In-hospital mortality risk high among patients with HF hospitalized with COVID-19
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Among patients hospitalized with COVID-19, in-hospital mortality risk was more substantial among those with HF history, according to new data published in Circulation: Heart Failure.
“According to the Centers for Disease Control and Prevention, factors associated with severe illness include heart conditions such as HF, coronary artery disease or cardiomyopathies,” Parag Goyal, MD, MSc, cardiovascular disease specialist in the department of medicine at Weill Cornell Medicine, and colleagues wrote. “While there are over 6 million people across the United States with HF, the characteristics of adults with HF hospitalized with COVID-19 and their outcomes have not been well elucidated.”
Researchers evaluated 8,920 adults hospitalized with COVID-19 (mean age, 61 years; 56% men) from January to July 2020 at one of 88 U.S. centers that participated in the American Heart Association’s COVID-19 Cardiovascular Disease registry. To assess associations between HF history and in-hospital mortality, researchers obtained sociodemographic and comorbid condition data and examined HF subtypes based on left ventricular ejection fraction in the past year.
In the cohort, 1.1% of patients had a history of HF. In-hospital mortality occurred in 31.6% of patients with a history of HF and 16.9% of patients without HF. HF history was associated with increased risk for in-hospital mortality in the fully adjusted model (RR = 1.16; 95% CI, 1.03-1.3).
Among the 335 patients with HF who had LVEF documented, 30.7% had HF with reduced ejection fraction, 14.3% had HF with midrange EF and 54.9% had HF with preserved EF. In-hospital mortality rates were 35% for those with HFrEF, 27.1% for this with HF with midrange EF and 30.4% for those with HFpEF. In a fully adjusted model, HFrEF was significantly associated with increased risk for in-hospital mortality (RR = 1.4; 95% CI, 1.1-1.79), but the same was not true for HF with midrange EF and HFpEF.
In addition, adults aged at least 65 years were found to have higher vulnerability for in-hospital mortality (RR = 1.17; 95% CI, 1.04-1.32) compared with adults younger than 65 years (RR = 1.11; 95% CI, 0.81-1.52; P for interaction < .01).
“Our study showed that in-hospital mortality for adults with a history of HF exceeded 30%, which was almost double the in-hospital mortality for adults without HF,” the researchers wrote. “Much of this risk was attributable to sociodemographic and comorbid conditions.”
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