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Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19

During the COVID-19 pandemic, it was observed that patients with heart disease are more likely to be hospitalized and develop severe COVID-19. Cardiac disease takes the top position among patient comorbidities, heart failure (HF) prevalence reaching almost 5% in the general population older than 35...

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Autores principales: Citu, Ioana Mihaela, Citu, Cosmin, Gorun, Florin, Neamtu, Radu, Motoc, Andrei, Burlea, Bogdan, Rosca, Ovidiu, Bratosin, Felix, Hosin, Samer, Manolescu, Diana, Patrascu, Raul, Gorun, Oana Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910859/
https://www.ncbi.nlm.nih.gov/pubmed/35268473
http://dx.doi.org/10.3390/jcm11051382
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author Citu, Ioana Mihaela
Citu, Cosmin
Gorun, Florin
Neamtu, Radu
Motoc, Andrei
Burlea, Bogdan
Rosca, Ovidiu
Bratosin, Felix
Hosin, Samer
Manolescu, Diana
Patrascu, Raul
Gorun, Oana Maria
author_facet Citu, Ioana Mihaela
Citu, Cosmin
Gorun, Florin
Neamtu, Radu
Motoc, Andrei
Burlea, Bogdan
Rosca, Ovidiu
Bratosin, Felix
Hosin, Samer
Manolescu, Diana
Patrascu, Raul
Gorun, Oana Maria
author_sort Citu, Ioana Mihaela
collection PubMed
description During the COVID-19 pandemic, it was observed that patients with heart disease are more likely to be hospitalized and develop severe COVID-19. Cardiac disease takes the top position among patient comorbidities, heart failure (HF) prevalence reaching almost 5% in the general population older than 35 years in Romania. This retrospective study aimed to determine the potential use of the NYHA classification for HF in hospitalized patients with COVID-19 as prognostic tool for in-hospital mortality, length of hospitalization, and probability of rehospitalization for HF decompensation. We observed that patients with advanced HF had a history of significantly more comorbid conditions that are associated with worse disease outcomes than the rest of patients classified as NYHA I and II. However, regardless of existing diseases, NYHA III, and, especially, NYHA IV, patients were at greatest risk for mortality following SARS-CoV-2 infection. They required significantly longer durations of hospitalization, ICU admission for mechanical ventilation, and developed multiple severe complications. NYHA IV patients required a median duration of 20 days of hospitalization, and their in-hospital mortality was as high as 47.8%. Cardiac biomarkers were significantly altered in patients with SARS-CoV-2 and advanced HF. Although the study sample was small, all patients with NYHA IV who recovered from COVID-19 required a rehospitalization in the following month, and 65.2% of the patients at initial presentation died during the next six months. The most significant risk factor for mortality was the development of severe in-hospital complications (OR = 4.38), while ICU admission was the strongest predictor for rehospitalization (OR = 5.19). Our result highlights that HF patients continue to be vulnerable post SARS-CoV-2 infection. Physicians and policymakers should consider this population’s high likelihood of hospital readmissions when making discharge, hospital capacity planning, and post-discharge patient monitoring choices.
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spelling pubmed-89108592022-03-11 Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19 Citu, Ioana Mihaela Citu, Cosmin Gorun, Florin Neamtu, Radu Motoc, Andrei Burlea, Bogdan Rosca, Ovidiu Bratosin, Felix Hosin, Samer Manolescu, Diana Patrascu, Raul Gorun, Oana Maria J Clin Med Article During the COVID-19 pandemic, it was observed that patients with heart disease are more likely to be hospitalized and develop severe COVID-19. Cardiac disease takes the top position among patient comorbidities, heart failure (HF) prevalence reaching almost 5% in the general population older than 35 years in Romania. This retrospective study aimed to determine the potential use of the NYHA classification for HF in hospitalized patients with COVID-19 as prognostic tool for in-hospital mortality, length of hospitalization, and probability of rehospitalization for HF decompensation. We observed that patients with advanced HF had a history of significantly more comorbid conditions that are associated with worse disease outcomes than the rest of patients classified as NYHA I and II. However, regardless of existing diseases, NYHA III, and, especially, NYHA IV, patients were at greatest risk for mortality following SARS-CoV-2 infection. They required significantly longer durations of hospitalization, ICU admission for mechanical ventilation, and developed multiple severe complications. NYHA IV patients required a median duration of 20 days of hospitalization, and their in-hospital mortality was as high as 47.8%. Cardiac biomarkers were significantly altered in patients with SARS-CoV-2 and advanced HF. Although the study sample was small, all patients with NYHA IV who recovered from COVID-19 required a rehospitalization in the following month, and 65.2% of the patients at initial presentation died during the next six months. The most significant risk factor for mortality was the development of severe in-hospital complications (OR = 4.38), while ICU admission was the strongest predictor for rehospitalization (OR = 5.19). Our result highlights that HF patients continue to be vulnerable post SARS-CoV-2 infection. Physicians and policymakers should consider this population’s high likelihood of hospital readmissions when making discharge, hospital capacity planning, and post-discharge patient monitoring choices. MDPI 2022-03-02 /pmc/articles/PMC8910859/ /pubmed/35268473 http://dx.doi.org/10.3390/jcm11051382 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Citu, Ioana Mihaela
Citu, Cosmin
Gorun, Florin
Neamtu, Radu
Motoc, Andrei
Burlea, Bogdan
Rosca, Ovidiu
Bratosin, Felix
Hosin, Samer
Manolescu, Diana
Patrascu, Raul
Gorun, Oana Maria
Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19
title Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19
title_full Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19
title_fullStr Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19
title_full_unstemmed Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19
title_short Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19
title_sort using the nyha classification as forecasting tool for hospital readmission and mortality in heart failure patients with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910859/
https://www.ncbi.nlm.nih.gov/pubmed/35268473
http://dx.doi.org/10.3390/jcm11051382
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