Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19

Aims Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID‐19). This prospective international multicentre study investigates the role of pre‐existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID‐19. Metho...

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Published in:ESC Heart Failure 2022-06, Vol.9 (3), p.1756-1765
Main Authors: Bruno, Raphael Romano, Wernly, Bernhard, Wolff, Georg, Fjølner, Jesper, Artigas, Antonio, Bollen Pinto, Bernardo, Schefold, Joerg C., Kindgen‐Milles, Detlef, Baldia, Philipp Heinrich, Kelm, Malte, Beil, Michael, Sviri, Sigal, Heerden, Peter Vernon, Szczeklik, Wojciech, Topeli, Arzu, Elhadi, Muhammed, Joannidis, Michael, Oeyen, Sandra, Kondili, Eumorfia, Marsh, Brian, Andersen, Finn H., Moreno, Rui, Leaver, Susannah, Boumendil, Ariane, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Jung, Christian
Format: Article
Language:English
Subjects:
Cardiovascular disease
Chronic Disease
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
Critical Care
Critical Illness
Elderly
Heart failure
Heart Failure - complications
Heart Failure - epidemiology
Hospitalization
Humans
Mortality
Original
Prognosis
Prospective Studies
Stroke Volume
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cites cdi_FETCH-LOGICAL-c5354-394181a9c4ae461af3b636e2491f5cad219c89fc6ed05979cfd4d422979d7fb3
container_end_page 1765
container_issue 3
container_start_page 1756
container_title ESC Heart Failure
container_volume 9
creator Bruno, Raphael Romano
Wernly, Bernhard
Wolff, Georg
Fjølner, Jesper
Artigas, Antonio
Bollen Pinto, Bernardo
Schefold, Joerg C.
Kindgen‐Milles, Detlef
Baldia, Philipp Heinrich
Kelm, Malte
Beil, Michael
Sviri, Sigal
Heerden, Peter Vernon
Szczeklik, Wojciech
Topeli, Arzu
Elhadi, Muhammed
Joannidis, Michael
Oeyen, Sandra
Kondili, Eumorfia
Marsh, Brian
Andersen, Finn H.
Moreno, Rui
Leaver, Susannah
Boumendil, Ariane
De Lange, Dylan W.
Guidet, Bertrand
Flaatten, Hans
Jung, Christian
description Aims Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID‐19). This prospective international multicentre study investigates the role of pre‐existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID‐19. Methods and results Patients with pre‐existing CHF were subclassified as having ischaemic or non‐ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre‐existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P 
doi_str_mv 10.1002/ehf2.13854
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This prospective international multicentre study investigates the role of pre‐existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID‐19. Methods and results Patients with pre‐existing CHF were subclassified as having ischaemic or non‐ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre‐existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P &lt; 0.001; odds ratio 1.87, 95% confidence interval (CI) 1.5–2.3] and 3 month mortality (69% vs. 56%, P &lt; 0.001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1.2, 95% CI 0.5–1.5; P = 0.137]. More patients suffered from pre‐existing ischaemic than from non‐ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non‐ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0.042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0.98, 95% CI 0.9–1.0; P = 0.128). Conclusions In critically ill older COVID‐19 patients, pre‐existing CHF was not independently associated with 30 day mortality. Trial registration number: NCT04321265.</description><identifier>ISSN: 2055-5822</identifier><identifier>EISSN: 2055-5822</identifier><identifier>DOI: 10.1002/ehf2.13854</identifier><identifier>PMID: 35274490</identifier><language>eng</language><publisher>England: John Wiley &amp; Sons, Inc</publisher><subject>Cardiovascular disease ; Chronic Disease ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - epidemiology ; Critical Care ; Critical Illness ; Elderly ; Heart failure ; Heart Failure - complications ; Heart Failure - epidemiology ; Hospitalization ; Humans ; Mortality ; Original ; Prognosis ; Prospective Studies ; Stroke Volume</subject><ispartof>ESC Heart Failure, 2022-06, Vol.9 (3), p.1756-1765</ispartof><rights>2022 The Authors. ESC Heart Failure published by John Wiley &amp; Sons Ltd on behalf of European Society of Cardiology.