Increased susceptibility to SARS-CoV-2 infection in patients with reduced left ventricular ejection fraction.
Acute Coronary Syndrome
/ complications
Aged
COVID-19
/ etiology
Disease Susceptibility
/ etiology
Female
France
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Propensity Score
Retrospective Studies
SARS-CoV-2
Stroke Volume
Ventricular Dysfunction, Left
/ complications
Acute coronary syndrome
Coronavirus disease 2019
Heart failure
Journal
ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
18
06
2020
revised:
03
09
2020
accepted:
13
10
2020
pubmed:
19
11
2020
medline:
6
3
2021
entrez:
18
11
2020
Statut:
ppublish
Résumé
Cardiovascular disease has been recognized as a major determinant of coronavirus disease 2019 (COVID-19) vulnerability and severity. Angiotensin-converting enzyme (ACE) 2 is a functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is up-regulated in patients with heart failure. We sought to examine the potential association between reduced left ventricular ejection fraction (LVEF) and the susceptibility to SARS-CoV-2 infection. Of the 1162 patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention between February 2014 and October 2018, we enrolled 889 patients with available clinical follow-up data. Follow-up was conducted by telephone interviews 1 month after the start of the French lockdown which began on 17 March 2020. Patients were divided into two groups according to LVEF <40% (reduced LVEF) (n = 91) or ≥40% (moderately reduced + preserved LVEF) (n = 798). The incidence of COVID-19-related hospitalization or death was significantly higher in the reduced LVEF group as compared with the moderately reduced + preserved LVEF group (9% vs. 1%, P < 0.001). No association was found between discontinuation of ACE-inhibitor or angiotensin-receptor blockers and COVID-19 test positivity. By multivariate logistic regression analysis, reduced LVEF was an independent predictor of COVID-19 hospitalization or death (odds ratio: 6.91, 95% confidence interval: 2.60 to 18.35, P < 0.001). In a large cohort of patients with previous ACS, reduced LVEF was associated with increased susceptibility to COVID-19. Aggressive COVID-19 testing and therapeutic strategies may be considered for patient with impaired heart function.
Identifiants
pubmed: 33205916
doi: 10.1002/ehf2.13083
pmc: PMC7753539
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
380-389Subventions
Organisme : GERCA
Informations de copyright
© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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