Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy

Summary

This observational cohort study of 99 COVID-19 patients hospitalised in Brescia, Italy (March 2020) compared clinical outcomes between 53 patients with pre-existing cardiac disease and 46 without. Patients with concomitant cardiac disease experienced substantially worse prognosis, with mortality more than double (36% vs. 15%), significantly elevated thrombo-embolic events and septic shock rates, despite similar demographic and clinical presentation between groups except for elevated cardiac biomarkers in the cardiac cohort.

UK applicability

These findings from early pandemic Italy are relevant to UK clinical practice in identifying COVID-19 patients at elevated risk of adverse outcomes, particularly those with pre-existing heart failure, atrial fibrillation, or coronary artery disease. UK clinicians managing COVID-19 admissions should consider heightened monitoring and intervention protocols for cardiac patients, though outcomes may differ with contemporary variants and vaccination status.

Key measures

In-hospital mortality rate, incidence of thrombo-embolic events, acute respiratory distress syndrome prevalence, septic shock incidence, serum creatinine, N-terminal pro-brain natriuretic peptide, high-sensitivity troponin T

Outcomes reported

The study compared mortality, thrombo-embolic events, acute respiratory distress syndrome, and septic shock rates between COVID-19 patients with and without concomitant cardiac disease. Mortality was significantly higher in cardiac patients (36% vs. 15%), with elevated rates of thrombo-embolic events (23% vs. 6%) and septic shock (11% vs. 0%).

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