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Weizman O, Duceau B, Trimaille A, Pommier T, Cellier J, Geneste L, Panagides V, Marsou W, Deney A, Attou S, Delmotte T, Ribeyrolles S, Chemaly P, Karsenty C, Giordano G, Gautier A, Chaumont C, Guilleminot P, Sagnard A, Pastier J, Ezzouhairi N, Perin B, Zakine C, Levasseur T, Ma I, Chavignier D, Noirclerc N, Darmon A, Mevelec M, Sutter W, Mika D, Fauvel C, Pezel T, Waldmann V, Cohen A, Bonnet G. Machine learning-based scoring system to predict in-hospital outcomes in patients hospitalized with COVID-19. Arch Cardiovasc Dis 2022; 115:617-626. [PMID: 36376208 PMCID: PMC9595484 DOI: 10.1016/j.acvd.2022.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/19/2022] [Accepted: 08/01/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The evolution of patients hospitalized with coronavirus disease 2019 (COVID-19) is still hard to predict, even after several months of dealing with the pandemic. AIMS To develop and validate a score to predict outcomes in patients hospitalized with COVID-19. METHODS All consecutive adults hospitalized for COVID-19 from February to April 2020 were included in a nationwide observational study. Primary composite outcome was transfer to an intensive care unit from an emergency department or conventional ward, or in-hospital death. A score that estimates the risk of experiencing the primary outcome was constructed from a derivation cohort using stacked LASSO (Least Absolute Shrinkage and Selection Operator), and was tested in a validation cohort. RESULTS Among 2873 patients analysed (57.9% men; 66.6±17.0 years), the primary outcome occurred in 838 (29.2%) patients: 551 (19.2%) were transferred to an intensive care unit; and 287 (10.0%) died in-hospital without transfer to an intensive care unit. Using stacked LASSO, we identified 11 variables independently associated with the primary outcome in multivariable analysis in the derivation cohort (n=2313), including demographics (sex), triage vitals (body temperature, dyspnoea, respiratory rate, fraction of inspired oxygen, blood oxygen saturation) and biological variables (pH, platelets, C-reactive protein, aspartate aminotransferase, estimated glomerular filtration rate). The Critical COVID-19 France (CCF) risk score was then developed, and displayed accurate calibration and discrimination in the derivation cohort, with C-statistics of 0.78 (95% confidence interval 0.75-0.80). The CCF risk score performed significantly better (i.e. higher C-statistics) than the usual critical care risk scores. CONCLUSIONS The CCF risk score was built using data collected routinely at hospital admission to predict outcomes in patients with COVID-19. This score holds promise to improve early triage of patients and allocation of healthcare resources.
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Affiliation(s)
- Orianne Weizman
- Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-lès-Nancy, France,Université de Paris, PARCC, INSERM, 75015 Paris, France
| | | | - Antonin Trimaille
- Nouvel Hopital Civil, Centre Hospitalier Régional Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Thibaut Pommier
- Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Joffrey Cellier
- Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | - Laura Geneste
- Centre Hospitalier Universitaire d’Amiens-Picardie, 80000 Amiens, France
| | - Vassili Panagides
- Centre Hospitalier Universitaire de Marseille, 13005 Marseille, France
| | - Wassima Marsou
- GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille, Faculté de Médecine et de Maïeutique, Université Catholique de Lille, 59800 Lille, France
| | - Antoine Deney
- Centre Hospitalier Universitaire de Toulouse, 31400 Toulouse, France
| | - Sabir Attou
- Centre Hospitalier Universitaire de Caen-Normandie, 14000 Caen, France
| | - Thomas Delmotte
- Centre Hospitalier Universitaire de Reims, 51100 Reims, France
| | | | | | - Clément Karsenty
- Centre Hospitalier Universitaire de Toulouse, 31400 Toulouse, France
| | - Gauthier Giordano
- Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-lès-Nancy, France
| | | | - Corentin Chaumont
