Opinion Review
Copyright ©The Author(s) 2022.
World J Virol. Jan 25, 2022; 11(1): 1-19
Published online Jan 25, 2022. doi: 10.5501/wjv.v11.i1.1
Table 1 Studies highlighting prevalence of heart failure, requirement of intensive care unit level of care and outcomes in hospitalized coronavirus disease 2019 patients, n (%)
No.
1
2
3
4
5
6
7
8
9
10
11
Ref.Inciardi et al[1]Singer et al[2]Zylla et al[3]Russo et al[4]Bhatla et al[5]Peltzer et al[6]Lala et al[7]Shi et al[8]Zhou et al[9]Chen et al[10]Jarrett et al[11]
CountryItalyUnited StatesGermanyItalyUnited StatesUnited StatesUnited StatesChinaChinaChinaUnited States
Total number of patients99737166414700105327364161912742634 (all patients died)
Patients with chronic heart failure21 (21)39 (5)-46 (11.1)88 (13)79 (7.5)276 (10.1)17 (4.1) -1 (< 1)291 (11.1)
Newly diagnosed LV dysfunction--5 (3)-----44 (23)43/176 (24)-
Study typeRC, single centreRC, single centreRC,multicenterRC, multicenterRC, single centreRC, multicenterRC, multicenterRC, single centreRC, multicenterRC, single centerRC of in-patients who died of COVID-19 in a single center
Age (mean ± SD)67 ± 1260 ± 1864.1 ± 16.766.9 ± 15.050 ± 1862 ± 1766.4 (median)64 (range: 21-95)56 (IQR: 46-67)62 (IQR: 44-70)Range: 21-107
Male8 (81)423 (57)108 (65.1)253 (61.1)315 (45)653 (62)1630 (59.5)205 (49.3)119 (62)171 (62)1664 (63.2)
LVEF, % (mean ± SD)48 ± 14-53.0 ± 12.3--HFrEF: 41 (3.8)-----
ICU admission12 (12)59 (8)65 (39.2)-79 (11.28)349 (33.14)--50 (26)-1299 (49.3)
NIV18 (19.1)40 (5)39 (23.5)----32 (7.7)26 (14)102 (37)-
IV2 (2)149 (20.2)37 (22.3)--327 (31.05)307 (11.2)51 (12.3)32 (17)17 (6)140 (53.2)
ECMO/ICD/CRT/PPM--PPM:3 (1.8), ICD:2 (1.2), ECMO:3 (1.8)-----ECMO: 3 (2)ECMO: 1 (<m1)-
Vasopressor--30 (18.1)--323 (30.67)-----
Hospital LOS, d, (mean ± SD)11.4 ± 6.54.7 ± 3.010.5 (IQR 5-22 d)[ICU stay: 8 (IQR 4-22.5)]---5.75 (IQR :3.36-9.56)-11 (7–14) [ICU stay: 8 (4–12)]--
ComplicationsVenous thrombo-embolism: 12 (12), Arterial thrombo-embolism: 3 (3), septic shock/sepsis: 6 (6)----Bacteremia:100 (9.5), VTE: 54 (5.13), stroke/TIA:18 (1.71), AKI requiring RRT: 34 (3.23)Hospitalized at time ofstudy publication: 1098 (40.1)CRRT: 2 (0.5), ARDS: 97 (23.3), Coagulation disorders: 12 (2.9), hospitalized at end of study period:319 (76.7)RRT: 10 (5), sepsis:112 (59), respiratory failure: 103 (54), ARDS: 59 (31), septic shock: 38 (20), coagulopathy: 37 (19), secondary infection:28 (15)AKI: 29 (11), CRRT: 3 (1), sepsis: 179 (65), DIC: 21 (8), shock: 46 (17), ALI: 13 (5)-
Mortality26 (26)68 (9)26 (15.7) 107 (25.8)30 (4)184 (17.47)506 (18.5)57 (13.7)54 (28.2)113 (40)2634 (100)
- Signifies that the variable was not reported in the study.
LV: Left ventricle; RC: Retrospective cohort; LVEF: Left ventricle ejection fraction; HFrEF: Heart failure with reduced ejection fraction; ICU: Intensive care unit; NIV: Non-invasive ventilation; IV: Invasive ventilation; ECMO: Extra-corporeal membrane oxygenation; ICD: Implantable cardiovascular-defibrillator; CRT: Cardiac resynchronisation therapy; PPM: Permanent pacemaker; LOS: Length of stay; IQR: Inter-quartile range; VTE: Venous thrombo-embolism; TIA: Transient ischemic attack; AKI: Acute kidney injury; CRRT: Continuous renal replacement therapy; RRT: Renal replacement therapy; ARDS: Acute respiratory distress syndrome; ALI: Acute liver injury; DIC: Disseminated intravascular coagulation.
