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      Heart Failure In Covid‐19 Patients: Prevalence, Incidence And Prognostic Implications

      , M.D. PhD. , 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 1 , , M.D. 2 , , M.D. 3 , , M.D. 3 , , M.D. Ph.D. FESC 1 , , M.D. PhD. FEHRA 1

      European Journal of Heart Failure

      John Wiley & Sons, Ltd.

      COVID‐19, heart failure, NT‐proBNP, drugs withdrawal, mortality, morbidity

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          ABSTRACT

          Aims

          Data regarding impact of COVID‐19 in chronic heart failure (CHF) patients and its potential to trigger acute heart failure (AHF) is lacking. The aim of this work was to study characteristics, cardiovascular outcomes and mortality in patients with confirmed COVID‐19 infection and prior diagnosis of HF. Also, to identify predictors and prognostic implications for AHF decompensations during hospital admission and to determine whether there was a correlation between withdrawal of HF guideline‐directed medical therapy (GDMT) and worse outcomes during hospitalization.

          Methods and results

          A total of 3080 consecutive patients with confirmed COVID‐19 infection and at least 30‐day follow‐up were analyzed. Patients with previous history of CHF (152, 4.9%), were more prone to develop AHF (11.2% vs 2.1%; p<0.001) and had higher levels of NT‐proBNP. Also, previous CHF group had higher mortality rates (48.7% vs 19.0%; p<0.001). In contrast, 77 patients (2.5%) were diagnosed of AHF and the vast majority (77.9%) developed in patients without history of HF. Arrhythmias during hospital admission and CHF were main predictors of AHF. Patients developing AHF had significantly higher mortality (46.8% vs 19.7%; p<0.001). Finally, withdrawal of beta‐blockers, mineralocorticoid antagonists and ACE/ARB inhibitors was associated with a significant increase of in‐hospital mortality.

          Conclusions

          Patients with COVID‐19 have a significant incidence of AHF, entity that carries within a very high mortality. Moreover, patients with history of CHF are prone to develop acute decompensation after COVID‐19 diagnosis. Withdrawal of GDMT was associated with higher mortality.

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          Author and article information

          Contributors
          cardcovid@arritmias.net
          Journal
          Eur J Heart Fail
          Eur. J. Heart Fail
          10.1002/(ISSN)1879-0844
          EJHF
          European Journal of Heart Failure
          John Wiley & Sons, Ltd. (Oxford, UK )
          1388-9842
          1879-0844
          24 August 2020
          Affiliations
          [ 1 ] From the Cardiology Hospital Universitario La Paz Madrid Spain
          [ 2 ] Clinical Analytics Hospital Universitario La Paz Madrid Spain
          [ 3 ] Pharmacy Department Hospital Universitario La Paz Madrid Spain
          Author notes
          [* ] Corresponding author

          Juan R Rey. Cardiology Department, Hospital Universitario La Paz. Address: Paseo de la Castellana, 261, 28046 Madrid, Spain. Telephone number +34917277000.

          Email: cardcovid@ 123456arritmias.net

          [†]

          Juan R. Rey and Juan Caro‐Codón contributed equally to this paper.

          Article
          EJHF1990 NA
          10.1002/ejhf.1990
          7461427
          32833283
          This article is protected by copyright. All rights reserved.

          This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

          Page count
          Figures: 3, Tables: 3, Pages: 1, Words: 400
          Product
          Categories
          Research Article
          Research Articles
          Custom metadata
          2.0
          accepted-manuscript
          Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.8 mode:remove_FC converted:01.09.2020

          Cardiovascular Medicine

          covid‐19, heart failure, nt‐probnp, drugs withdrawal, mortality, morbidity

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