- Centre Hospitalier Universitaire de Rouen, FHU REMOD-VHF, 76000 Rouen, France
| | | | - Audrey Sagnard
- Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Julie Pastier
- Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Nacim Ezzouhairi
- Centre Hospitalier Universitaire de Bordeaux, 33076 Bordeaux, France
| | - Benjamin Perin
- Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-lès-Nancy, France
| | - Cyril Zakine
- Clinique Saint-Gatien, 37540 Saint-Cyr-sur-Loire, France
| | - Thomas Levasseur
- Centre Hospitalier Intercommunal Fréjus-Saint-Raphaël, 83600 Fréjus, France
| | - Iris Ma
- Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | | | | | - Arthur Darmon
- Hôpital Bichat-Claude-Bernard, AP–HP, Université de Paris, 75018 Paris, France
| | - Marine Mevelec
- Centre Hospitalier Régional de Orléans, 45100 Orléans, France
| | - Willy Sutter
- Université de Paris, PARCC, INSERM, 75015 Paris, France
| | - Delphine Mika
- Université Paris-Saclay, Inserm, UMR-S 1180, 92296 Chatenay-Malabry, France
| | - Charles Fauvel
- Centre Hospitalier Universitaire de Rouen, FHU REMOD-VHF, 76000 Rouen, France
| | - Théo Pezel
- Hôpital Lariboisière, AP–HP, Université de Paris, 75010 Paris, France
| | - Victor Waldmann
- Université de Paris, PARCC, INSERM, 75015 Paris, France,Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | - Ariel Cohen
- Hôpital Saint-Antoine, 75012 Paris, France,Corresponding author. Hôpital Saint-Antoine, 184, Rue du Faubourg Saint-Antoine, 75012 Paris, France
| | - Guillaume Bonnet
- Université de Paris, PARCC, INSERM, 75015 Paris, France,Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
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Panagides V, Vincent F, Weizman O, Jonveaux M, Trimaille A, Pommier T, Cellier J, Geneste L, Marsou W, Deney A, Attou S, Delmotte T, Fauvel C, Ezzouhairi N, Perin B, Zakine C, Levasseur T, Ma I, Chavignier D, Noirclerc N, Darmon A, Mevelec M, Karsenty C, Duceau B, Sutter W, Mika D, Pezel T, Waldmann V, Ternacle J, Cohen A, Bonnet G. History of heart failure in patients with coronavirus disease 2019: Insights from a French registry. Arch Cardiovasc Dis 2021; 114:415-425. [PMID: 34099379 PMCID: PMC8141712 DOI: 10.1016/j.acvd.2021.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although cardiovascular comorbidities seem to be strongly associated with worse outcomes in patients with coronavirus disease 2019 (COVID-19), data regarding patients with preexisting heart failure are limited. AIMS To investigate the incidence, characteristics and clinical outcomes of patients with COVID-19 with a history of heart failure with preserved or reduced ejection fraction. METHODS We performed an observational multicentre study including all patients hospitalized for COVID-19 across 24 centres in France from 26 February to 20 April 2020. The primary endpoint was a composite of in-hospital death or need for orotracheal intubation. RESULTS Overall, 2809 patients (mean age 66.4±16.9years) were included. Three hundred and seventeen patients (11.2%) had a history of heart failure; among them, 49.2% had heart failure with reduced ejection fraction and 50.8% had heart failure with preserved ejection fraction. COVID-19 severity at admission, defined by a quick sequential organ failure assessment score>1, was similar in patients with versus without a history of heart failure. Before and after adjustment for age, male sex, cardiovascular comorbidities and quick sequential organ failure assessment score, history of heart failure was associated with the primary endpoint (hazard ratio [HR]: 1.41, 95% confidence interval [CI]: 1.06-1.90; P=0.02). This result seemed to be mainly driven by a history of heart failure with preserved ejection fraction (HR: 1.61, 95% CI: 1.13-2.27; P=0.01) rather than heart failure with reduced ejection fraction (HR: 1.19, 95% CI: 0.79-1.81; P=0.41). CONCLUSIONS History of heart failure in patients with COVID-19 was associated with a higher risk of in-hospital death or orotracheal intubation. These findings suggest that patients with a history of heart failure, particularly heart failure with preserved ejection fraction, should be considered at high risk of clinical deterioration.
