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Lekkala SP, Mohammed AS, Ahmed H, Al-Sulami M, Khan J, Desai R, Ghantasala P, Singh H, Ali SS, Bianco C. Sex-Specific Risk Factors and Predictors of Major Adverse Cardiac and Cerebrovascular Events in Heart Failure with Preserved Ejection Fraction with SARS-CoV-2 Infection: A Nationwide Analysis. J Clin Med 2025; 14:1469. [PMID: 40094849 PMCID: PMC11900245 DOI: 10.3390/jcm14051469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 01/31/2025] [Accepted: 02/01/2025] [Indexed: 03/19/2025] Open
Abstract
Background: Heart failure with preserved ejection fraction (HFpEF) is a condition with limited large-scale data on the short- and long-term effects of SARS-CoV-2 infection. This study aimed to evaluate the prevalence of major adverse cardiac and cerebrovascular events (MACCEs) in HFpEF patients hospitalized with SARS-CoV-2 and identify sex-specific risk factors and predictors of MACCEs in this population. Methods: This retrospective study analyzed HFpEF patients hospitalized with SARS-CoV-2 from the 2020 National Inpatient Sample (NIS) using ICD-10 codes. Patients hospitalized with HFpEF and SARS-CoV-2 were categorized by age (18-44, 45-64, ≥65 years). Multivariate logistic regression was used to adjust for potential confounders, with the statistical significance set at a two-tailed p-value < 0.05. Results: Among 109,750 HFpEF patients hospitalized with SARS-CoV-2, 31,960 (29.1%) experienced MACCEs. Males experienced a higher rate of MACCEs than females (31.1% vs. 27.5%, OR: 1.20, 95% CI: 1.12-1.28, p < 0.001). Adjusted analysis revealed that elderly patients (≥65 years, OR: 1.47, 95% CI: 1.33-1.62) compared with the 45-64 age group and males (OR: 1.20, 95% CI: 1.12-1.28, p < 0.001) had a higher risk of MACCEs. Key predictors included prior coronary artery bypass grafting (CABG; OR: 1.15, 95% CI: 1.02-1.30), cancer (OR: 1.24, 95% CI: 1.08-1.42), and chronic kidney disease (OR: 1.15, 95% CI: 1.08-1.23). Subgroup analysis identified additional sex-specific risk factors. In males, hyperlipidemia, obesity, tobacco use disorder, prior stroke/transient ischemic attack (TIA), prior venous thromboembolism (VTE), alcohol abuse, depression, and valvular disease were significant predictors of MACCEs. In females, hyperlipidemia, tobacco use disorder, prior stroke/TIA, prior VTE, and depression were significant predictors. Conclusions: HFpEF patients hospitalized with SARS-CoV-2 have a high risk of MACCEs, with male sex, older age, prior CABG, cancer, and chronic kidney disease as key risk factors. This study provides the first large-scale analysis of sex-specific predictors of MACCEs in HFpEF patients hospitalized with SARS-CoV-2. These findings underscore the need for focused research and clinical gender-based strategies to mitigate cardiovascular risks in this unique and high-risk population.
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Affiliation(s)
- Sai Prasanna Lekkala
- Department of Internal Medicine, UCHealth Parkview Medical Center, Pueblo, CO 81003, USA;
| | - Adil Sarvar Mohammed
- Department of Internal Medicine, College of Medicine, Central Michigan University, Saginaw, MI 48859, USA;
| | - Hafeezuddin Ahmed
- Department of Internal Medicine, Corewell Health Beaumont Royal Oak, Royal Oak, MI 48073, USA;
| | - Meshal Al-Sulami
- Department of Cardiovascular Medicine, West Virginia University, Morgantown, WV 26506, USA; (M.A.-S.); (C.B.)
| | - Jahangir Khan
- Department of Internal Medicine, Covenant Healthcare, Saginaw, MI 48706, USA;
| | - Rupak Desai
- Independent Researcher, Atlanta, GA 30033, USA;
| | - Paritharsh Ghantasala
- Department of Internal Medicine, College of Medicine, Central Michigan University, Saginaw, MI 48859, USA;
| | - Hemindermeet Singh
- Department of Cardiovascular Medicine, Mercy St. Vincent Medical Center, Toledo, OH 43608, USA; (H.S.); (S.S.A.)
| | - Syed Sohail Ali
- Department of Cardiovascular Medicine, Mercy St. Vincent Medical Center, Toledo, OH 43608, USA; (H.S.); (S.S.A.)
| | - Christopher Bianco
- Department of Cardiovascular Medicine, West Virginia University, Morgantown, WV 26506, USA; (M.A.-S.); (C.B.)
