PMC:7796041 / 10200-13764 JSONTXT

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Baseline Characteristics and Outcomes in Overall Cohort\nMedian age was 64.1 ± 16.7 years, and the majority of patients were male (n = 108, 65.1%). Arterial hypertension constituted the most common risk factor (n = 83, 50.0%). Cardiovascular disease was present in 18.1% (n = 30), cardiomyopathy in 3.0% (n = 5), diabetes mellitus in 17.5% (n = 29), and obesity in 21.7% (n = 36). Other relevant comorbidities comprised pulmonary disease (e.g., chronic obstructive pulmonary disease, pulmonary fibrosis) in 14.5% (n = 24), previous or active cancer disease in 8.4% (n = 14), and conditions associated with immunodeficiency (e.g., due to chronic immunosuppression therapy after organ transplantation or hematological disease) in 8.4% (n = 14). Information on left ventricular ejection fraction (LVEF) was available in 44 patients (26.5%). Mean LVEF in this subgroup was 53.0 ± 12.3%. In three patients a cardiac pacemaker had been implanted (1.8%). Implanted cardioverter-defibrillators (ICDs) were present in two patients (1.2%). Seven patients (4.2%) presented with syncope in association with COVID-19 prior to hospital admission.\nMedian duration of hospitalization was 10.5 days (P25: 5 days; P75: 22 days, n = 154). In 12 patients, data on duration of hospitalization could not be assessed due to transfer to a different center not participating in this study. The majority of patients required oxygen therapy in the course of hospital stay, and over a third of all patients was admitted to intensive care (ICU) or intermediate care units (IMC) (Figure 1). Median duration of ICU/IMC-therapy was 8 days (P25: 4 days; P75: 22.5 days). High-flow oxygen therapy and/or non-invasive ventilation (NIV) by continuous positive airway pressure (CPAP) was necessary in 39 patients (23.5%), and pharmacological circulatory support by vasopressors was provided in 30 patients (18.1%). Thirty-seven patients (22.3%) received mechanical ventilation with a median duration of 17 days (P25: 7.5 days; P75: 26 days). Of these, six patients had to be re-intubated after initially successful weaning (Figure 1). Only a minority of patients underwent extracorporeal membrane oxygenation (ECMO) or in-hospital cardiopulmonary resuscitation (Figure 1).\nWith respect to cardiovascular events, myocarditis was suspected in one patient based on cardiac biomarker-kinetics and mildly reduced LVEF in echocardiography. This patient died due to respiratory failure during the hospital stay. However, the diagnosis of myocarditis could not be confirmed upon autopsy. Four patients were diagnosed with myocardial infarction (2.4%) during hospitalization. Percutaneous coronary intervention (PCI) was performed in two cases, of which one patient presented with ST segment elevation myocardial infarction (STEMI) and one patient with non-ST segment elevation myocardial infarction (NSTEMI). In the other two cases diagnosed with NSTEMI, medical therapy alone was preferred due to clinical instability with predominant respiratory symptoms and stable echocardiographic and ECG findings. One patient with NSTEMI and PCI died in the course of hospitalization due to mesenteric ischemia. Stroke or transient ischemic attack (TIA) was seen in three patients (1.8%). Twenty-six patients died during hospitalization, predominantly due to respiratory failure (n = 20, 76.9%) or other non-cardiac reasons (n = 5, 19.2%). Only one death was attributed to cardiac causes (3.8%), i.e., cardiac circulatory failure in a mechanically ventilated patient with pre-existent severe cardiovascular disease."}

