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open access

Vol 28, No 2 (2021)
Original Article
Submitted: 2020-07-26
Accepted: 2020-11-09
Published online: 2020-12-17
View PDF Download PDF file Supp./Additional Files [1]
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Underlying heart diseases and acute COVID-19 outcomes

Iván J. Núñez-Gil1, Antonio Fernández-Ortiz1, Charbel Maroud Eid2, Jia Huang3, Rodolfo Romero4, Victor Manuel Becerra-Muñoz5, Aitor Uribarri6, Gisela Feltes7, Daniela Trabatoni8, Inmaculada Fernandez-Rozas9, Maria C. Viana-Llamas10, Martino Pepe11, Enrico Cerrato12, Maurizio Bertaina13, Thamar Capel Astrua14, Emilio Alfonso15, Alex F. Castro-Mejía16, Sergio Raposeiras-Roubin17, Fabrizio D'Ascenzo18, Carolina Espejo Paeres19, Jaime Signes-Costa20, Alfredo Bardaji21, Cristina Fernandez-Pérez1, Francisco Marin22, Oscar Fabregat-Andres23, Ibrahim Akin24, Vicente Estrada1, Carlos Macaya1
DOI: 10.5603/CJ.a2020.0183
·
Pubmed: 33346365
·
Cardiol J 2021;28(2):202-214.
Affiliations
  1. Hospital Clinico San Carlos, Prof Martin Lagos, sn, 28040 Madrid, Spain
  2. H La Paz, Madrid, Spain.
  3. The Second People's Hospital of Shenzhen, Shenzhen, China
  4. Hospital Universitario Getafe, Madrid, Spain
  5. Unidad de Gestión Clínica Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Málaga, Spain
  6. Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  7. Hospital Nuestra Señora de América
  8. Centro Cardiologico Monzino, IRCCS, Milano, Italy.
  9. Hospital Severo Ochoa, Leganés, Spain
  10. Hospital Universitario Guadalajara, Guadalajara, Spain
  11. Azienda ospedaliero-universitaria consorziale policlinico di Bari
  12. San Luigi Gonzaga University Hospital, Rivoli, Turin. Italy
  13. Martini Hospital,via Tofane, Turin. Italy.
  14. Hospital Virgen del Mar, Madrid, Spain
  15. Instituto de Cardiología y Cirugía Cardiovascular, Havana, Cuba.
  16. Hospital General del norte de Guayaquil IESS Los Ceibos
  17. University Hospital Álvaro Cunqueiro, Vigo. Spain
  18. San Giovanni Battista
  19. H Principe Asturias, Alcalá de Henares, Spain
  20. Hospital Clínico Universitario, Incliva, Universidad de Valencia, Valencia, Spain
  21. University Hospital Joan XXIII. Tarragona. Spain
  22. Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, CIBERCV, Murcia, Spain
  23. Hospital IMED, Valencia, Spain
  24. First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany

open access

Vol 28, No 2 (2021)
Original articles — COVID-19
Submitted: 2020-07-26
Accepted: 2020-11-09
Published online: 2020-12-17

Abstract

Background: The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19).


Methods: The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive.

Results: HOPE enrolled 2798 patients from 35 centers in 7 countries. Median age was 67 years (IQR: 53.0–78.0), and most were male (59.5%). A relevant heart disease was present in 682 (24%) cases. These were older, more frequently male, with higher overall burden of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, smoking habit, obesity) and other comorbidities such renal failure, lung, cerebrovascular disease and oncologic antecedents (p < 0.01, for all). The heart cohort received more corticoids (28.9% vs. 20.4%, p < 0.001), antibiotics, but less hydroxychloroquine, antivirals or tocilizumab. Considering the epidemiologic profile, a previous heart condition was independently related with shortterm mortality in the Cox multivariate analysis (1.62; 95% CI 1.29–2.03; p < 0.001). Moreover, heart patients needed more respiratory, circulatory support, and presented more in-hospital events, such heart failure, renal failure, respiratory insufficiency, sepsis, systemic infammatory response syndrome and clinically relevant bleedings (all, p < 0.001), and mortality (39.7% vs. 15.5%; p < 0.001).

Conclusions: An underlying heart disease is an adverse prognostic factor for patients suffering COVID-19. Its presence could be related with different clinical drug management and would benefit from maintaining treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers during in-hospital stay.

Abstract

Background: The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19).


Methods: The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive.

Results: HOPE enrolled 2798 patients from 35 centers in 7 countries. Median age was 67 years (IQR: 53.0–78.0), and most were male (59.5%). A relevant heart disease was present in 682 (24%) cases. These were older, more frequently male, with higher overall burden of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, smoking habit, obesity) and other comorbidities such renal failure, lung, cerebrovascular disease and oncologic antecedents (p < 0.01, for all). The heart cohort received more corticoids (28.9% vs. 20.4%, p < 0.001), antibiotics, but less hydroxychloroquine, antivirals or tocilizumab. Considering the epidemiologic profile, a previous heart condition was independently related with shortterm mortality in the Cox multivariate analysis (1.62; 95% CI 1.29–2.03; p < 0.001). Moreover, heart patients needed more respiratory, circulatory support, and presented more in-hospital events, such heart failure, renal failure, respiratory insufficiency, sepsis, systemic infammatory response syndrome and clinically relevant bleedings (all, p < 0.001), and mortality (39.7% vs. 15.5%; p < 0.001).

Conclusions: An underlying heart disease is an adverse prognostic factor for patients suffering COVID-19. Its presence could be related with different clinical drug management and would benefit from maintaining treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers during in-hospital stay.

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Keywords

COVID-19, mortality, cardiology, registry, prognosis, heart disease

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About this article
Title

Underlying heart diseases and acute COVID-19 outcomes

Journal

Cardiology Journal

Issue

Vol 28, No 2 (2021)

Article type

Original Article

Pages

202-214

Published online

2020-12-17

Page views

3094

Article views/downloads

2160

DOI

10.5603/CJ.a2020.0183

Pubmed

33346365

Bibliographic record

Cardiol J 2021;28(2):202-214.

Keywords

COVID-19
mortality
cardiology
registry
prognosis
heart disease

Authors

Iván J. Núñez-Gil
Antonio Fernández-Ortiz
Charbel Maroud Eid
Jia Huang
Rodolfo Romero
Victor Manuel Becerra-Muñoz
Aitor Uribarri
Gisela Feltes
Daniela Trabatoni
Inmaculada Fernandez-Rozas
Maria C. Viana-Llamas
Martino Pepe
Enrico Cerrato
Maurizio Bertaina
Thamar Capel Astrua
Emilio Alfonso
Alex F. Castro-Mejía
Sergio Raposeiras-Roubin
Fabrizio D'Ascenzo
Carolina Espejo Paeres
Jaime Signes-Costa
Alfredo Bardaji
Cristina Fernandez-Pérez
Francisco Marin
Oscar Fabregat-Andres
Ibrahim Akin
Vicente Estrada
Carlos Macaya

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