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Chang LY, Chao CY, Huang JL, Chen YY, Wang CY, Lee WL, Lin WW. Impact of the Coronavirus Disease 2019 [COVID-19] Pandemic on Post-Acute Care of Patients with Heart Failure and the Effectiveness of Vaccine Prevention. Healthcare (Basel) 2024; 12:2171. [PMID: 39517383 PMCID: PMC11544847 DOI: 10.3390/healthcare12212171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 10/26/2024] [Accepted: 10/29/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND The Heart Failure Post-Acute Care [HF-PAC] program is a specialized healthcare program aimed at providing comprehensive care and support for patients with heart failure [HF] as they transition from acute hospital settings to home. But the impact of the coronavirus disease 2019 [COVID-19] pandemic on the HF-PAC program remains unknown. Furthermore, the effects of the comprehensive COVID-19 vaccination program on these patients with HF-PAC warrants further investigation. METHODS A total of 265 patients with acute decompensated HF were admitted to the hospital between May 2020 and October 2022. Of these, 159 patients underwent planned HF-PAC follow-up for 6 months, followed by scheduled follow-up visits every 3 months and unscheduled telephone randomized visits for at least another 6 months. RESULTS The program completion rate was nearly 92%. COVID-19 significantly impacted patients with HF-PAC, leading to an increased mortality [13.3%] compared to before the pandemic [6.5%]. In our patient cohort, 83% had received at least 1 dose of vaccine and 61% had received > 3 doses. Of these patients with HF-PAC, 34% contracted COVID-19 infection post discharge, and 8.8% died owing to the infection. Of the mortality group, 42.9% patients were not vaccinated, and 28.6% received 1 vaccine dose, and their vaccination rate was lower than in the survival group [p = 0.01]. CONCLUSIONS The COVID-19 pandemic had a significant impact on patients enrolled in the HF-PAC program; receiving more than 3 doses of the COVID-19 vaccine was associated with a significant reduction in mortality rates among these patients.
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Affiliation(s)
- Lin-Yuan Chang
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Nursing Department, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Chin-Yi Chao
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Nursing Department, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- Nursing Department, National Taichung University of Science and Technology, Taichung 40343, Taiwan
| | - Jin-Long Huang
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Cardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University School of Medicine, Taipei 112304, Taiwan
- Department of Medical Education, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Yun-Yu Chen
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Cardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Chi-Yen Wang
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Department of Medicine, Chung-Shan Medical University, Taichung 40201, Taiwan
| | - Wen-Lieng Lee
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Cardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University School of Medicine, Taipei 112304, Taiwan
| | - Wei-Wen Lin
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (L.-Y.C.); (C.-Y.C.); (J.-L.H.); (Y.-Y.C.); (C.-Y.W.); (W.-L.L.)
