RESUMEN
Background Chest computed tomography (CT) provides an effective modality to evaluate patients with suspected coronavirus disease 2019 (COVID-19). However, overlapping imaging findings with cardiogenic pulmonary edema is not uncommon. Reports comparing the chest CT features of these diseases have not been elaborated. Thus, we aimed to show the difference between the low-dose lung CT findings of COVID-19 pneumonia and comparing them to those with acute heart failure (HF). Methods This retrospective analysis enrolled hospitalized patients with COVID-19 (n=10) and acute heart failure (n=9) that exclusively underwent low-dose chest CT scans within 24 hours of admission. Clinical and lung CT characteristics were collected and analyzed. Results The appearance of ground-glass-opacities (GGOs) has been recorded in all individuals in the HF and COVID-19 groups. There was no significant statistical difference between the two groups for rounded morphology, consolidation, crazy paving pattern, lesion distribution, and parenchymal band (P> 0.05). However, diffuse lesions were more frequent in HF cases (55.6% vs. 0%) than in COVID-19 pneumonia, which had a predominantly multifocal pattern. Notably, CT images in HF patients were more likely to have signs of interstitial tissue thickening, such as the interlobular septums, fissures, and peribronchovascular interstitium (55.6% vs 0%, 88.9% vs 20% and 44.4% vs 0%, respectively), as well as cardiomegaly (77.8% vs 0%), increased artery to bronchus ratio (55.6% vs 0%), and pleural effusions (77.8% vs 0%). Conclusions Major overlaps of lung CT imaging features existed between COVID-19 pneumonia and acute HF cases. However, signs of fluid redistribution are clues that favor HF over COVID-19 pneumonia.
RESUMEN
BACKGROUND: This study aimed to assess the factors contributing to the outcomes of recently hospitalized patients with heart failure (HF). METHODS: A prospective data of 76 adults who were admitted due to acute HF between October 1, 2019 and June 30, 2020 at our center were analyzed. Endpoints included survival and rehospitalization within six months after discharge. RESULTS: The mean age was 64.9 ± 13.8 years, with a male preponderance (68.4%). Approximately 60.5% of patients had the left ventricular ejection fraction (LVEF) <40%, whereas 26.3% of patients had LVEF ≥50%. Coronary artery disease (75%), arterial hypertension (72.4%), chronic kidney disease (46.1%), and diabetes mellitus (46.1%) were the most frequent comorbidities. Poor compliance (40.8%) and non-cardiac infection (21.1%) were the common precipitating factors for hospitalization. The majority of subjects had severe symptoms, indicated by the frequent need of intensive care unit (43%), high N-terminal prohormone brain natriuretic peptide levels [NT-proBNP; median, 4765 (1539.7-11782.2) pg/mL], and presence of either atrial fibrillation, severe mitral regurgitation, or significant pulmonary hypertension in approximately one-third of cases. Even though in-hospital mortality was relatively low (2.6%), the all-cause mortality and rehospitalization rates in the next six months after discharge were still high, reaching 22.54% and 19.72%, respectively. Further survival analysis showed that tachycardia on admission and pre-existing chronic kidney disease (CKD) resulted in low six-month survival rates among these patients. CONCLUSION: After hospital discharge, patients with HF were still exposed to higher risks of death and readmission albeit with the medication addressed. Tachycardia on admission and pre-existing CKD might predict worse outcomes.