Background: Patients with heart failure (HF) are at high risk of unfavorable courses of COVID-19. The aim of this study was to evaluate characteristics and outcomes of COVID-19 patients with HF. Methods: Data of patients hospitalized in a tertiary hospital in Poland between March 2020 and May 2021 with laboratory-confirmed COVID-19 were analyzed. The study population was divided into a HF group (patients with a history of HF) and a non-HF group. Results: Out of 2184 patients (65 ± 13 years old, 50% male), 12% had a history of HF. Patients from the HF group were older, more often males, had more comorbidities, more often dyspnea, pulmonary and peripheral congestion, inflammation, and end-organ damage biomarkers. HF patients had longer and more complicated hospital stay, with more frequent acute HF development as compared with non-HF. They had significantly higher mortality assessed in hospital (35% vs. 12%) at three (53% vs. 22%) and six months (72% vs. 47%). Of 76 (4%) patients who developed acute HF, 71% died during hospitalization, 79% at three, and 87% at six months. Conclusions: The history of HF identifies patients with COVID-19 who are at high risk of in-hospital complications and mortality up to six months of follow-up.
The coronavirus disease 2019 (COVID-19) shows high incidence of thromboembolic events in humans. In the present study, we aimed to evaluate if anticoagulation prior to COVID-19 infection may impact clinical profile, as well as mortality rate among patients hospitalized with COVID-19. The study was based on retrospective analysis of medical records of patients with laboratory confirmed SARS-CoV-2 infection. After propensity score matching (PSM), a group of 236 patients receiving any anticoagulant treatment prior to COVID-19 infection (AT group) was compared to 236 patients without previous anticoagulation (no AT group). In 180 days, the observation we noted comparable mortality rate in AT and no AT groups (38.5% vs. 41.1%, p = 0.51). Similarly, we did not observe any statistically significant differences in admission in the intensive care unit (14.1% vs. 9.6%, p = 0.20), intubation and mechanical ventilation (15.0% vs. 11.6%, p = 0.38), catecholamines usage (14.3% vs. 13.8%, p = 0.86), and bleeding rate (6.3% vs. 8.9%, p = 0.37) in both groups. Our results suggest that antithrombotic treatment prior to COVID-19 infection is unlikely to be protective for morbidity and mortality in patients hospitalized with COVID-19.
Background: Multimorbidity is a common problem worldwide. It carries the risk of reduced quality of life, disability, frequent hospitalizations, and death. The present study was designed to assess the relationships that exist between multimorbidity and disability in elderly patients. Methods: The study included 100 patients and was conducted between October 2020 and January 2021. Inclusion criteria included age >65 years, presence of a minimum of two comorbidities in the subject, and consent to participate in the study. Standardized survey instruments such as Tilburg Frailty Indicator (TFI), Charlson Comorbidities Index (CCI), Assessment of Basic Activities of Daily Living—Katz Scale (ADL), and Assessment of Complex Activities of Daily Living—Lawton Scale (IADL) were used in the study. Results: The majority of the subjects (92) had a frailty syndrome (TFI). A small group of respondents (8%) suffered from severe comorbidities (CCI). Among the subjects surveyed, 71% maintained full function in performing simple activities of daily living (ADL), while 29% demonstrated moderate disability on the scale. Full independence in performing complex activities of daily living (IADL) was present in 33% of the respondents, and 67% were partially independent. Independence in complex activities of daily living (IADL) was significantly higher in patients with fewer comorbidities. The severity of comorbidities (CCI) had a significant effect on the decrease in the level of independence (ADL and IADL). Independence in performing complex activities (IADL) was worse among older patients. Conclusions: An increase in the number of comorbidities contributes to a decrease in the level of performance of complex activities of daily living. The severity of comorbidities significantly reduces the level of independence of the subjects in simple and complex activities of daily living. In patients with a higher level of independence in performing simple and complex activities, the co-occurrence of frailty syndrome was less severe. As the age of the subjects increases, the frequency in which they show moderate dependence on third parties in performing complex activities of daily living increases.
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