Clinical characteristics and risk factors for mortality upon admission in patients with heart failure hospitalized due to COVID-19 in Spain

Rev Clin Esp (Barc). 2022 May;222(5):255-265. doi: 10.1016/j.rceng.2021.06.004. Epub 2021 Oct 8.

Abstract
in English, Spanish

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.

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.

Keywords: Coronavirus disease-2019; Enfermedad por coronavirus-2019; Factor de riesgo; Heart failure; Hospitalización; Hospitalization; Insuficiencia cardíaca; Mortalidad; Mortality; Risk factor.

Publication types

  • Multicenter Study

MeSH terms

  • Aged, 80 and over
  • COVID-19* / complications
  • Female
  • Heart Failure* / epidemiology
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Spain / epidemiology