cardiology today, 7th Jan 2023, Adapted from Arutyunov GP, et al. ESC Heart Fail. 2022; doi:10.1002/ehf2.14243.
Hospitalized patients with COVID-19 who have a history of chronic HF are at an increased risk for all-cause mortality, according to a study published in ESC Heart Failure.
“Advanced chronic HF (NYHA classes III and IV) is the strongest risk predictor of fatal outcome for COVID-19, and its negative impact on prognosis extends into the early post-hospitalization period, when COVID-19 patients with chronic HF feel worse than those without it, are more likely to seek unplanned medical care, and are more likely to develop de novo disease,” Gregory P. Arutyunov, MD, DSc, RAS, head of the department of internal diseases at Pirogov Russian National Research Medical University in Russia and colleagues wrote. “This suggests the need to develop optimal rehabilitation regimens and a multidisciplinary approach to the management of patients with chronic HF following COVID-19 infection.”
Hospitalized patients with COVID-19 who have a history of chronic HF are at an increased risk for all-cause mortality.
To observe the relationship between all-cause mortality rates and chronic HF history in patients hospitalized with COVID-19, Arutyunov and colleagues analyzed 5,616 patients aged 18 years or older (16.3% with chronic HF) hospitalized with COVID-19 in the Analysis of Comorbid Disease Dynamics in Patients with SARS-CoV-2 Infection (ACTIV) international registry. Patients were divided into two groups based on whether they had a history of chronic HF. All-cause mortality rates were collected in-hospital, as well as after 3 and 6 months of follow-up.
Researchers found that in-hospital mortality was higher in patients with a history of chronic HF than in those without a history of chronic HF (OR = 4.614; 95% CI, 3.633-5.859; P < .001). In-hospital all-cause mortality risk was higher in patients with more severe chronic HF, with patients in NYHA functional classes III and IV (OR vs. no chronic HF = 6.124; 95% CI, 4.538-8.266; P < .001) having higher risks than patients in functional classes I and II (OR vs. no chronic HF = 2.446; 95% CI, 1.831-3.267; P < .001). All-cause mortality risk was also higher in patients with ischemic chronic HF than in patients with nonischemic chronic HF (OR = 1.58; 95% CI, 1.05-2.45; P < .03). In addition, the increased all-cause mortality risk for patients with a history of chronic HF remained after 3 and 6 months of follow-up, according to researchers. “This detrimental interplay of chronic HF and COVID-19 requires careful monitoring, as there is a high likelihood of an increased burden of chronic HF and a change in the course of this condition due to COVID-19 infection,” Arutyunov and colleagues wrote. “Patients with chronic HF should be a priority group in national or population-wide vaccination programs.”