Table 2 Studies reporting outcomes in coronavirus disease 2019 patients admitted to intensive care unit, n (%)
No.
1
2
3
4
5
6
Ref.Zeng et al[16]Petrilli et al[17]Bhatla et al [5]Hayek et al[18]Iaccarino et al[19] Arentz et al[20]
CountryChinaUnited StatesUnited StatesUnited StatesItalyUnited States
Total number of patients in ICU3599079501939521
Patients with chronic heart failureNR189 (19.1)22 (28)512 (10.20)60 (15.2)9 (42.9)
Newly diagnosed LV dysfunction/acute heart failure5 (14)--166 (3.3)-7 (33.3)
Study typeRetrospective cohort, single centreProspective cohort, single centreRetrospective cohort, single centreRetrospective cohort, multicenterCross-sectional study, multicenterRetrospective cohort, single centre
Age, (mean ± SD)64.00 (59.50–68.00)68 (58-78)63 ± 1660 ± 15, 63 ± 141 68.9±0.770 (43-92) range
Male23 (66)656 (66.3)40 (51)3165 (63.06)291 (73.7)11 (52)
Risk factorsHypertension: 13 (37), coronary artery disease: 2 (6), arrhythmia: 2 (6), valvular disease:1 (3), diabetes: 10 (29), COPD: 1 (3)Diabetes: 389 (39.3), asthma or COPD: 169 (17.1), chronic kidney disease: 259 (26.2), cancer: 138 (13.9)Coronary heart disease: 21 (27), diabetes mellitus :35 (44), hypertension: 62 (78), atrial fibrillation history: 5 (6), obstructive sleep apnea: 23 (29), COPD: 14 (18), liver disease: 14 (18), chronic kidney disease: 16 (20), current tobacco: 4 (5)Current or former tobacco use: 2174 (43.31), diabetes mellitus: 2110 (42.04), hypertension:3086 (61.48), coronary artery disease:676 (13.46), chronic obstructive pulmonary disease: 43 (0.85), chronic or end stage kidney disease: 819 (16.31), active malignancy:227 (4.52)Hypertension: 256 (65.3), obesity: 49 (12.4), diabetes: 90 (22.8), COPD: 41 (10.4), CKD: 34 (8.6), coronary artery disease: 62 (15.7)Asthma: 2 (9.1), chronic obstructive pulmonary disease: 7 (33.3), diabetes: 7 (33.3), obstructive sleep apnea: 6 (28.6), chronic kidney disease: 10 (47.6), end-stage kidney disease: 2 (9.5), history of solid organ transplant: 2 (9.5), cirrhosis: 1 (4.8), immunosuppression: 3 (14.3)
HFrEF,5 (14)-----
HFpEF0 (0)-----
Drugs----ACE-inhibitors: 97 (24.6), ARB: 66 (16.7), beta-blockers: 96 (24.3), ca-antagonists: 31 (7.8), diuretics: 58 (14.7), alpha-blockers: 7 (1.8)-
ICD--5 (6)---
Ventilation35 (100)647 (65.35)---19 (90.5)
NIV17 (49)----4 (19)
IV18 (51)647 (65.35)-3663 (72.98)-15 (71)
ECMO5 (15)--176 (3.51)--
VasopressorNR--1617 (32.22)-14 (67)
ICU stay duration in days38 (33–47)36 (32-40)-17 (9-30), 6 (4-10)1--
Organ dysfunctionNR--Acute kidney injury requiring RRT: 1003-AKI: 4 (19.1), ALI: 3 (14.3)
Morbidityacute cardiac injury: 21 (60), atrial or ventricular tachyarrhythmia:3 (9)86 (8.68) patients being ventilated and 74 (7.47) patients still admitted at the end of study period-Still in hospital 30 days after ICU admission: 169-Admitted in ICU at end of study: 8 (38.1)
Mortality3 (9)485 (49)-2043 (40.71)-11 (52.4)
1Baseline characteristics of patients who did not have cardiac arrest and those who had cardiac arrest respectively.
- Signifies that the variable was not reported in the study.
