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Original article
DOI: 10.1016/j.rceng.2021.06.004
Available online 8 October 2021
Clinical characteristics and risk factors for mortality upon admission in patients with heart failure hospitalized due to COVID-19 in Spain
Características clínicas y factores de riesgo de mortalidad al ingreso en pacientes con insuficiencia cardíaca hospitalizados por COVID-19 en España
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A. Salinas-Botrána,
Corresponding author
asalinasbotran@yahoo.es

Corresponding authors.
, J. Sanz-Cánovasb, J. Pérez-Somarribaa, L.M. Pérez-Belmonteb,
Corresponding author
luismiguelpb1984@gmail.com

Corresponding authors.
, L. Cobos-Palaciosb, M. Rubio-Rivasc, S. de-Cossío-Tejidod, J.M. Ramos-Rincóne, M. Méndez-Bailóna,1, R. Gómez-Huelgasb,1, on behalf of the SEMI-COVID-19 group 2
a Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
b Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
c Servicio de Medicina Interna, Hospital Universitario Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
d Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain
e Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Alicante, Spain
Received 27 March 2021. Accepted 17 June 2021
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Figures (1)
Tables (3)
Table 1. Clinical characteristics, presentation, and laboratory and radiology data for patients with heart failure hospitalised for COVID-19.
Table 2. Treatments and in-hospital complications of patients with heart failure hospitalised for COVID-19.
Table 3. Risk factors at admission associated with in-hospital mortality of patients with heart failure hospitalised due to COVID-19. Multiple regression analysis.
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Abstract
Background

There are few studies on patients with heart failure (HF) hospitalized for COVID-19. Our aim is to describe the clinical characteristics of patients with HF hospitalized for COVID-19 and identify risk factors for in-hospital mortality upon admission.

Methods

We conducted a retrospective, multicenter study in patients with HF hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). A multivariate logistic regression analysis was performed to identify admission factors associated with in-hospital mortality.

Results

A total of 1718 patients were analyzed (56.5% men; median age 81.4 years). The overall case fatality rate was 47.6% (n = 819). The independent risk factors at admission for in-hospital mortality were: age (adjusted odds ratio [AOR]: 1.03; 95% confidence interval [95%CI]: 1.02–1.05; p < 0.001); severe dependence (AOR: 1.62; 95%CI: 1.19–2.20; p = 0.002); tachycardia (AOR: 1.01; 95%CI: 1.00–1.01; p = 0.004); and high C-reactive protein (AOR: 1.004; 95%CI:1.002−1.004; p < 0.001), LDH (AOR: 1.001; 95%CI: 1.001−1.002; p < 0.001), and serum creatinine levels (AOR: 1.35; 95%CI: 1.18−1.54; p < 0.001).

Conclusions

Patients with HF hospitalized for COVID-19 have a high in-hospital mortality rate. Some simple clinical and laboratory tests can help to identify patients with a worse prognosis.

Keywords:
Heart failure
Coronavirus disease-2019
Hospitalization
Risk factor
Mortality
Resumen
Introducción

Existen pocos estudios sobre pacientes con insuficiencia cardíaca (IC) ingresados por COVID-19. Nuestro objetivo es describir las características clínicas de los pacientes con IC ingresados por COVID-19 e identificar los factores de riesgo al ingreso de mortalidad intrahospitalaria.

Material y métodos

Estudio retrospectivo y multicéntrico de pacientes con IC ingresados por COVID-19 en 150 hospitales españoles (Registro SEMI-COVID-19). Se realizó un análisis de regresión logística para identificar los factores de riesgo al ingreso asociados a la mortalidad.

Resultados

Se analizaron 1.718 pacientes (56,5% varones; edad mediana 81,4 años). La tasa de mortalidad global fue del 47,6% (n = 819). Los factores de riesgo independientes al ingreso para mortalidad fueron: la edad (odds ratio ajustado [ORA]: 1,03; intervalo de confianza 95% [IC95%]: 1,02–1,05; p < 0,001), la dependencia severa (ORA: 1,62; IC95%: 1,19–2,20; p = 0,002), la taquicardia (ORA: 1,01; IC95%: 1,00–1,01; p = 0,004), la proteína C reactiva (ORA: 1,004; IC95%:1,002–1,004; p < 0,001), la LDH (ORA: 1,001; IC95%: 1,001–1,002; p < 0,001) y la creatinina sérica (ORA: 1,35; IC95%: 1,18–1,54; p < 0,001).

Conclusiones

Los pacientes con IC hospitalizados por COVID-19 tienen una alta mortalidad intrahospitalaria. Existen factores clínico-analíticos simples que pueden ayudar a identificar a los pacientes con peor pronóstico.

Palabras clave:
Insuficiencia cardíaca
Enfermedad por coronavirus-2019
Hospitalización
Factor de riesgo
Mortalidad

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