Méndez Bailón Manuel, Lorenzo Villalba Noel, Garcia Onrubia Jorge, Rubio Rivas Manuel, Nuñez Rodriguez Maria Victoria, de Los Reyes Pascual Pérez María, Díaz Pedroche Carmen, Fonseca Aizpuru Eva María, Villalba Garcia Maria Victoria, Garcia Garcia Gema Maria, Pesqueira Fontán Paula María, Artero Arturo, Montero Hernandez Esther, Alcalá Pedrajas José Nicolás, Giner Galvan Vicente, Monge Monge Daniel, Letona Giménez Laura, García Gómez Miriam, Martínez Cilleros Carmen, Puente Ruiz Nuria, Escobar Sevilla Joaquin, Gómez Méndez Raquel, Ramos-Rincón José Manuel, Gomez Huelgas Ricardo
Department of Internal Medicine Hospital Clínico San Carlos, Hospital Clinico San Carlos (IdISSC), 28040 Madrid, Spain.
Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
J Clin Med. 2023 Jul 12;12(14):4649. doi: 10.3390/jcm12144649.
Since the beginning of the COVID-19 pandemic in March 2020, an intimate relationship between this disease and cardiovascular diseases has been seen. However, few studies assess the development of heart failure during this infection. This study aims to determine the predisposing factors for the development of heart failure (HF) during hospital admission of COVID-19 patients.
A retrospective and multicenter study of patients with HF admitted for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). A bivariate analysis was performed to relate the different variables evaluated in patients developing heart failure during hospital admission. A multivariate analysis including the most relevant clinical variables obtained in bivariate analyses to predict the outcome of heart failure was performed.
A total of 16.474 patients hospitalized for COVID-19 were included (57.5% men, mean age 67 years), 958 of them (5.8%) developed HF during hospitalization. The risk factors for HF development were: age (odds ratio [OR]): 1.042; confidence interval 95% (CI 95%): 1.035-1.050; < 0.001), atrial fibrillation (OR: 2.022; CI 95%: 1.697-2.410; < 0.001), BMI > 30 kg/m (OR: 1.460 CI 95%: 1.230-1.733; < 0001), and peripheral vascular disease (OR: 1.564; CI 95%: 1.217-2.201; < 0.001). Patients who developed HF had a higher rate of mortality (54.1% vs. 19.1%, < 0.001), intubation rate (OR: 2,36; < 0.001), and ICU admissions (OR: 2.38; < 0001).
Patients who presented a higher risk of developing HF were older with cardiovascular risk factors. The risk factors for HF development were age, atrial fibrillation, obesity, and peripheral vascular disease. In addition, patients who developed HF more frequently required to be intubated or admitted to the ICU.
自2020年3月新冠疫情开始以来，人们已经看到这种疾病与心血管疾病之间存在密切关系。然而，很少有研究评估这种感染期间心力衰竭的发生情况。本研究旨在确定新冠患者住院期间发生心力衰竭（HF）的诱发因素。
对西班牙150家医院收治的因新冠住院的心力衰竭患者进行回顾性多中心研究（SEMI-COVID-19注册研究）。进行双变量分析以关联住院期间发生心力衰竭的患者中评估的不同变量。进行多变量分析，包括在双变量分析中获得的最相关临床变量，以预测心力衰竭的结果。
共纳入16474例因新冠住院的患者（男性占57.5%，平均年龄67岁），其中958例（5.8%）在住院期间发生HF。发生HF的危险因素为：年龄（比值比[OR]）：1.042；95%置信区间（CI 95%）：1.035 - 1.050；P < 0.001）、心房颤动（OR：2.022；CI 95%：1.697 - 2.410；P < 0.001）、体重指数>30 kg/m²（OR：1.460，CI 95%：1.230 - 1.733；P < 0.001）和外周血管疾病（OR：1.564；CI 95%：1.217 - 2.201；P < 0.001）。发生HF的患者死亡率更高（54.1%对19.1%，P < 0.001）、插管率更高（OR：2.36；P < 0.001）和入住重症监护病房率更高（OR：2.38；P < 0.001）。
发生HF风险较高的患者年龄较大且有心血管危险因素。发生HF的危险因素为年龄、心房颤动、肥胖和外周血管疾病。此外。发生HF的患者更频繁地需要插管或入住重症监护病房。
