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Showing content from https://pubmed.ncbi.nlm.nih.gov/32997657/ below:

COVID-19 infections and outcomes in a live registry of heart failure patients across an integrated health care system

. 2020 Sep 30;15(9):e0238829. doi: 10.1371/journal.pone.0238829. eCollection 2020. COVID-19 infections and outcomes in a live registry of heart failure patients across an integrated health care system Megan McCullough³, Michael A Fuery³, Fouad Chouairi⁴, Craig Keating⁵, Neal G Ravindra¹, P Elliott Miller¹, Maricar Malinis⁶, Nitu Kashyap⁵, Allen Hsiao⁵, F Perry Wilson⁷, Jeptha P Curtis^{1 2}, Matthew Grant³, Eric J Velazquez¹, Nihar R Desai^{1 2}, Tariq Ahmad^{1 2}

Affiliations

¹ Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
² Center for Outcomes Research & Evaluation (CORE), Yale New Haven Hospital, New Haven, CT, United States of America.
³ Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America.
⁴ Yale University School of Medicine, New Haven, CT, United States of America.
⁵ Joint Data Analytics Team, Yale New Haven Hospital, New Haven, CT, United States of America.
⁶ Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America.
⁷ Department of Internal Medicine, Section of Nephrology, Yale School of Medicine, New Haven, CT, United States of America.

PMID: 32997657
PMCID: PMC7526909
DOI: 10.1371/journal.pone.0238829

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COVID-19 infections and outcomes in a live registry of heart failure patients across an integrated health care system

César Caraballo et al. PLoS One. 2020.

. 2020 Sep 30;15(9):e0238829. doi: 10.1371/journal.pone.0238829. eCollection 2020. Authors César Caraballo^{1 2}, Megan McCullough³, Michael A Fuery³, Fouad Chouairi⁴, Craig Keating⁵, Neal G Ravindra¹, P Elliott Miller¹, Maricar Malinis⁶, Nitu Kashyap⁵, Allen Hsiao⁵, F Perry Wilson⁷, Jeptha P Curtis^{1 2}, Matthew Grant³, Eric J Velazquez¹, Nihar R Desai^{1 2}, Tariq Ahmad^{1 2} Affiliations

¹ Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
² Center for Outcomes Research & Evaluation (CORE), Yale New Haven Hospital, New Haven, CT, United States of America.
³ Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America.
⁴ Yale University School of Medicine, New Haven, CT, United States of America.
⁵ Joint Data Analytics Team, Yale New Haven Hospital, New Haven, CT, United States of America.
⁶ Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America.
⁷ Department of Internal Medicine, Section of Nephrology, Yale School of Medicine, New Haven, CT, United States of America.

PMID: 32997657
PMCID: PMC7526909
DOI: 10.1371/journal.pone.0238829

Item in Clipboard

Abstract

Background: Patients with comorbid conditions have a higher risk of mortality with SARS-CoV-2 (COVID-19) infection, but the impact on heart failure patients living near a disease hotspot is unknown. Therefore, we sought to characterize the prevalence and outcomes of COVID-19 in a live registry of heart failure patients across an integrated health care system in Connecticut.

Methods: In this retrospective analysis, the Yale Heart Failure Registry (NCT04237701) that includes 26,703 patients with heart failure across a 6-hospital integrated health care system in Connecticut was queried on April 16th, 2020 for all patients tested for COVID-19. Sociodemographic and geospatial data as well as, clinical management, respiratory failure, and patient mortality were obtained via the real-time registry. Data on COVID-19 specific care was extracted by retrospective chart review.

Results: COVID-19 testing was performed on 900 symptomatic patients, comprising 3.4% of the Yale Heart Failure Registry (N = 26,703). Overall, 206 (23%) were COVID- 19+. As compared to COVID-19-, these patients were more likely to be older, black, have hypertension, coronary artery disease, and were less likely to be on renin angiotensin blockers (P<0.05, all). COVID-19- patients tended to be more diffusely spread across the state whereas COVID-19+ were largely clustered around urban centers. 20% of COVID-19+ patients died, and age was associated with increased risk of death [OR 1.92 95% CI (1.33-2.78); P<0.001]. Among COVID-19+ patients who were ≥85 years of age rates of hospitalization were 87%, rates of death 36%, and continuing hospitalization 62% at time of manuscript preparation.

Conclusions: In this real-world snapshot of COVID-19 infection among a large cohort of heart failure patients, we found that a small proportion had undergone testing. Patients found to be COVID-19+ tended to be black with multiple comorbidities and clustered around lower socioeconomic status communities. Elderly COVID-19+ patients were very likely to be admitted to the hospital and experience high rates of mortality.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures
Fig 1. Population distribution of patients in…

Fig 1. Population distribution of patients in the Yale Heart Failure Registry*.

*Darker shading represents…

Fig 1. Population distribution of patients in the Yale Heart Failure Registry*.

*Darker shading represents a greater density of patients in the registry from a zip code.

Fig 2

(a) . Geospatial mapping of…

Fig 2

(a) . Geospatial mapping of heart failure patients who tested negative for COVID-19.…

Fig 2

(a). Geospatial mapping of heart failure patients who tested negative for COVID-19. Dots represent individual patient home addresses. (b). Geospatial mapping of heart failure patients who tested positive for COVID-19. Dots represent individual patient home addresses.

Fig 3. Medical and supportive interventions in…

Fig 3. Medical and supportive interventions in COVID-19+ patients according to clinical outcome.

ICU =…

Fig 3. Medical and supportive interventions in COVID-19+ patients according to clinical outcome.

ICU = Intensive Care Unit; HFNC = High flow nasal canula; NIPPV = Non-invasive positive pressure ventilation; CMO = comfort measures only.