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Affiliation(s)
- Vassili Panagides
- Aix-Marseille Université, Intensive Care Unit, Hôpital Nord, AP-HM, 13015 Marseille, France
| | - Flavien Vincent
- Centre Hospitalier Universitaire de Lille, Institut Cœur Poumon, Cardiology, Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, INSERM U1011, Institut Pasteur de Lille, EGID, Université de Lille, 59800 Lille, France
| | - Orianne Weizman
- Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, 54500 Vandœuvre-les-Nancy, France; Université de Paris, Paris Cardiovascular Research Centre (PARCC), INSERM, UMR-S970, 75015 Paris, France
| | - Melchior Jonveaux
- Département de Cardiologie, Expert Valve Center, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, 94010 Créteil, France
| | - Antonin Trimaille
- Nouvel Hôpital Civil, Centre Hospitalier Régional Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Thibaut Pommier
- Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Joffrey Cellier
- Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | - Laura Geneste
- Centre Hospitalier Universitaire d'Amiens-Picardie, 80000 Amiens, France
| | - Wassima Marsou
- GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille, Faculté de Médecine et de Maïeutique, Université Catholique de Lille, 59800 Lille, France
| | - Antoine Deney
- Centre Hospitalier Universitaire de Toulouse, 31400 Toulouse, France
| | - Sabir Attou
- Centre Hospitalier Universitaire de Caen-Normandie, 14000 Caen, France
| | - Thomas Delmotte
- Centre Hospitalier Universitaire de Reims, 51100 Reims, France
| | - Charles Fauvel
- Rouen University Hospital, FHU REMOD-VHF, 76000 Rouen, France
| | - Nacim Ezzouhairi
- University of Bordeaux, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Benjamin Perin
- Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, 54500 Vandœuvre-les-Nancy, France
| | - Cyril Zakine
- Clinique Saint-Gatien, 37540 Saint-Cyr-sur-Loire, France
| | - Thomas Levasseur
- Centre Hospitalier Intercommunal Fréjus-Saint-Raphaël, 83600 Fréjus, France
| | - Iris Ma
- Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | | | | | - Arthur Darmon
- Hôpital Bichat-Claude-Bernard, AP-HP, Université de Paris, 75018 Paris, France
| | - Marine Mevelec
- Centre Hospitalier Annecy Genevois, 74370 Épagny-Metz-Tessy, France
| | - Clément Karsenty
- Centre Hospitalier Universitaire de Toulouse, 31400 Toulouse, France
| | - Baptiste Duceau
- Département de Cardiologie, Expert Valve Center, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, 94010 Créteil, France
| | - Willy Sutter
- Département de Cardiologie, Expert Valve Center, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, 94010 Créteil, France
| | - Delphine Mika
- Université Paris-Saclay, INSERM, UMR-S 1180, 92296 Châtenay-Malabry, France
| | - Théo Pezel
- Hôpital Lariboisière, AP-HP, University of Paris, 75010 Paris, France
| | - Victor Waldmann
- Département de Cardiologie, Expert Valve Center, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, 94010 Créteil, France
| | - Julien Ternacle
- University of Bordeaux, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France; Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval/Québec Heart and Lung Institute, Laval University, Québec G1V 4G5, Canada
| | | | - Guillaume Bonnet
- Université de Paris, Paris Cardiovascular Research Centre (PARCC), INSERM, UMR-S970, 75015 Paris, France; University of Bordeaux, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
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3
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Chocron R, Duceau B, Gendron N, Ezzouhairi N, Khider L, Trimaille A, Goudot G, Weizman O, Alsac JM, Pommier T, Bory O, Cellier J, Philippe A, Geneste L, Ben Abdallah I, Panagides V, El Batti S, Marsou W, Juvin P, Deney A, Messas E, Attou S, Planquette B, Mika D, Gaussem P, Fauvel C, Diehl JL, Pezel T, Mirault T, Sutter W, Sanchez O, Bonnet G, Cohen A, Smadja DM. D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study. Arch Cardiovasc Dis 2021; 114:381-393. [PMID: 33846096 PMCID: PMC7942155 DOI: 10.1016/j.acvd.2021.