality of this population.

“The best way to avoid COVID-related side effects is to avoid contracting COVID. For heart failure patients, this means wearing religious masks and being extra careful with physical distancing, even with family members who do not live in their household, ”said Solomon. “Heart failure patients should be at the top of the list to get vaccines when they are available.”

Disproportionate load

According to an accompanying editorial, patients with HF hospitalized with COVID-19 were more likely to be Black and / or Spanish, which was consistent with previous evidence of the disproportionate burden of COVID-19 on traditionally underrepresented groups.

Ersilia M. DeFilippis

“The reasons for these obvious differences are complex and include high housing density, lower socio-economic status and, most importantly, poor access to health care due to structural inequalities in society.” Ersilia M. DeFilippis, MD, Cardiologist at Columbia University Irving Medical Center, and colleagues wrote. “Such patients are also heavily represented in the food service business and other classes of key workers, further increasing their risk of infection with COVID-19.”

To reduce the risk for patients with HF during COVID-19, DeFilippis and colleagues suggested focusing efforts on strategies to minimize inequalities, such as: B. Facilitate access to tests, facilitate contact tracing in densely populated communities, and provide spaces where families can be socially isolated in overcrowded housing.

“These results should remind us to be innovative and thoughtful in treating patients with HF while trying to maintain equity and health for all,” wrote DeFilippis and colleagues.

Reference:

For more informations:

Scott D. Solomon, MD, can be reached at ssolomon@bwh.harvard.edu.

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