Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy

Inciardi, Riccardo M; Adamo, Marianna; Lupi, Laura; Cani, Dario S; Di Pasquale, Mattia; Tomasoni, Daniela; Italia, Leonardo; Zaccone, Gregorio; Tedino, Chiara; Fabbricatore, Davide; Curnis, Antonio; Faggiano, Pompilio; Gorga, Elio; Lombardi, Carlo M; Milesi, Giuseppe; Vizzardi, Enrico; Volpini, Marco; Nodari, Savina; Specchia, Claudia; Maroldi, Roberto; Bezzi, Michela; Metra, Marco

AIMS: To compare demographic characteristics, clinical presentation, and outcomes of patients with and without concomitant cardiac disease, hospitalized for COVID-19 in Brescia, Lombardy, Italy. METHODS AND RESULTS: The study population includes 99 consecutive patients with COVID-19 pneumonia admitted to our hospital between 4 March and 25 March 2020. Fifty-three patients with a history of cardiac disease were compared with 46 without cardiac disease. Among cardiac patients, 40% had a history of heart failure, 36% had atrial fibrillation, and 30% had coronary artery disease. Mean age was 67 ± 12 years, and 80 (81%) patients were males. No differences were found between cardiac and non-cardiac patients except for higher values of serum creatinine, N-terminal probrain natriuretic peptide, and high sensitivity troponin T in cardiac patients. During hospitalization, 26% patients died, 15% developed thrombo-embolic events, 19% had acute respiratory distress syndrome, and 6% had septic shock. Mortality was higher in patients with cardiac disease compared with the others (36% vs. 15%, log-rank P = 0.019; relative risk 2.35; 95% confidence interval 1.08–5.09). The rate of thrombo-embolic events and septic shock during the hospitalization was also higher in cardiac patients (23% vs. 6% and 11% vs. 0%, respectively). CONCLUSIONS: Hospitalized patients with concomitant cardiac disease and COVID-19 have an extremely poor prognosis compared with subjects without a history of cardiac disease, with higher mortality, thrombo-embolic events, and septic shock rates.