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Vol. 161. Issue 11.
Pages 476-482 (December 2023)
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Vol. 161. Issue 11.
Pages 476-482 (December 2023)
Original article
Impact of SARS-CoV-2 infection in patients with cardiac amyloidosis: Results of a multicentre registry
Impacto de la infección por SARS-CoV-2 en pacientes con amiloidosis cardiaca: resultados de un registro multicéntrico
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José M. Larrañaga-Moreiraa,
Corresponding author
c.larranaga88@gmail.com

Corresponding author.
, Ana I. Rodriguez-Serranob,c, Fernando Domínguezc,d,e, Andrea Lalariof, Esther Zorioe,g,h, Roberto Barriales-Villaa,e, on behalf of the Dilemma International Cardiomyopathy, Heart Failure Registry Investigators Group
a Unidad de Cardiopatías Familiares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Hospital Universitario de A Coruña (HUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
b Hospital Universitario Virgen de Arrixaca, Murcia. Spain
c European Reference Networks for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), Amsterdam, The Netherlands
d Unidad Cardiopatias Familiares, Hospital Universitario Puerta Hierro Majadahonda, IDIPHISA, Madrid, Spain
e Center for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Madrid, Spain
f Cardiovascular Department ‘Ospedali Riuniti’ and University of Trieste, Trieste, Italy
g Unidad Cardiopatías Familiares, Hospital Universitario y Politécnico La Fe, Valencia, Spain
h Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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Tables (4)
Table 1. Baseline characteristics of outpatient and hospitalized CA patients with SARS-CoV-2 infection.
Table 2. Characteristics of alive and dead patients with CA and SARS-CoV-2 infection.
Table 3. Mortality and hospitalization in cardiac amyloidosis and control groups according to age intervals.
Table 4. Comparison of CA patients with control population (univariable and multivariable analysis).
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Additional material (4)
Abstract
Background

Descriptions on impact of SARS-CoV-2 infection in patients with cardiac amyloidosis (CA) are lacking. Our aim was to describe the prognosis of those patients.

Methods

Retrospective observational study of unvaccinated patients with CA who developed SARS-CoV-2 infection enrolled in eleven centres (March 2020 to May 2021). Descriptive analysis of basal characteristics, hospitalization, mortality, and severe clinical course was performed. Comparisons to a population-based control group were made.

Results

Forty-one patients were identified. Most patients had wild-type transthyretin CA (61%) and were on NYHA Class II–III (80.5%). CA patients were commonly hospitalized (73.2%) and those were more symptomatic than outpatients (p=0.035). The 24.4% of CA patients died as consequence of SARS-CoV-2 infection. Patients with CA had an increased risk of hospitalization [OR 6.23 (3.05–12.74), p<0.001] and mortality [OR 2.18 (1.01–4.68), p=0.047] when compared to control population after adjustment by age and sex. After a medium follow-time of 311 days, 41.5% of the CA cohort died.

Conclusions

SARS-CoV-2 infection is associated with high mortality and hospitalization rates in patients with CA, which exceed that expected by their sex and advanced age.

Keywords:
Cardiac amyloidosis
COVID-19
Heart failure
Prognosis
Registries
SARS-CoV-2 infection
Abbreviations:
AL
ATTR
ATTRv
ATTRwt
BMI
CA
COPD
ED
HF
HFpEF
HFmEF
HFrEF
ICU
IQR
LVEF
LVWT
NYHA
SARS-CoV-2
SD
Resumen
Antecedentes

El impacto de la infección por SARS-CoV-2 en pacientes con amiloidosis cardíaca (AC) es desconocido. El principal objetivo de este estudio es describir el pronóstico de estos pacientes.

Métodos

Estudio observacional retrospectivo de pacientes con AC no vacunados que desarrollaron infección por SARS-CoV-2 identificados en 11 centros (marzo 2020/mayo 2021). Se realiza un análisis descriptivo de características basales, hospitalización, mortalidad y curso clínico grave, y se comparan los resultados con una cohorte poblacional.

Resultados

Cuarenta y un pacientes fueron identificados. La mayoría eran AC por transtirretina wild-type (61%) y estaban en clase NYHA II-III (80,5%). La mayoría de los pacientes fueron hospitalizados (73,2%), los cuales tenían peor clase funcional que los ambulatorios (p=0,035). El 24,4% de los pacientes fallecieron como consecuencia de la infección. Los pacientes con AC tenían un mayor riesgo de hospitalización (OR: 6,23; 3.05-12.74; p<0,001) y fallecimiento (OR: 2,18; 1,01-4,68; p=0,047) que la cohorte poblacional tras ajuste por sexo y edad. Tras un seguimiento medio de 311 días, el 41,5% de los pacientes fallecieron.

Conclusiones

La infección por SARS-CoV-2 presenta alto riesgo de mortalidad y hospitalización en pacientes con AC, mayor que la esperada por su sexo y edad.

Palabras clave:
Amiloidosis cardíaca
COVID-19
Insuficiencia cardíaca
Pronóstico
Registro
Infección por SARS-CoV-2

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