Clinical characteristics and outcomes of patients with heart failure admitted to the intensive care unit with coronavirus disease 2019 (COVID19): a multicenter cohort study

Badreldin, H; Hafidh, DR; Bin Saleh, DR; Al Sulaiman, DR; Al Juhani, DR; Alharbi, DR; Alanazi, DR; Almujarri, MS; Alobathani, MS; Al Harbi, MR; Al Harbi, DR

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: Patients with heart failure in the setting of COVID-19 requiring admission to the intensive care unit may present a set of unique challenges. There is limited data to describe the clinical characteristics and outcomes in this subset of the patient population. PURPOSE: The study"s purpose was to extensively describe the characteristics and outcomes of heart failure patients admitted to the intensive care unit with COVID-19 compared to non-heart failure patients . METHODS: We conducted a multicenter, prospective analysis for all adult critically ill patients with heart failure admitted to intensive care units (ICUs) between March 1 to August 31, 2020, with an objectively confirmed diagnosis of COVID-19. RESULTS: A total of 723 critically ill patients with COVID-19 had been admitted in ICUs, 59 patients with heart failure, and 664 patients with no heart failure before ICU admission. Heart failure patients had significantly more comorbid conditions such as diabetes mellitus, hypertension, dyslipidemia, atrial fibrillation, and acute coronary syndrome. Higher baseline severity scores (APACHE II & SOFA score) and nutritional risk (NUTRIC Score) were observed in heart failure patients. Also, heart failure patients had more acute kidney injury during ICU admission and required more mechanical ventilation within 24 hours of ICU admission. Patients with heart failure had a similar incidence of thrombosis compared to patients with no heart failure. Critically ill patients with COVID-19 and heart failure had similar ICU length of stay (LOS), mechanical ventilation duration, and hospital LOS compared to patients with no heart failure. During ICU stay, patients with heart failure had more in-hospital and ICU deaths in comparison to the non-heart failure group (64.3% vs. 44.6%, P-value <0.01) and (54.5% vs. 39%, P-value = 0.02) respectively. CONCLUSION: In this observational study evaluating the clinical characteristics and outcomes of critically ill COVID-19 patients with heart failure, patients with COVID-19 and heart failure had similar ICU LOS, duration of MV and hospital LOS, thrombosis rate compared to patients with no heart failure. However, during ICU stay, patients with heart failure had more in-hospital and ICU deaths than the non-heart failure group.