Worsening of heart failure by coronavirus disease 2019 is associated with high mortality.

Autor: Bocchi EA; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Lima IGCV; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Biselli B; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Salemi VMC; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Ferreira SMA; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Chizzola PR; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Munhoz RT; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil., Pessoa RS; Heart Institute (Incor) of São Paulo University Medical School, São Paulo, Brazil., Cardoso FAM; Heart Institute (Incor) of São Paulo University Medical School, São Paulo, Brazil., Bello MVO; Heart Institute (Incor) of São Paulo University Medical School, São Paulo, Brazil., Hajjar LA; Heart Institute (Incor) of São Paulo University Medical School, São Paulo, Brazil., Gomes BR; Heart Failure Clinics of the Heart Institute (InCor) of São Paulo University Medical School, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2021 Apr; Vol. 8 (2), pp. 943-952. Date of Electronic Publication: 2021 Jan 26.
DOI: 10.1002/ehf2.13199
Abstrakt: Aims: Patients with advanced heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) and concurrent coronavirus disease 2019 (COVID-19) might have a higher risk of severe events.
Methods and Results: We retrospectively studied 16 patients with advanced HFrEF who developed COVID-19 between 1 March and 29 May 2020. Follow-up lasted until 30 September. Ten patients previously hospitalized with decompensated HFrEF were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during hospitalization. Six patients undergoing ambulatory care at initiation of COVID-19 symptoms were hospitalized because of advanced HFrEF. All patients who experienced worsening of HFrEF due to COVID-19 required higher doses or introduction of additional inotropic drugs or intra-aortic balloon pump in the intensive care unit. The mean intravenous dobutamine dose before SARS-CoV-2 infection in previously hospitalized patients (n = 10) and the median (inter-quartile range) peak intravenous dobutamine dose during SARS-CoV-2 infection in all patients (n = 16) were 2 (0-7) μg/kg/min and 20 (14-20) (P < 0.001), respectively. During follow-up, 56% underwent heart transplantation (n = 2) or died (n = 7). Four patients died during hospitalization from mixed shock consequent to severe acute respiratory syndrome with inflammatory storm syndrome associated with septic and cardiogenic shock during COVID-19. After COVID-19 recovery, two patients died from mixed septic and cardiogenic shock and one from sustained ventricular tachycardia and cardiogenic shock. Five patients were discharged from hospital to ambulatory care. Four were awaiting heart transplantation.
Conclusion: Worsening of advanced HF by COVID-19 is associated with high mortality. This report highlights the importance of preventing COVID-19 in patients with advanced HF.
(© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Databáze: MEDLINE
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