Clinical and prognostic criteria for the course of heart failure in new coronavirus infection (COVID-19)

Abstract

Background. There is no data on the effect of COVID-19 on patients with chronic heart failure (CHF) and its ability to cause acute heart failure (AHF). The purpose of the work is to study the characteristics, cardiovascular outcomes and mortality in patients with confirmed COVID-19 infection and a previous diagnosis of heart failure (HF), as well as to identify predictors and prognostic consequences of CHF decompensation during hospitalization. Materials and methods. Data were analyzed from 330 patients with confirmed COVID-19 infection and followed up for at least 30 days. Results. The analysis showed that the presence of CHF in the anamnesis, as well as chronic obstructive pulmonary disease and old age, determined a more severe initial clinical condition and were independent predictors of the development of AHF during hospitalization for COVID-19. However, the most important predictor of AHF in these patients was the development of atrial arrhythmias during hospitalization. Atrial fibrillation was by far the most common arrhythmia in these patients. Its consequences can be mediated by numerous and well-known mechanisms, such as loss of mechanical atrial contraction, poor heart rate control, impaired diastolic filling, irregular R-R intervals and neurohormonal activation. Conclusions. Patients with COVID-19 have a significant frequency of CHF, which is associated with a poor prognosis. Moreover, patients with a history of CHF are prone to developing acute decompensation after the diagnosis of COVID-19. Cardiac arrhythmias are the main predictor of the development of AHF.

Keywords

• covid-19
• heart failure
• morbidity
• mortality
• nt-probnp