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c5354-394181a9c4ae461af3b636e2491f5cad219c89fc6ed05979cfd4d422979d7fb3</cites><orcidid>0000-0003-3776-3530 ; 0000-0001-8325-250X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2659003503/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2659003503?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,11542,25732,27903,27904,36991,36992,38495,43874,44569,46030,46454,53769,53771,74158,74872</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35274490$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bruno, Raphael Romano</creatorcontrib><creatorcontrib>Wernly, Bernhard</creatorcontrib><creatorcontrib>Wolff, Georg</creatorcontrib><creatorcontrib>Fjølner, Jesper</creatorcontrib><creatorcontrib>Artigas, Antonio</creatorcontrib><creatorcontrib>Bollen Pinto, Bernardo</creatorcontrib><creatorcontrib>Schefold, Joerg C.</creatorcontrib><creatorcontrib>Kindgen‐Milles, Detlef</creatorcontrib><creatorcontrib>Baldia, Philipp Heinrich</creatorcontrib><creatorcontrib>Kelm, Malte</creatorcontrib><creatorcontrib>Beil, Michael</creatorcontrib><creatorcontrib>Sviri, Sigal</creatorcontrib><creatorcontrib>Heerden, Peter Vernon</creatorcontrib><creatorcontrib>Szczeklik, Wojciech</creatorcontrib><creatorcontrib>Topeli, Arzu</creatorcontrib><creatorcontrib>Elhadi, Muhammed</creatorcontrib><creatorcontrib>Joannidis, Michael</creatorcontrib><creatorcontrib>Oeyen, Sandra</creatorcontrib><creatorcontrib>Kondili, Eumorfia</creatorcontrib><creatorcontrib>Marsh, Brian</creatorcontrib><creatorcontrib>Andersen, Finn H.</creatorcontrib><creatorcontrib>Moreno, Rui</creatorcontrib><creatorcontrib>Leaver, Susannah</creatorcontrib><creatorcontrib>Boumendil, Ariane</creatorcontrib><creatorcontrib>De Lange, Dylan W.</creatorcontrib><creatorcontrib>Guidet, Bertrand</creatorcontrib><creatorcontrib>Flaatten, Hans</creatorcontrib><creatorcontrib>Jung, Christian</creatorcontrib><creatorcontrib>COVIP study group</creatorcontrib><title>Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19</title><title>ESC Heart Failure</title><addtitle>ESC Heart Fail</addtitle><description>Aims Chronic heart failure (CHF) is a major risk factor for mortality in coronavirus disease 2019 (COVID‐19). This prospective international multicentre study investigates the role of pre‐existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID‐19. Methods and results Patients with pre‐existing CHF were subclassified as having ischaemic or non‐ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre‐existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P &lt; 0.001; odds ratio 1.87, 95% confidence interval (CI) 1.5–2.3] and 3 month mortality (69% vs. 56%, P &lt; 0.001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1.2, 95% CI 0.5–1.5; P = 0.137]. More patients suffered from pre‐existing ischaemic than from non‐ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non‐ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0.042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0.98, 95% CI 0.9–1.0; P = 0.128). Conclusions In critically ill older COVID‐19 patients, pre‐existing CHF was not independently associated with 30 day mortality. 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Wernly, Bernhard ; Wolff, Georg ; Fjølner, Jesper ; Artigas, Antonio ; Bollen Pinto, Bernardo ; Schefold, Joerg C. ; Kindgen‐Milles, Detlef ; Baldia, Philipp Heinrich ; Kelm, Malte ; Beil, Michael ; Sviri, Sigal ; Heerden, Peter Vernon ; Szczeklik, Wojciech ; Topeli, Arzu ; Elhadi, Muhammed ; Joannidis, Michael ; Oeyen, Sandra ; Kondili, Eumorfia ; Marsh, Brian ; Andersen, Finn H. ; Moreno, Rui ; Leaver, Susannah ; Boumendil, Ariane ; De Lange, Dylan W. ; Guidet, Bertrand ; Flaatten, Hans ; Jung, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5354-394181a9c4ae461af3b636e2491f5cad219c89fc6ed05979cfd4d422979d7fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cardiovascular disease</topic><topic>Chronic Disease</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - epidemiology</topic><topic>Critical Care</topic><topic>Critical Illness</topic><topic>Elderly</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - epidemiology</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Mortality</topic><topic>Original</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Stroke Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bruno, Raphael Romano</creatorcontrib><creatorcontrib>Wernly, Bernhard</creatorcontrib><creatorcontrib>Wolff, Georg</creatorcontrib><creatorcontrib>Fjølner, Jesper</creatorcontrib><creatorcontrib>Artigas, Antonio</creatorcontrib><creatorcontrib>Bollen Pinto, Bernardo</creatorcontrib><creatorcontrib>Schefold, Joerg C.