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Because of the lack of data on characteristics and outcomes in patients with COVID-19 with preexisting heart failure (HF), this retrospective cohort study used electronic health records from a New York City hospital system to analyze and compare data from 422 patients with HF and 6017 patients without HF. Eligible patients were adults who were hospitalized for laboratory-confirmed COVID-19. Length of hospital stay was significantly longer for patients with previous HF (8 days) compared with patients with no history of HF (6 days). Compared with other patients, individuals with a history of HF had a higher risk of mortality and of requiring mechanical ventilation. No differences were found within the HF group based on LVEF or use of RAS inhibitors.
These data indicate that patients with a history of HF are at elevated risk of adverse outcomes regardless of LVEF, suggesting that they may require more aggressive therapies and that further research is needed to develop recommendations to aid in their management.
This abstract is available on the publisher's site.
Patients with pre-existing heart failure (HF) are likely at higher risk for adverse outcomes in coronavirus disease-2019 (COVID-19), but data on this population are sparse.
This study described the clinical profile and associated outcomes among patients with HF hospitalized with COVID-19.
This study conducted a retrospective analysis of 6,439 patients admitted for COVID-19 at 1 of 5 Mount Sinai Health System hospitals in New York City between February 27 and June 26, 2020. Clinical characteristics and outcomes (length of stay, need for intensive care unit, mechanical ventilation, and in-hospital mortality) were captured from electronic health records. For patients identified as having a history of HF by International Classification of Diseases-9th and/or 10th Revisions codes, manual chart abstraction informed etiology, functional class, and left ventricular ejection fraction (LVEF).
Mean age was 63.5 years, and 45% were women. Compared with patients without HF, those with previous HF experienced longer length of stay (8 days vs. 6 days; p < 0.001), increased risk of mechanical ventilation (22.8% vs. 11.9%; adjusted odds ratio: 3.64; 95% confidence interval: 2.56 to 5.16; p < 0.001), and mortality (40.0% vs. 24.9%; adjusted odds ratio: 1.88; 95% confidence interval: 1.27 to 2.78; p = 0.002). Outcomes among patients with HF were similar, regardless of LVEF or renin-angiotensin-aldosterone inhibitor use.
History of HF was associated with higher risk of mechanical ventilation and mortality among patients hospitalized for COVID-19, regardless of LVEF.