A study conducted by prof. Marco Metra of the University of Brescia, Director of the Cardiology Unit of ASST-Spedali Civili, describes, for the first time, in the world literature, the demographic data, the clinical characteristics and the prognosis of cardiac Covid-19 patients and compares these data with those of patients without concomitant heart disease. All patients were hospitalized for Covid-19 pneumonia between 4 and 25 March 2020. The results of the study are published in the scientific journal European Heart Journal, the most important in the world in the cardiology field.
“Our analysis showed that Covid-19 patients with concomitant heart disease have an extremely severe prognosis, significantly worse than the already severe one of non-cardiac patients with COVID-19 pneumonia. The main causes of mortality were acute respiratory distress syndrome (ARDS), thromboembolic events, including pulmonary embolism, and septic shock – explains prof. Marco Metra, coordinator of the study -. The studies carried out on Chinese case studies had already suggested the greater susceptibility for heart disease of COVID-19 pneumonia and the possibility of heart damage during infection. In this study, for the first time, both the clinical characteristics and the risk factors for increased mortality of these patients are described: age, history of heart failure, history of renal failure, diabetes. The prognostic significance of some simple laboratory parameters such as creatininemia, plasma troponin, lymphopenia is also confirmed “.
The study series counts 99 consecutive patients with Covid-19 pneumonia: 53 heart patients and 46 without concomitant heart disease.
Among the cardiac patients in the study, 40% had a history of heart failure, 36%, atrial fibrillation and 30% had ischemic heart disease; 67 years the average age with 81% of male patients. In total cases, during hospitalization, 26% of patients died, 15% had thromboembolic events, 19%, an acute respiratory distress syndrome, 6%, a septic shock. The comparison between heart and non-cardiac patients showed the highest mortality of patients with heart disease, 36% against 15% of non-cardiac patients with a higher thromboembolic event and septic shock rate, also higher: 23% against 6%, and 11 % versus 0%, respectively.
Describing for the first time the clinical characteristics and risk factors for increased mortality of heart patients, this study paves the way for future research on Covid-19 infection and the cardiovascular system.