</creatorcontrib><creatorcontrib>Kindgen‐Milles, Detlef</creatorcontrib><creatorcontrib>Baldia, Philipp Heinrich</creatorcontrib><creatorcontrib>Kelm, Malte</creatorcontrib><creatorcontrib>Beil, Michael</creatorcontrib><creatorcontrib>Sviri, Sigal</creatorcontrib><creatorcontrib>Heerden, Peter Vernon</creatorcontrib><creatorcontrib>Szczeklik, Wojciech</creatorcontrib><creatorcontrib>Topeli, Arzu</creatorcontrib><creatorcontrib>Elhadi, Muhammed</creatorcontrib><creatorcontrib>Joannidis, Michael</creatorcontrib><creatorcontrib>Oeyen, Sandra</creatorcontrib><creatorcontrib>Kondili, Eumorfia</creatorcontrib><creatorcontrib>Marsh, Brian</creatorcontrib><creatorcontrib>Andersen, Finn H.</creatorcontrib><creatorcontrib>Moreno, Rui</creatorcontrib><creatorcontrib>Leaver, Susannah</creatorcontrib><creatorcontrib>Boumendil, Ariane</creatorcontrib><creatorcontrib>De Lange, Dylan W.</creatorcontrib><creatorcontrib>Guidet, Bertrand</creatorcontrib><creatorcontrib>Flaatten, Hans</creatorcontrib><creatorcontrib>Jung, Christian</creatorcontrib><creatorcontrib>COVIP study group</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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This prospective international multicentre study investigates the role of pre‐existing CHF on clinical outcomes of critically ill old (≥70 years) intensive care patients with COVID‐19. Methods and results Patients with pre‐existing CHF were subclassified as having ischaemic or non‐ischaemic cardiac disease; patients with a documented ejection fraction (EF) were subclassified according to heart failure EF: reduced (HFrEF, n = 132), mild (HFmrEF, n = 91), or preserved (HFpEF, n = 103). Associations of heart failure characteristics with the 30 day mortality were analysed in univariate and multivariate logistic regression analyses. Pre‐existing CHF was reported in 566 of 3917 patients (14%). Patients with CHF were older, frailer, and had significantly higher SOFA scores on admission. CHF patients showed significantly higher crude 30 day mortality [60% vs. 48%, P &lt; 0.001; odds ratio 1.87, 95% confidence interval (CI) 1.5–2.3] and 3 month mortality (69% vs. 56%, P &lt; 0.001). After multivariate adjustment for confounders (SOFA, age, sex, and frailty), no independent association of CHF with mortality remained [adjusted odds ratio (aOR) 1.2, 95% CI 0.5–1.5; P = 0.137]. More patients suffered from pre‐existing ischaemic than from non‐ischaemic disease [233 vs. 328 patients (n = 5 unknown aetiology)]. There were no differences in baseline characteristics between ischaemic and non‐ischaemic disease or between HFrEF, HFmrEF, and HFpEF. Crude 30 day mortality was significantly higher in HFrEF compared with HFpEF (64% vs. 48%, P = 0.042). EF as a continuous variable was not independently associated with 30 day mortality (aOR 0.98, 95% CI 0.9–1.0; P = 0.128). Conclusions In critically ill older COVID‐19 patients, pre‐existing CHF was not independently associated with 30 day mortality. Trial registration number: NCT04321265.</abstract><cop>England</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>35274490</pmid><doi>10.1002/ehf2.13854</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3776-3530</orcidid><orcidid>https://orcid.org/0000-0001-8325-250X</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 2055-5822
ispartof ESC Heart Failure, 2022-06, Vol.9 (3), p.1756-1765
issn 2055-5822
2055-5822
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_186d2796dc964a2498683610b042eb25
source Open Access: Wiley-Blackwell Open Access Journals; Publicly Available Content Database; PubMed Central; Coronavirus Research Database
subjects Cardiovascular disease
Chronic Disease
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
Critical Care
Critical Illness
Elderly
Heart failure
Heart Failure - complications
Heart Failure - epidemiology
Hospitalization
Humans
Mortality
Original
Prognosis
Prospective Studies
Stroke Volume
title Association of chronic heart failure with mortality in old intensive care patients suffering from Covid‐19
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