ICU: Intensive care unit; LV: Left ventricle; COPD: Chronic obstructive pulmonary disease; CKD: Chronic kidney disease; HFrEF: Heart failure with reduced ejection fraction; HFpEF: Heart failure with preserved ejection fraction; ACE: Angiotensin converting enzyme; ARB: Angiotensin receptor blocker; ICD: Implantable cardiovascular-defibrillator; NIV: Non-invasive ventilation; IV: Invasive ventilation; ECMO: Extra-corporeal membrane oxygenation; ECMO: Extra-corporeal membrane oxygenation; RRT: Renal replacement therapy; AKI: Acute kidney injury; ALI: Acute liver injury.
Table 3 Studies reporting outcomes in heart failure patients with coronavirus disease 2019, n (%)
No.
1
2
3
4
5
Ref.Bhatt et alI[21]Alvarez-Garcia et al[22]Caraballo et al[23]Tomasoni et al[24] Andersson et al[25]
CountryUnited StatesUnited StatesUnited StatesItalyDenmark
Patient number83834222069090
Study typeRetrospective cohort, multicentreRetrospective cohort, multicentreRetrospective cohort, multicentreRetrospective cohort, multicentreRetrospective cohort. multicentre
Age, (mean±SD)71.7 ± 13.272.5 ± 13.378 (IQR: 65-87)73.0 ± 11.4
Male4178 (49.8)236 (55.9)93 (45.1)66 (73.3)
Risk factorsObesity: 2461 (29.4), morbid obesity: 1425 (17.0), hypertension: 6997 (83.5), diabetes: 5107 (60.9), history of arrhythmia: 4548 (54.3), valvular disease: 1417 (16.9), kidney disease: 5020 (59.9), ESKD: 1689 (20.1), smoking: 3665 (43.7), pulmonary disease: 3539 (42.2), asthma: 628 (7.5), anemia: 628 (7.5), malignancy: 290 (3.5)Obesity: 169 (40.0), hypertension: 382 (90.5), diabetes mellitus: 269 (63.7), dyslipidemia: 228 (54.0), CAD: 235 (55.7), stroke: 114 (27.0), atrial fibrillation: 160 (37.9), CKD: 177 (41.9), COPD: 94 (22.3), asthma: 58 (13.7), OSA: 57 (13.5)Hypertension: 164 (79.6)COPD: 67 (32.5)CAD: 73 (35.4)Renal disease:7 9 (38.3)Smoker: 42 (55.3), hypertension: 68 (75.6), dyslipidaemia: 56 (62.2), diabetes: 37 (41.1), atrial fibrillation: 42 (46.7), coronary artery disease: 55 (61.1), COPD: 22 (24.4), CKD: 49 (54.4)
LVEF (%), (mean ± SD)---42.1 ± 13.1-
HFrEF3318 (39.6)128 (30.3)36 (17.5)64 (71)-
HFmrEF-44 (10.4)---
HFpEF3486 (41.6)250 (59.3)-26 (29)-
RV dysfunction---16 (28.6)-
Drugs prior to hospitalization-RAAS inhibitors: 260 (61.6), beta-blockers: 354 (83.9), MRA: 60 (14.2), loop diuretics: 318 (75.4), thiazides: 64 (15.2), antiplatelet: 327 (77.5), anticoagulant: 175 (41.5), statins: 351 (83.2)ACEi/ARB: 58 (28.2), beta-blocker: 94 (45.6), CCB: 69 (33.5), SGLT2i: 1 (0.5), warfarin: 16 (7.8), NOAC: 47 (22.8), diuretic: 99 (48.1), statin: 117 (56.8)ACEi/ARBs/ARNI: 42 (50.0), MRAs: 23 (34.8), beta-blockers: 69 (81.2), direct oral anticoagulants: 17 (20.5), warfarin: 18 (21.6), statins: 47 (56.0)-
ICD/CRT---ICD: 20 (22.2), CRT: 8 (8.9) (both prior to hospitalization)-
ICU2431 (29)98 (23.2)---
Ventilation-96 (22.8)---
NIV---28 (31.1)-
IV-96 (22.8)-5 (5.6)-
ECMO3 (0.04)----
ICU stay duration -5 (2-11)---
Mortality2026 (24.2)169 (40.0)41 (20)37 (41.1)33 (27)
- Signifies that the variable was not reported in the study.