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/16/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders, in particular high concentrations of D-dimer, and increased frequency of venous thromboembolism. Aim To explore the association between D-dimer at admission and in-hospital mortality in patients hospitalised for COVID-19, with or without symptomatic venous thromboembolism. Methods From 26 February to 20 April 2020, D-dimer concentration at admission and outcomes (in-hospital mortality and venous thromboembolism) of patients hospitalised for COVID-19 in medical wards were retrospectively analysed in a multicenter study in 24 French hospitals. Results Among 2878 patients enrolled in the study, 1154 (40.1%) patients had D-dimer measurement at admission. Receiver operating characteristic curve analysis identified a D-dimer concentration > 1128 ng/mL as the best cut-off value for in-hospital mortality (area under the curve 64.9%, 95% confidence interval [CI] 60–69), with a sensitivity of 71.1% (95% CI 62–78) and a specificity of 55.6% (95% CI 52–58), which did not differ in the subgroup of patients with venous thromboembolism during hospitalisation. Among 545 (47.2%) patients with D-dimer concentration > 1128 ng/mL at admission, 86 (15.8%) deaths occurred during hospitalisation. After adjustment, in Cox proportional hazards and logistic regression models, D-dimer concentration > 1128 ng/mL at admission was also associated with a worse prognosis, with an odds ratio of 3.07 (95% CI 2.05–4.69; P < 0.001) and an adjusted hazard ratio of 2.11 (95% CI 1.31–3.4; P < 0.01). Conclusions D-dimer concentration > 1128 ng/mL is a relevant predictive factor for in-hospital mortality in patients hospitalised for COVID-19 in a medical ward, regardless of the occurrence of venous thromboembolism during hospitalisation.
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Affiliation(s)
- Richard Chocron
- Université de Paris, PARCC, INSERM; Emergency department, Georges-Pompidou European hospital, AP-HP, 75015 Paris, France.
| | | | - Nicolas Gendron
- Université de Paris, Innovative therapies in haemostasis, INSERM; Haematology department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
| | - Nacim Ezzouhairi
- Université de médecine de Bordeaux, Centre hospitalier universitaire de Bordeaux, 33076 Bordeaux, France
| | - Lina Khider
- Université de Paris, Vascular medicine department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Antonin Trimaille
- Nouvel hôpital civil, Centre hospitalier régional universitaire de Strasbourg, 67000 Strasbourg, France
| | - Guillaume Goudot
- Université de Paris, Vascular medicine department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Orianne Weizman
- Centre hospitalier régional universitaire de Nancy, 54511 Vandœuvre-Les-Nancy, France
| | - Jean Marc Alsac
- Université de Paris, Innovative therapies in haemostasis, INSERM; Vascular surgery department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
| | | | - Olivier Bory
- Université de Paris, Emergency department, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Joffrey Cellier
- Georges-Pompidou European Hospital, AP-HP, Université de Paris, 75015 Paris, France
| | - Aurélien Philippe
- Université de Paris, Innovative therapies in haemostasis, INSERM; Haematology department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
| | - Laura Geneste
- Centre hospitalier universitaire d'Amiens-Picardie, 80000 Amiens, France
| | - Iannis Ben Abdallah
- Université de Paris, Innovative therapies in haemostasis, INSERM; Vascular surgery department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
| | - Vassili Panagides
- Centre hospitalier universitaire de Marseille, 13005 Marseille, France
| | - Salma El Batti
- Université de Paris, Innovative therapies in haemostasis, INSERM; Vascular surgery department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
| | - Wassima Marsou
- Centre hospitalier universitaire de Lille, Université catholique de Lille, 59000 Lille, France
| | - Philippe Juvin
- Université de Paris, Emergency department, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Antoine Deney
- Centre hospitalier universitaire de Toulouse, 31400 Toulouse, France
| | - Emmanuel Messas
- Université de Paris, PARCC, INSERM; Vascular medicine department, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Sabir Attou
- Centre hospitalier universitaire de Caen-Normandie, 14000 Caen, France
| | - Benjamin Planquette
