Background:It is important to understand the risk for in-hospital mortality of adults hospitalized with acute coronavirus disease 2019 (COVID-19) infection with a history of heart failure (HF).Methods:We examined patients hospitalized with COVID-19 infection from January 1, 2020 to July 22, 2020, from 88 centers across the US participating in the American Heart Association’s COVID-19 Cardiovascular Disease registry. The primary exposure was history of HF and the primary outcome was in-hospital mortality. To examine the association between history of HF and in-hospital mortality, we conducted multivariable modified Poisson regression models that included sociodemographics and comorbid conditions. We also examined HF subtypes based on left ventricular ejection fraction in the prior year, when available.Results:Among 8920 patients hospitalized with COVID-19, mean age was 61.4±17.5 years and 55.5% were men. History of HF was present in 979 (11%) patients. In-hospital mortality occurred in 31.6% of patients with history of HF, and 16.9% in patients without a history of HF. In a fully adjusted model, history of HF was associated with increased risk for in-hospital mortality (relative risk: 1.16 [95% CI, 1.03–1.30]). Among 335 patients with left ventricular ejection fraction, heart failure with reduced ejection fraction was significantly associated with in-hospital mortality in a fully adjusted model (heart failure with reduced ejection fraction relative risk: 1.40 [95% CI, 1.10–1.79]; heart failure with mid-range ejection fraction relative risk: 1.06 [95% CI, 0.65–1.73]; heart failure with preserved ejection fraction relative risk, 1.06 [95% CI, 0.84–1.33]).Conclusions:Risk for in-hospital mortality was substantial among adults with history of HF, in large part due to age and comorbid conditions. History of heart failure with reduced ejection fraction may confer especially elevated risk. This population thus merits prioritization for the COVID-19 vaccine.

中文翻译：

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因 COVID-19 住院的有心力衰竭病史的成人的临床特征和结局

背景：重要的是要了解因 2019 年急性冠状病毒病 (COVID-19) 感染住院并有心力衰竭 (HF) 病史的成人住院死亡率的风险。方法：我们检查了因 COVID-19 感染住院的患者2020 年 1 月 1 日至 2020 年 7 月 22 日，来自全美 88 个中心参与美国心脏协会的 COVID-19 心血管疾病登记。主要暴露是 HF 病史，主要结果是住院死亡率。为了检查 HF 病史与住院死亡率之间的关联，我们进行了多变量修正泊松回归模型，其中包括社会人口统计学和合并症。我们还根据前一年的左心室射血分数检查了 HF 亚型（如果有的话）。结果：在因 COVID-19 住院的 8920 名患者中，平均年龄为 61.4±17.5 岁，55.5% 为男性。979 名 (11%) 患者有 HF 病史。有 HF 病史的患者住院死亡率为 31.6%，无 HF 病史的患者为 16.9%。在完全调整的模型中，HF 病史与住院死亡率风险增加相关（相对风险：1.16 [95% CI，1.03-1.30]）。在 335 名左心室射血分数患者中，射血分数降低的心力衰竭与完全校正模型的住院死亡率显着相关（射血分数降低的心力衰竭相对风险：1.40 [95% CI，1.10-1.79]；心脏射血分数中等相对风险的心力衰竭：1.06 [95% CI，0.65–1.73]；射血分数保留的心力衰竭相对风险，1.06 [95% CI，0.84–1.33]）。结论：在有 HF 病史的成年人中，住院死亡率的风险很高，这在很大程度上是由于年龄和合并症。射血分数降低的心力衰竭病史可能会带来特别高的风险。因此，这一人群值得优先使用 COVID-19 疫苗。