Pre-exposure immunohematologic features of heart failure associate with COVID-19 mortality
Chronic heart failure, like diabetes, is a pro-inflammatory cardiometabolic condition, but its association with immunodeficiency is less well established. We conducted a retrospective cohort study of US Veterans infected during the first wave of COVID-19 (n = 92,533) to identify relationships between comorbidities, pre-infection immunohematologic (IH) features (based on complete blood cell count parameters), and 60-day mortality. A biomarker sub-analysis of anti-SARS CoV2 antibodies and cytokine levels was also performed (n = 44). Heart failure was independently associated with higher COVID-19 mortality and with the specific IH alterations (especially relative anemia, anisocytosis, and lymphopenia) which themselves predicted non-survival or protracted inflammation. Over half the risk conferred by heart failure was mediated by its anticipatory IH features whereas diabetes risk was unrelated to its associated IH profile. These findings indicate that heart failure is associated with a COVID-19 immunodeficiency distinct from that of diabetes which correlates with antecedent erythrocyte and lymphocyte dyshomeostasis.
Authors
- Lauren Huntington
- Mukesh K. Jain (ORCID: https://orcid.org/0000-0002-1301-292X)
- Carey L. Shive (ORCID: https://orcid.org/0000-0002-6908-1246)
- Varun Sundaram (ORCID: https://orcid.org/0000-0001-6543-8482)
- David R. Sweet (ORCID: https://orcid.org/0000-0002-1982-2958)
- Donald D. Anthony (ORCID: https://orcid.org/0000-0002-1226-5976)
- Christopher L. King (ORCID: https://orcid.org/0000-0003-3873-7860)
- W.H. Wilson Tang (ORCID: https://orcid.org/0000-0002-8335-735X)
- Sadeer G Al-Kindi (ORCID: https://orcid.org/0000-0002-1122-7695)
- Jacek Skarbinski (ORCID: https://orcid.org/0000-0003-1630-5733)
- Jonathan Karn (ORCID: https://orcid.org/0000-0002-2900-094X)
- Mohammad Karnib
- Carl B. Gillombardo
- Jarrod E. Dalton (ORCID: https://orcid.org/0000-0001-8336-1212)
- Steven Juchnowski (ORCID: https://orcid.org/0009-0002-4648-6942)
- Brigid Wilson (ORCID: https://orcid.org/0000-0003-2966-2940)
- Timothy A. Chan (ORCID: https://orcid.org/0000-0002-9265-0283)
- Jürgen Bosch (ORCID: https://orcid.org/0000-0002-2624-4105)
- Douglas Gunzler (ORCID: https://orcid.org/0000-0003-3786-8578)
- Mina K. Chung
- David A. Zidar (ORCID: https://orcid.org/0000-0002-2805-3986)
- Sahil A. Parikh
Institutions
- Cleveland Clinic (US)
- Kaiser Permanente (US)
- Brown University (US)
- University Hospitals of Cleveland (US)
- Columbia University Irving Medical Center (US)
- University Hospitals Cleveland Medical Center (US)
- Louis Stokes Cleveland VA Medical Center (US)
- University School (US)
- MetroHealth Medical Center (US)
- Case Western Reserve University (US)
Publication Details
- Journal
- npj Cardiovascular Health
- Published
- 2024-11-21
- DOI
- https://doi.org/10.1038/s44325-024-00025-7
- Citations
- 2
- Primary Topic
- COVID-19 Clinical Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.78
Funders
- U.S. Department of Veterans Affairs
- Gilead Sciences
- Boston Scientific Corporation
- Kiniksa Pharmaceuticals
- Abiomed
- National Institutes of Health
- National Cancer Institute