- Université de Paris, Innovative therapies in haemostasis, INSERM; Respiratory medicine department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European hospital, AH-HP, 75015 Paris, France
| | - Delphine Mika
- Université Paris-Saclay, INSERM, UMR-S 1180, 92296 Chatenay-Malabry, France
| | - Pascale Gaussem
- Université de Paris, Innovative therapies in haemostasis, INSERM; Haematology department, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Charles Fauvel
- Rouen university hospital, FHU REMOD-VHF, 76000 Rouen, France
| | - Jean-Luc Diehl
- Université de Paris, Innovative therapies in haemostasis, INSERM; Intensive care medicine department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
| | - Theo Pezel
- Lariboisière hospital, AP-HP, Université de Paris, 75010 Paris, France
| | - Tristan Mirault
- Université de Paris, PARCC, INSERM; Vascular medicine department, Georges-Pompidou European Hospital, AP-HP, 75015 Paris, France
| | - Willy Sutter
- Université de Paris, PARCC, INSERM, 75015 Paris, France
| | - Olivier Sanchez
- Université de Paris, Innovative therapies in haemostasis, INSERM; Respiratory medicine department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European hospital, AH-HP, 75015 Paris, France
| | | | - Ariel Cohen
- Department of cardiology, Saint-Antoine hospital, AP-HP, 75012 Paris, France
| | - David M Smadja
- Université de Paris, Innovative therapies in haemostasis, INSERM; Haematology department and biosurgical research laboratory (Carpentier Foundation), Georges-Pompidou European Hospital, AH-HP, 75015 Paris, France
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4
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Bonnet G, Weizman O, Trimaille A, Pommier T, Cellier J, Geneste L, Panagides V, Marsou W, Deney A, Attou S, Delmotte T, Ribeyrolles S, Chemaly P, Karsenty C, Giordano G, Gautier A, Chaumont C, Guilleminot P, Sagnard A, Pastiero J, Ezzouhairi N, Perin B, Zakine C, Levasseur T, Ma I, Chavignier D, Noirclerc N, Darmon A, Mevelec M, Duceau B, Sutter W, Mika D, Fauvel C, Pezel T, Waldmann V, Cohen A. Characteristics and outcomes of patients hospitalized for COVID-19 in France: The Critical COVID-19 France (CCF) study. Arch Cardiovasc Dis 2021; 114:352-363. [PMID: 34154953 PMCID: PMC7923854 DOI: 10.1016/j.acvd.2021.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 01/08/2023]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has led to a public health crisis. Only limited data are available on the characteristics and outcomes of patients hospitalized for COVID-19 in France. Aims To investigate the characteristics, cardiovascular complications and outcomes of patients hospitalized for COVID-19 in France. Methods The Critical COVID-19 France (CCF) study is a French nationwide study including all consecutive adults with a diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection hospitalized in 24 centres between 26 February and 20 April 2020. Patients admitted directly to intensive care were excluded. Clinical, biological and imaging parameters were systematically collected at hospital admission. The primary outcome was in-hospital death. Results Of 2878 patients included (mean ± SD age 66.6 ± 17.0 years, 57.8% men), 360 (12.5%) died in the hospital setting, of which 7 (20.7%) were transferred to intensive care before death. The majority of patients had at least one (72.6%) or two (41.6%) cardiovascular risk factors, mostly hypertension (50.8%), obesity (30.3%), dyslipidaemia (28.0%) and diabetes (23.7%). In multivariable analysis, older age (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.03 − 1.06; P < 0.001), male sex (HR 1.69, 95% CI 1.11 − 2.57; P = 0.01), diabetes (HR 1.72, 95% CI 1.12 − 2.63; P = 0.01), chronic kidney failure (HR 1.57, 95% CI 1.02 − 2.41; P = 0.04), elevated troponin (HR 1.66, 95% CI 1.11 − 2.49; P = 0.01), elevated B-type natriuretic peptide or N-terminal pro-B-type natriuretic peptide (HR 1.69, 95% CI 1.0004 − 2.86; P = 0.049) and quick Sequential Organ Failure Assessment score ≥ 2 (HR 1.71, 95% CI 1.12 − 2.60; P = 0.01) were independently associated with in-hospital death. Conclusions In this large nationwide cohort of patients hospitalized for COVID-19 in France, cardiovascular comorbidities and risk factors were associated with a substantial morbi-mortality burden.
