Otwarty dostęp

Acute Decompensated Heart Failure in Patients With and Without COVID-19 — The Experience of a Romanian Center

Ana-Maria Vintilă
Ana-Maria Vintilă
, 
Mihaela Horumbă
Mihaela Horumbă
, 
Paul Miron
Paul Miron
, 
Răzvan Balan
Răzvan Balan
, 
Maria-Beatrice Catrangiu
Maria-Beatrice Catrangiu
, 
Iris-Andreea Negoescu
Iris-Andreea Negoescu
, 
Iuliana Trifan
Iuliana Trifan
, 
Vlad-Damian Vintilă
Vlad-Damian Vintilă
, 
Adriana Gurghean
Adriana Gurghean
 oraz 
Ilinca Săvulescu-Fiedler
Ilinca Săvulescu-Fiedler
   | 11 lis 2022
Romanian Journal of Cardiology's Cover Image
O artykule
Poprzedni artykuł
Następny artykuł
Zacytuj
Article Category: Original Article
Data publikacji: 11 lis 2022
Zakres stron: 149 - 155
DOI: https://doi.org/10.2478/rjc-2022-0024
Słowa kluczowe
© 2022 Ana-Maria Vintilă et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Relationship between COVID-19 vaccination status, rate of ICU admission during hospitalization, and mortality (in-hospital and at follow-up) viewed comparatively according to COVID-19 status
Relationship between COVID-19 vaccination status, rate of ICU admission during hospitalization, and mortality (in-hospital and at follow-up) viewed comparatively according to COVID-19 status

Figure 2

Heart failure patients included in the analysis were divided by phenotype (HFpEF and non-HFpEF). The figure above shows the percentage of COVID-19 positive patients among each phenotype – non-HFpEF patients were more likely to be admitted for heart failure symptoms, whereas HFpEF patients were more likely to be admitted for COVID-19 symptomsAbbreviations: HFpEF – heart failure with preserved ejection fractions; non-HFpEF – pooled data on patients with heart failure with mildly reduced and reduced ejection fractions
Heart failure patients included in the analysis were divided by phenotype (HFpEF and non-HFpEF). The figure above shows the percentage of COVID-19 positive patients among each phenotype – non-HFpEF patients were more likely to be admitted for heart failure symptoms, whereas HFpEF patients were more likely to be admitted for COVID-19 symptomsAbbreviations: HFpEF – heart failure with preserved ejection fractions; non-HFpEF – pooled data on patients with heart failure with mildly reduced and reduced ejection fractions

Figure 3

Comorbidity frequency in our heart failure patients grouped by COVID-19 status. Abbreviations: HTN – arterial hypertension; T2DM – type 2 diabetes mellitus; CKD – chronic kidney disease (G4 and lower); AF – atrial fibrillation/flutter; CAD – coronary artery disease
Comorbidity frequency in our heart failure patients grouped by COVID-19 status. Abbreviations: HTN – arterial hypertension; T2DM – type 2 diabetes mellitus; CKD – chronic kidney disease (G4 and lower); AF – atrial fibrillation/flutter; CAD – coronary artery disease

Laboratory assay values (at admission) reported for COVID-19 positive patients compared to COVID-19 negative patientsa,b