ESKD: End stage kidney disease; CAD: Coronary artery disease; CKD: Chronic kidney disease; COPD: Chronic obstructive pulmonary disease; OSA: Obstructive sleep apnea; LVEF: Left ventricle ejection fraction; HFrEF: Heart failure with reduced ejection fraction; HFmrEF: Heart failure with mid-range ejection fraction; HFpEF: Heart failure with preserved ejection fraction; RV: Right ventricle; RAAS: Renin angiotensin aldosterone system; MRA: Mineralocorticoid receptor antagonist; ACEi: Angiotensin converting enzyme inhibitor; ARB: Angiotensin receptor blocker; CCB: Calcium channel blocker; SGLT: Sodium-glucose linked transporter; NOAC: Novel oral anticoagulants; ARNI: Angiotensin receptor II blocker – neprilysin inhibitor; ICD: Implantable cardiovascular-defibrillator; CRT: Cardiac resynchronisation therapy; ICU: Intensive care unit; NIV: Non-invasive ventilation; IV: Invasive ventilation; ECMO: Extra-corporeal membrane oxygenation.
Table 4 Studies reporting outcomes in heart-transplant patients with coronavirus disease 2019, n (%)
No.
1
2
3
4
5
Ref.Latif et al[27]Ketcham et al[28]Singhvi et al[29]Lima et al[30]Bottio et al[31]
CountryUnited StatesUnited StatesUnited StatesUnited StatesItaly
Patient number28622538
Study typeRetrospective observationalRetrospective observationalRetrospective observationalRetrospective observationalRetrospective observational
Age, (mean ± SD)64 (53.5-70.5)57 (34–73)158.6 (49.1–71.2)262 ± 9.864.9 ± 12.0
Male22 (79)6 (100)14 (63.6)4 (80)31 (82)
Risk factorsHypertension:20 (71), diabetes:17 (61), lung disease: 10 (36), malignancy: 5 (18), chronic kidney disease: 10 (36)Chronic heart failure: 4 (67), chronic kidney disease: 4 (67), Chronic anemia: 3 (50), coronary artery disease: 4 (67), former tobacco smoker: 1 (17), diabetes mellitus: 4 (67), hypertension: 6 (100), obesity: 3 (50), obstructive sleep apnea: 3 (50)Hypertension: 21 (95.5), diabetes: 12 (54.5), lung disease: 3 (13.6), chronic kidney disease stage ≥ III: 14 (63.6), end stage renal disease on dialysis: 3 (13.6), malignancy (excluding non-melanoma skin cancers): 6 (27.3), HIV: 1 (4.5), current smoker: 1 (4.5), former smoker: 7 (31.8), permanent pacemaker: 3 (13.6), charlson comorbidity index ≥ 5: 12 (54.5)Ischemic cardiomyopathy (pre‐HTx): 2 (40), hypertension: 5 (100), hyperlipidemia: 3 (60), diabetes mellitus: 1 (20), obesity: 2 (40), post‐transplant renal insufficiency: 2 (40)Obesity: 7 (18), arterial hypertension: 25 (66), dyslipidemia: 18 (47), diabetes mellitus: 7 (18), former smoker: 8 (21), peripheral vascular disease: 8 (21), COPD: 3 (8), stroke: 1 (2), malignancy: 3 (8), previous PCI: 11 (29)
NYHA class----I:27 (71), II:8 (21), III:3 (8), IV:0 (0)
ICU7 (25)6 (100)4 (18.18)2 (40)4 (10.5)
Ventilation7 (25)5 (83)7 (31.81)2 (40)17 (44)
NIV-03 (13.63)015 (39.4)
IV7 (25)5 (83)4 (18.18)2 (40)2 (5.2)
ECMO-0-00 (0)
Vasopressor-5 (83)3 (13.63)-3 (7.9%)
ICU stay duration in days-8.25 (4-12.5)7 (4-9)--
Organ dysfunctionHD: 3 (10.71)AKI requiring CRRT: 5 (83)RRT: 3 (13.63)AKI requiring HD: 1 (20)-
Morbidity4 (18) patients remained hospitalized at the end of study period2 (33) patients still admitted at the end of the study period-One patient developed mild acute cellular rejectionBacterial coinfection:5 (13), sepsis: 4 (10.5), neurological complication: 1 (2.6), gastrointestinal complication: 1 (2.6)
Mortality7 (25)2 (33)4 (18.18)0 (0)14 (36.8)
1Range.
2IQR.
- signifies that the variable was not reported in the study. All patients had COVID-19 confirmed by RT-PCR.
HIV: Human immunodeficiency virus; Htx: Heart transplant; PCI: Percutaneous coronary intervention; COPD: Chronic obstructive pulmonary disease; NYHA: New York Heart Association; ICU: Intensive care unit; NIV: Non-invasive ventilation; IV: Invasive ventilation; ECMO: Extra-corporeal membrane oxygenation; HD: Hemodialysis; AKI: Acute kidney injury; CRRT: Continuous renal replacement therapy; RRT: Renal replacement therapy; AKI: Acute kidney injury.