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Baseline Characteristics and Outcomes in Overall Cohort\nMedian age was 64.1 ± 16.7 years, and the majority of patients were male (n = 108, 65.1%). Arterial hypertension constituted the most common risk factor (n = 83, 50.0%). Cardiovascular disease was present in 18.1% (n = 30), cardiomyopathy in 3.0% (n = 5), diabetes mellitus in 17.5% (n = 29), and obesity in 21.7% (n = 36). Other relevant comorbidities comprised pulmonary disease (e.g., chronic obstructive pulmonary disease, pulmonary fibrosis) in 14.5% (n = 24), previous or active cancer disease in 8.4% (n = 14), and conditions associated with immunodeficiency (e.g., due to chronic immunosuppression therapy after organ transplantation or hematological disease) in 8.4% (n = 14). Information on left ventricular ejection fraction (LVEF) was available in 44 patients (26.5%). Mean LVEF in this subgroup was 53.0 ± 12.3%. In three patients a cardiac pacemaker had been implanted (1.8%). Implanted cardioverter-defibrillators (ICDs) were present in two patients (1.2%). Seven patients (4.2%) presented with syncope in association with COVID-19 prior to hospital admission.\nMedian duration of hospitalization was 10.5 days (P25: 5 days; P75: 22 days, n = 154). In 12 patients, data on duration of hospitalization could not be assessed due to transfer to a different center not participating in this study. The majority of patients required oxygen therapy in the course of hospital stay, and over a third of all patients was admitted to intensive care (ICU) or intermediate care units (IMC) (Figure 1). Median duration of ICU/IMC-therapy was 8 days (P25: 4 days; P75: 22.5 days). High-flow oxygen therapy and/or non-invasive ventilation (NIV) by continuous positive airway pressure (CPAP) was necessary in 39 patients (23.5%), and pharmacological circulatory support by vasopressors was provided in 30 patients (18.1%). Thirty-seven patients (22.3%) received mechanical ventilation with a median duration of 17 days (P25: 7.5 days; P75: 26 days). Of these, six patients had to be re-intubated after initially successful weaning (Figure 1). Only a minority of patients underwent extracorporeal membrane oxygenation (ECMO) or in-hospital cardiopulmonary resuscitation (Figure 1).\nWith respect to cardiovascular events, myocarditis was suspected in one patient based on cardiac biomarker-kinetics and mildly reduced LVEF in echocardiography. This patient died due to respiratory failure during the hospital stay. However, the diagnosis of myocarditis could not be confirmed upon autopsy. Four patients were diagnosed with myocardial infarction (2.4%) during hospitalization. Percutaneous coronary intervention (PCI) was performed in two cases, of which one patient presented with ST segment elevation myocardial infarction (STEMI) and one patient with non-ST segment elevation myocardial infarction (NSTEMI). In the other two cases diagnosed with NSTEMI, medical therapy alone was preferred due to clinical instability with predominant respiratory symptoms and stable echocardiographic and ECG findings. One patient with NSTEMI and PCI died in the course of hospitalization due to mesenteric ischemia. Stroke or transient ischemic attack (TIA) was seen in three patients (1.8%). Twenty-six patients died during hospitalization, predominantly due to respiratory failure (n = 20, 76.9%) or other non-cardiac reasons (n = 5, 19.2%). Only one death was attributed to cardiac causes (3.8%), i.e., cardiac circulatory failure in a mechanically ventilated patient with pre-existent severe cardiovascular disease."}

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Baseline Characteristics and Outcomes in Overall Cohort\nMedian age was 64.1 ± 16.7 years, and the majority of patients were male (n = 108, 65.1%). Arterial hypertension constituted the most common risk factor (n = 83, 50.0%). Cardiovascular disease was present in 18.1% (n = 30), cardiomyopathy in 3.0% (n = 5), diabetes mellitus in 17.5% (n = 29), and obesity in 21.7% (n = 36). Other relevant comorbidities comprised pulmonary disease (e.g., chronic obstructive pulmonary disease, pulmonary fibrosis) in 14.5% (n = 24), previous or active cancer disease in 8.4% (n = 14), and conditions associated with immunodeficiency (e.g., due to chronic immunosuppression therapy after organ transplantation or hematological disease) in 8.4% (n = 14). Information on left ventricular ejection fraction (LVEF) was available in 44 patients (26.5%). Mean LVEF in this subgroup was 53.0 ± 12.3%. In three patients a cardiac pacemaker had been implanted (1.8%). Implanted cardioverter-defibrillators (ICDs) were present in two patients (1.2%). Seven patients (4.2%) presented with syncope in association with COVID-19 prior to hospital admission.\nMedian duration of hospitalization was 10.5 days (P25: 5 days; P75: 22 days, n = 154). In 12 patients, data on duration of hospitalization could not be assessed due to transfer to a different center not participating in this study. The majority of patients required oxygen therapy in the course of hospital stay, and over a third of all patients was admitted to intensive care (ICU) or intermediate care units (IMC) (Figure 1). Median duration of ICU/IMC-therapy was 8 days (P25: 4 days; P75: 22.5 days). High-flow oxygen therapy and/or non-invasive ventilation (NIV) by continuous positive airway pressure (CPAP) was necessary in 39 patients (23.5%), and pharmacological circulatory support by vasopressors was provided in 30 patients (18.1%). Thirty-seven patients (22.3%) received mechanical ventilation with a median duration of 17 days (P25: 7.5 days; P75: 26 days). Of these, six patients had to be re-intubated after initially successful weaning (Figure 1). Only a minority of patients underwent extracorporeal membrane oxygenation (ECMO) or in-hospital cardiopulmonary resuscitation (Figure 1).\nWith respect to cardiovascular events, myocarditis was suspected in one patient based on cardiac biomarker-kinetics and mildly reduced LVEF in echocardiography. This patient died due to respiratory failure during the hospital stay. However, the diagnosis of myocarditis could not be confirmed upon autopsy. Four patients were diagnosed with myocardial infarction (2.4%) during hospitalization. Percutaneous coronary intervention (PCI) was performed in two cases, of which one patient presented with ST segment elevation myocardial infarction (STEMI) and one patient with non-ST segment elevation myocardial infarction (NSTEMI). In the other two cases diagnosed with NSTEMI, medical therapy alone was preferred due to clinical instability with predominant respiratory symptoms and stable echocardiographic and ECG findings. One patient with NSTEMI and PCI died in the course of hospitalization due to mesenteric ischemia. Stroke or transient ischemic attack (TIA) was seen in three patients (1.8%). Twenty-six patients died during hospitalization, predominantly due to respiratory failure (n = 20, 76.9%) or other non-cardiac reasons (n = 5, 19.2%). Only one death was attributed to cardiac causes (3.8%), i.e., cardiac circulatory failure in a mechanically ventilated patient with pre-existent severe cardiovascular disease."}