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Affiliation(s)
- Guillaume Bonnet
- Université de Paris, PARCC, inserm, 75015 Paris, France; Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | - Orianne Weizman
- Université de Paris, PARCC, inserm, 75015 Paris, France; Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-Les-Nancy, France
| | - Antonin Trimaille
- Nouvel hopital Civil, Centre Hospitalier régional universitaire de Strasbourg, 67000 Strasbourg, France
| | - Thibaut Pommier
- Lariboisiere hospital, AP-HP, university of Paris, 75010 Paris, France; Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Joffrey Cellier
- Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | - Laura Geneste
- Centre Hospitalier universitaire d'Amiens-Picardie, 80000 Amiens, France
| | - Vassili Panagides
- Centre Hospitalier Universitaire de Marseille, 13005 Marseille, France
| | - Wassima Marsou
- GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille, Faculté de Médecine et de Maïeutique, Université Catholique de Lille, Lille, France
| | - Antoine Deney
- Centre Hospitalier universitaire de Toulouse, 31400 Toulouse, France
| | - Sabir Attou
- Centre Hospitalier universitaire de Caen-Normandie, 14000 Caen, France
| | - Thomas Delmotte
- Centre Hospitalier universitaire de Reims, 51100 Reims, France
| | | | | | - Clément Karsenty
- Centre Hospitalier universitaire de Toulouse, 31400 Toulouse, France
| | - Gauthier Giordano
- Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-Les-Nancy, France
| | | | | | | | - Audrey Sagnard
- Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Julie Pastiero
- Centre Hospitalier Universitaire de Dijon, 21000 Dijon, France
| | - Nacim Ezzouhairi
- Centre Hospitalier universitaire de Bordeaux, 33076 Bordeaux, France
| | - Benjamin Perin
- Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-Les-Nancy, France
| | - Cyril Zakine
- Clinique Saint-Gatien, 37540 Saint-Cyr-sur-Loire, France
| | - Thomas Levasseur
- Centre Hospitalier intercommunal Fréjus-Saint-Raphaël, 83600 Fréjus, France
| | - Iris Ma
- Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | | | | | - Arthur Darmon
- Hôpital Bichat-Claude-Bernard, AP-HP, université de Paris, 75018 Paris, France
| | - Marine Mevelec
- Centre Hospitalier régional de Orléans, 45100 Orléans, France
| | - Baptiste Duceau
- Université de Paris, PARCC, inserm, 75015 Paris, France; Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-Les-Nancy, France
| | - Willy Sutter
- Université de Paris, PARCC, inserm, 75015 Paris, France; Centre Hospitalier Régional Universitaire de Nancy, 54511 Vandoeuvre-Les-Nancy, France
| | - Delphine Mika
- Université Paris-Saclay, Inserm, UMR-S 1180, 92296 Chatenay-Malabry, France
| | - Charles Fauvel
- Rouen University Hospital, FHU REMOD-VHF, 76000 Rouen, France
| | - Théo Pezel
- Lariboisiere hospital, AP-HP, university of Paris, 75010 Paris, France
| | - Victor Waldmann
- Université de Paris, PARCC, inserm, 75015 Paris, France; Hôpital Européen Georges-Pompidou, Université de Paris, 75015 Paris, France
| | - Ariel Cohen
- Hôpital Saint-Antoine, Saint-Antoine and Tenon hospitals, AP-HP, Inserm UMRS-ICAN 1166 Sorbonne-Université, French Society of Cardiology 2020-2022, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France.
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