Laboratory test References COVID (+) COVID (−) p-value
WBC (×103/μl) 4–11 9.38 7.70 0.098
HGB (g/dl) 12.0–15.0 12.8 12.3 0.639
PLT (×103/μl) 150–400 243 231 0.866
Neutrophils (×103/μl) 2.2–5 7.17 5.87 0.052
Lymphocytes (×103/μl) 1.3–3.0 1.13 1.10 0.842
Glucose (mg/dl) 74–106 125 120 0.261
Urea (mg/dl) 15–36 57.6 53.5 0.577
Creatinine (mg/dl) 0.6–1.2 1.09 1.05 0.218
eGFR (ml/min/1.73m2) > 60 60.9 62.2 0.446
Uric acid (mg/dl) 3.1–7.8 5.45 7.8 0.120
Na (mmol/l) 137–145 139.6 138.5 0.882
K (mmol/l) 3.6–5 4.12 4.55 0.195
AST (U/L) 14–36 34 28 0.288
ALT (U/L) 10–49 30 21 0.349
TBIL (mg/dL) 0.2–1.3 0.86 0.69 0.884
DBIL (mg/dL) 0.0–0.4 0.4 0.4 0.504
GGT (U/L) 12–43 55.9 50.4 0.409
LDH (U/L) 120–246 293 183 0.017
Total protein (g/dL) 6.3–8.2 6.3 6.6 0.881
Albumin (g/dL) 3.5–5 3.3 3.9 0.397
Serum iron (μg/dL) 37–170 42.5 40.3 0.924
Ferritin (ng/mL) 24–260 765 178 0.179
Cholesterol (mg/dL) 130–239 117 120 0.664
LDL-cholesterol (mg/dL) 50–150 75 75 0.803
Triglycerids (mg/dL) 70–175 98.5 79 0.119
HDL-cholesterol (mg/dL) 35–95 32 39 0.115
HbA1c (%) 4.5–6.0 6.7 6.7 0.785
CK (U/L) 30–135 53 49 0.176
CKMB (U/L) 0.2–16 7 9 0.623
Troponin (ng/mL) 0–0.12 0.03 0.04 0.522
NTproBNP 0–300 2660 3350 0.572
ESR (mm/1h) 0–30 35 34.5 0.821
Fibrinogen (mg/dL) 150–400 578 451 0.473
C reactive protein (mg/dL) 0–0.32 4.03 0.91 0.003
APTT (s) 24–36 30.3 30.8 0.806
D-dimer (ug/mL FEU) 0–0.50 1.19 [0.3–20] 2.35 [0.4–5] 0.430

Differences in heart failure treatment in COVID-19 positive and negative patients on admission and at discharge

On admission p-value At discharge p-value
COVID (+) COVID (−) COVID (+) COVID (−)
ACEi/ARNi (%) 19.6 44.0 0.026 21.6 34.8 0.205
BB (%) 35.3 60.0 0.036 56.8 73.9 0.143
MRA (%) 7.8 24.0 0.058 10.8 39.1 0.012
Loop diuretic (%) 11.8 36.0 0.016 10.8 60.9 <0.001
SGLT2-i (%) 5.9 4.0 0.601 5.9 12.0 0.306

Study population divided by COVID-19 status displaying heart failure phenotype distribution, prevalence of associated conditions and outcome during hospitalization and at follow-up

Heart Failure Phenotype COVID (+) COVID (−) p-value
Gender - % of women 58.8 60.0 0.562
Arterial Hypertension (%) 76.5 84.0 0.330
HTN - grade 3 (%) 40.5 55.0 0.221
Type 2 Diabetes Mellitus (%) 33.3 48.0 0.162
Atrial Fibrillation (%) 13.7 16.0 0.521
Coronary Artery Disease (%) 11.8 28.0 0.077
Chronic Kidney Disease (% of G2 or lower eGRF) 71.4 91.3 0.510
Late-stage CKD (% of G4 or lower eGRF) 14.3 21.7 0.318
Stroke History (%) 15.7 4.0 0.133
Cancer (%) 17.6 20.0 0.517
Fully vaccinated (%) 17.4 29.4 0.239
ICU admission (%) 30.6 8.3 0.030
In-hospital mortality (%) 27.5 8.0 0.044
Follow-up mortality (%) 41.2 8.0 0.002
HFpEF (%) 90.2 60.0 0.003
Non-HFpEF (%) 5.9 28.0 0.012
NYHA Class III&IV 13.7 56.0 <0.001
eISSN:
2734-6382
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Cardiology, Pediatrics and Juvenile Medicine, Paediatric Cardiology, Surgery, Cardiac Surgery
Kanał RSS czasopisma