Saleh Khalid Bin, Hafiz Awattif, Alsulaiman Khalid, Aljuhani Ohoud, Alharbi Shmeylan, Alharbi Aisha, Vishwakarma Ramesh, Albekairy Abdulkareem, Alkathiri Abdulmalik, Alanazi Faisal, Almujarri Ghada, Alobathani Seba, Alharbi Yazeed, Zowawi Hosam M, Badreldin Hisham A
Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Department of Pharmaceutical Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Am Heart J Plus. 2021 Jul;7:100033. doi: 10.1016/j.ahjo.2021.100033. Epub 2021 Jul 19.
Patients with underlying heart failure (HF) in the setting of COVID-19 who require admission to the intensive care unit (ICU) might present with a unique set of challenges. This study aims to extensively describe the characteristics and outcomes of patients with HF who were admitted to ICU with COVID-19.
We conducted a multicenter retrospective analysis for all adult patients with HF and an objectively confirmed diagnosis of COVID-19 who were admitted to ICUs between March 1 and August 31, 2020, in Saudi Arabia.
A total of 723 critically ill patients with COVID-19 were admitted into ICUs during the study period: 59 patients with HF and 664 patients with no HF before admission to ICU. Patients with HF had statistically significant more comorbidities, including diabetes mellitus, hypertension, dyslipidemia, atrial fibrillation, and acute coronary syndrome. Moreover, higher baseline severity scores (APACHE II & SOFA score) and nutritional risk (NUTRIC score) were observed in HF patients. Overall, patients with HF had more in-hospital and ICU deaths in comparison to patients without HF: (64.3% vs. 44.6%, -value <0.01) and (54.5% vs. 39%, P-value = 0.02), respectively. Patients with HF had a similar incidence of thrombosis, ICU length of stay, duration of mechanical ventilation, and hospital length of stay compared to patients with no HF.
In this study, patients with HF had more in-hospital and ICU deaths than patients with no HF. Thus, history of HF could be used to help direct case management during hospitalization and possibly dictate proactive COVID-19 care.
患有基础心力衰竭（HF）且因2019冠状病毒病（COVID-19）需要入住重症监护病房（ICU）的患者可能面临一系列独特的挑战。本研究旨在全面描述因COVID-19入住ICU的心力衰竭患者的特征和结局。
我们对2020年3月1日至8月31日期间在沙特阿拉伯入住ICU的所有成年心力衰竭患者以及经客观确诊为COVID-19的患者进行了多中心回顾性分析。
在研究期间，共有723例COVID-19危重症患者入住ICU：59例为心力衰竭患者，664例在入住ICU前无心力衰竭。心力衰竭患者的合并症在统计学上显著更多，包括糖尿病、高血压、血脂异常、心房颤动和急性冠状动脉综合征。此外，心力衰竭患者的基线严重程度评分（急性生理与慢性健康状况评分系统II [APACHE II]和序贯器官衰竭评估 [SOFA]评分）和营养风险（营养风险评分 [NUTRIC]）更高。总体而言，与无心力衰竭患者相比，心力衰竭患者的院内死亡和ICU死亡更多：分别为（64.3%对44.6%，P值<0.01）和（54.5%对39%，P值 = 0.02）。与无心力衰竭患者相比，心力衰竭患者的血栓形成发生率、ICU住院时间、机械通气持续时间和住院时间相似。
在本研究中，心力衰竭患者的院内死亡和ICU死亡比无心力衰竭患者更多。因此，心力衰竭病史可用于指导住院期间的病例管理，并可能决定对COVID-19的积极治疗。
