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Underlying heart diseases and acute COVID-19 outcomes | Núñez-Gil | Cardiology Journal

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Original Article
Published online: 2020-12-17
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Underlying heart diseases and acute COVID-19 outcomes

Iván Javier 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
DOI: 10.5603/CJ.a2020.0183
·
Pubmed: 33346365

open access

Ahead of print
Original articles
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 short-term 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, SIRS 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. 

Trial Numbers: NCT04334291/ EUPAS34399

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 short-term 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, SIRS 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. 

Trial Numbers: NCT04334291/ EUPAS34399

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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

Ahead of print

Article type

Original Article

Published online

2020-12-17

DOI

10.5603/CJ.a2020.0183

Pubmed

33346365

Keywords

COVID-19
mortality
cardiology
registry
prognosis
heart disease

Authors

Iván Javier 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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