COVID-19 in patients with cardiac disease: Impact and variables associated with mortality in a cardiology center in Brazil

• Published in: American heart journal plus Vol. 12; p. 100069
• Main Authors: Paulino, Mariah Rodrigues, Moreira, José Alfredo de Sousa, Correia, Marcelo Goulart, dos Santos, Léo Rodrigo Abrahão, Duarte, Ingrid Paiva, Sabioni, Letícia Roberto, Mucillo, Fabiana Bergamin, Garrido, Rafael Quaresma, Pacheco, Stephan Lachtermacher, de Lorenzo, Andrea, Lamas, Cristiane da Cruz
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2021; The Authors. Published by Elsevier Inc; Elsevier
• Subjects: Cardiac disease; Cardiac surgery; Coronavirus; COVID-19; Hospitalization; Mortality; Research Paper; COVID-19; Hospitalization; Coronavirus; Cardiac surgery; Cardiac disease; Mortality
• ISSN: 2666-6022; 2666-6022
• DOI: 10.1016/j.ahjo.2021.100069

Cardiovascular disease is associated with severe COVID-19. Our aim was to describe clinical and laboratory features (including electrocardiographic and echocardiographic ones) and outcomes of patients with cardiac disease hospitalized with COVID-19. This is an observational retrospective study of consecutive adult patients admitted, between March and September of 2020, with confirmed SARSCoV-2 infection. Data were collected as per the ISARIC case report form and complemented with variables related to heart disease. One hundred twenty-one patients were included. Mean age was 60 SD 15.2 years and 80/121(66.1%) were male. Two-thirds of the patients (80/121, 66.1%) had COVID-19 at the time of hospital admission and COVID-19 was the reason for hospitalization in 42 (34.7%). Other reasons for hospital admission were acute coronary syndrome (26%) and decompensated heart failure (14.8%). Chronic cardiac diseases were found in 106/121 (87.6%), mostly coronary artery disease (62%) or valve disease (33.9%). A transthoracic echocardiogram was performed in 93/121(76.8%) and enlarged cardiac chambers were found in 71% (66/93); admission ECG was done in 93 cases (93/121, 76.8%), and 89.2% (83/93) were abnormal. Hospital-acquisition of COVID-19 occurred in 20 (16.5%) of patients and their mortality was 50%. On bivariate analysis for mortality, BNP levels and troponin levels were NOT associated with mortality. On multivariate analysis, only C reactive protein levels and creatinine levels were significant. COVID-19 impacted the profile of hospital admissions in cardiac patients. BNP and troponin levels were not associated with mortality and may not be good prognostic discriminators in cardiac patients. •Cardiac patients with COVID-19 often presented with dyspnea, chest pain and heart failure•Tomographic images showed ground-glass opacities in nearly 3/4 of patients and pleural effusions in 1/4.•Nearly 1/5 cardiac patients acquired COVID-19 while in hospital.•CRP and creatinine levels were associated with mortality in cardiac patients.•BNP and troponin levels were not associated with mortality.