- Cardiovascular Research Center, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Life Science Department, Tunghai University, Taichung 407224, Taiwan
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Vera-Delgado V, García-Rosado D, Pérez-Hernández O, Martín-Ponce E, de La Paz-Estrello AM, García-Marichal C, Pérez-Fernández S, Rodríguez-Morón V, Alemán-Valls R, González-Reimers E, Martín-González C. Mortality and COVID Infection: Predictors of Mortality 10 Months after Discharge. Diseases 2024; 12:123. [PMID: 38920555 PMCID: PMC11203287 DOI: 10.3390/diseases12060123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The long-term survival of patients hospitalized with COVID-19 and the factors associated with poorer survival months after infection are not well understood. The aims of the present study were to analyze the overall mortality 10 months after admission. METHODS 762 patients with COVID-19 disease were included. Patients underwent a complete clinical evaluation, routine laboratory analysis and chest X-ray. Data collected included demographic and clinical data, such as vascular risk factors, tobacco or alcohol use, comorbidity, and institutionalization. RESULTS Ten-month mortality was 25.6%: 108 deaths occurred in-hospital, while 87 patients died after discharge. In-hospital mortality was independently related to NT-proBNP values > 503.5 pg/mL [OR = 4.67 (2.38-9.20)], urea > 37 mg/dL [3.21 (1.86-7.31)] and age older than 71 years [OR = 1.93 (1.05-3.54)]. NT-proBNP values > 503.5 pg/mL [OR = 5.00 (3.06-8.19)], urea > 37 mg/dL [3.51 (1.97-6.27)], cognitive impairment [OR = 1.96 (1.30-2.95), cancer [OR = 2.23 (1.36-3.68), and leukocytes > 6330/mm3 [OR = 1.64 (1.08-2.50)], were independently associated with long-term mortality. CONCLUSIONS the risk of death remains high even months after COVID-19 infection. Overall mortality of COVID-19 patients during 10 months after hospital discharge is nearly as high as that observed during hospital admission. Comorbidities such as cancer or cognitive impairment, organ dysfunction and inflammatory reaction are independent prognostic markers of long-term mortality.
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Affiliation(s)
- Víctor Vera-Delgado
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Dácil García-Rosado
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Onán Pérez-Hernández
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Esther Martín-Ponce
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Alejandro Mario de La Paz-Estrello
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | | | - Sergio Pérez-Fernández
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Valle Rodríguez-Morón
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Remedios Alemán-Valls
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
| | - Emilio González-Reimers
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
| | - Candelaria Martín-González
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
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Bilal MI, Gajjar R, Bobba A, Zabel KM, Davis MG, Nasrullah A, Gangu K, Sheikh AB, Yadav N. Assessing 30-day readmissions and outcomes in acute heart failure patients with concurrent COVID-19: A nationwide study during the 2020 pandemic. Curr Probl Cardiol 2024; 49:102246. [PMID: 38048854 DOI: 10.1016/j.cpcardiol.2023.102246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Acute heart failure (HF) is a significant cause of readmission and mortality, particularly within 30 days post-discharge. The interplay between COVID-19 and HF is still being studied. METHODS This retrospective study utilized The National Readmission Database to examine outcomes and predictors among patients with COVID-19 and concomitant acute HF between January 1, 2020, and November 31, 2020. 53,336 index hospitalizations and 8,158 readmissions were included. The primary outcome was the 30-day all-cause readmission rate. Predictor variables included patient demographics, medical comorbidities and discharge disposition. RESULTS The primary outcome was 21.2 %. COVID-19 infection was the most predominant all-cause reason for acute HF readmission (24.7 %). Hypertensive heart disease with chronic kidney disease was the most prevalent cardiac cause (7.7 %). Mortality rate during index hospitalization was significantly higher compared to readmission. CONCLUSIONS The highlighted prevalent complications, comorbidities, and demographics driving readmissions offer valuable insights to improve outcomes in this population.
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Affiliation(s)
| | - Rohan Gajjar
- Department of Internal Medicine, John Hopkins Stronger, Jr. Hospital of Cook County, Chicago, IL, USA
| | - Aniesh Bobba
- Department of Cardiology, John Hopkins Stronger, Jr. Hospital of Cook County, Chicago, IL, USA
| | - Kenneth M Zabel
- Department of Internal Medicine, University of New Mexico Health System, Albuquerque, NM, USA
| | - Monique G Davis
- Department of Internal Medicine, University of New Mexico Health System, Albuquerque, NM, USA
| | - Adeel Nasrullah
- Department of Pulmonology and Critical Care, Allegheny Health Network, Pittsburg PA, USA
| | - Karthik Gangu
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health System, 1 University of New Mexico, Albuquerque, NM, 87131, MSC10-55501, NM, USA.
| | - Neha Yadav
- Department of Cardiology, John Hopkins Stronger, Jr. Hospital of Cook County, Chicago, IL, USA
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