RISK FACTORS FOR UNFAVORABLE PROGNOSIS AND PROGRESSION OF CHRONIC HEART FAILURE IN COVID-19 PNEUMONIA

Abstract

Introduction. Patients with chronic heart failure are vulnerable to coronavirus disease (COVID-19). Objectives. To investigate risk factors for unfavorable prognosis and progression of heart failure in hospitalized patients with chronic heart failure and COVID-19 pneumonia. Methods. A retrospective analysis of the medical records of 555 hospitalized patients diagnosed with COVID-19 was conducted. Subsequently, the data of 90 patients with chronic heart failure (CHF) and COVID-19 pneumonia from January – February 2021 were collected at Lviv Clinical Hospital of Emergency Medical Care. The following indices were evaluated: anthropometric and demographic data, complications, treatment results, results of clinical, laboratory, and instrumental examinations, and dynamic NT-proBNP. Results. CHF is recorded in 42.9% of hospitalized patients with COVID-19 and is accompanied by lower values of blood oxygen level (p=0.0474), hemoglobin (p=0.0090), prothrombin time (p=0.0196), prothrombin index (p=0.0196) and higher indicators of glucose (p=0.0032), creatinine (p=0.00001), interleukin-6 (p=0.0041). CHF decompensation is associated with lower values of body temperature (p=0.0047) and blood oxygen saturation (p=0.0076), while hemoglobin level (p=0.0026), higher creatinine values (p=0.0034), interleukin-6 (p=0.0300), aspartate aminotransferase (p=0.0035), troponin I (p=0.0061); are associated with the development of myocardial infarction (p=0.0014), acute arrhythmias (p=0.0011), hypertensive crisis (p=0.0096) and increased mortality (OR=5.72; 95). % CI: 1.84, 17.81; p=0.0026). Conclusions. CHF is common and often fatal in patients with COVID-19, especially in decompensated CHF. Low blood oxygen saturation, myocardial infarction, arrhythmia, hypertensive crisis, increased cardio cytolysis markers and pro-inflammatory cytokines preceding adverse cardiovascular risk factors contribute to CHF decompensation in patients with COVID-19.