ESC Heart Failure (Aug 2022)

Impact of SARS‐Cov‐2 infection in patients with hypertrophic cardiomyopathy: results of an international multicentre registry

  • Juan R. Gimeno,
  • Iacopo Olivotto,
  • Ana Isabel Rodríguez,
  • Carolyn Y. Ho,
  • Adrián Fernández,
  • Alejandro Quiroga,
  • Mari Angeles Espinosa,
  • Cristina Gómez‐González,
  • María Robledo,
  • Lucas Tojal‐Sierra,
  • Sharlene M. Day,
  • Anjali Owens,
  • Roberto Barriales‐Villa,
  • Jose María Larrañaga,
  • Jose Rodríguez‐Palomares,
  • Maribel González‐del‐Hoyo,
  • Jesús Piqueras‐Flores,
  • Nosheen Reza,
  • Olga Chumakova,
  • Euan A. Ashley,
  • Victoria Parikh,
  • Matthew Wheeler,
  • Daniel Jacoby,
  • Alexandre C. Pereira,
  • Sara Saberi,
  • Adam S. Helms,
  • Eduardo Villacorta,
  • María Gallego‐Delgado,
  • Daniel deCastro,
  • Fernando Domínguez,
  • Tomás Ripoll‐Vera,
  • Esther Zorio‐Grima,
  • José Carlos Sánchez‐Martínez,
  • Ana García‐Álvarez,
  • Elena Arbelo,
  • María Victoria Mogollón,
  • María Eugenia Fuentes‐Cañamero,
  • Elias Grande,
  • Carlos Peña,
  • Lorenzo Monserrat,
  • Neal K. Lakdawala,
  • Dilema International Cardiomyopathy and Heart Failure Registry and international SHaRe (Sarcomeric Human Cardiomyopathy Registry) Investigators group

Journal volume & issue
Vol. 9, no. 4
pp. 2189 – 2198


Read online

Abstract Aims To describe the natural history of SARS‐CoV‐2 infection in patients with hypertrophic cardiomyopathy (HCM) compared with a control group and to identify predictors of adverse events. Methods and results Three hundred and five patients [age 56.6 ± 16.9 years old, 191 (62.6%) male patients] with HCM and SARS‐Cov‐2 infection were enrolled. The control group consisted of 91 131 infected individuals. Endpoints were (i) SARS‐CoV‐2 related mortality and (ii) severe clinical course [death or intensive care unit (ICU) admission]. New onset of atrial fibrillation, ventricular arrhythmias, shock, stroke, and cardiac arrest were also recorded. Sixty‐nine (22.9%) HCM patients were hospitalized for non‐ICU level care, and 21 (7.0%) required ICU care. Seventeen (5.6%) died: eight (2.6%) of respiratory failure, four (1.3%) of heart failure, two (0.7%) suddenly, and three (1.0%) due to other SARS‐CoV‐2‐related complications. Covariates associated with mortality in the multivariable were age {odds ratio (OR) per 10 year increase 2.25 [95% confidence interval (CI): 1.12–4.51], P = 0.0229}, baseline New York Heart Association class [OR per one‐unit increase 4.01 (95%CI: 1.75–9.20), P = 0.0011], presence of left ventricular outflow tract obstruction [OR 5.59 (95%CI: 1.16–26.92), P = 0.0317], and left ventricular systolic impairment [OR 7.72 (95%CI: 1.20–49.79), P = 0.0316]. Controlling for age and sex and comparing HCM patients with a community‐based SARS‐CoV‐2 cohort, the presence of HCM was associated with a borderline significant increased risk of mortality OR 1.70 (95%CI: 0.98–2.91, P = 0.0600). Conclusions Over one‐fourth of HCM patients infected with SARS‐Cov‐2 required hospitalization, including 6% in an ICU setting. Age and cardiac features related to HCM, including baseline functional class, left ventricular outflow tract obstruction, and systolic impairment, conveyed increased risk of mortality.