Since early 2020, different studies have shown an increased prevalence of COVID-19 and poorer prognosis in older adults with cardiovascular comorbidities. This study aimed to assess the impact of heart failure (HF) on cardiovascular complications, intensive care unit (ICU) admissions, and in-hospital mortality in patients hospitalized with COVID-19. The CARDIO COVID 19-20 registry includes 3260 hospitalized patients with a COVID-19 serological diagnosis between May 2020 and June 2021 from Latin American countries. A history of HF was identified in 182 patients (5.6%). In patients with and without previous HF, the incidence of supraventricular arrhythmia was 16.5% vs. 6.3%, respectively (p = 0.001), and that of acute coronary syndrome was 7.1% vs. 2.7%, respectively (p = 0.001). Patients with a history of HF had higher rates of ICU admission (61.5% vs. 53.1%, respectively; p = 0.031) and in-hospital mortality (41.8% vs. 24.5%, respectively; p = 0.001) than patients without HF. Cardiovascular mortality at discharge (42.1% vs. 18.5%, respectively; p < 0.001) and at 30 days post-discharge (66.7% vs. 18.0%, respectively) was higher for patients with a history of HF than for patients without HF. In patients hospitalized with COVID-19, previous history of HF was associated with a more severe cardiovascular profile, with increased risk of cardiovascular complications, and poor in-hospital and 30-day outcomes.

Background: The COVID-19 pandemic has highlighted a correlation between cardiac complications and elevated cardiac biomarkers, which are linked to poorer clinical outcomes. Objective: This study aims to determine the clinical impact of cardiac biomarkers in COVID-19 patients in Latin America. Subjects and methods: The CARDIO COVID 19-20 Registry is a multicenter observational study across 44 hospitals in Latin America and the Caribbean. It included hospitalized COVID-19 patients (n = 476) who underwent troponin, natriuretic peptide, and D-dimer tests. Patients were grouped based on the number of positive biomarkers. Results: Among the 476 patients tested, 139 had one positive biomarker (Group C), 190 had two (Group B), 118 had three (Group A), and 29 had none (Group D). A directly proportional relationship was observed between the number of positive biomarkers and the incidence of decompensated heart failure. Similarly, there was a proportional relationship between the number of positive biomarkers and increased mortality. In Group B, patients with elevated troponin and natriuretic peptide and those with elevated troponin and D-dimer had 1.4 and 1.5 times higher mortality, respectively, than those with elevated natriuretic peptide and D-dimer. Conclusions: In Latin American COVID-19 patients, a higher number of positive cardiac biomarkers is associated with increased cardiovascular complications and mortality. These findings suggest that cardiac biomarkers should be utilized to guide acute-phase treatment strategies.

Background: An advanced age elevates risk for COVID-19-related cardiovascular complications and mortality. This study analyzes cardiovascular comorbidities and outcomes in hospitalized COVID-19 patients across age groups to assess its impact. Methods: The CARDIO COVID 19-20 registry is a prospective, multicenter cohort study of hospitalized SARS-CoV-2 patients across 44 institutions in 14 Latin American countries. Patients were categorized into four age groups, Group 1: under 40 years, Group 2: 40 to 64 years, Group 3: 65 to 79 years, and Group 4: 80 years or older. Results: A total of 3260 patients were included. A total of 36.8% were women, and key comorbidities included overweight/obesity (49.7% [G1: 48.9%, G2: 56.3%, G3: 45.6%, G4: 32.7%]), and hypertension (49% [G1: 11.3%, G2: 40.3%, G3: 67.9%, G4: 80.4%]). Primary cardiovascular complications during hospitalization were arrhythmias (9.1% [G1: 3.4%, G2: 6.1%, G3: 14.9%, G4: 12.9%]), and acute heart failure (8.5% [G1: 3.6%, G2: 6.1%, G3: 12.1%, and G4: 15.2%]). In our cohort, 53.5% of the patients were admitted to the intensive care unit (G1: 49.2%, G2: 57%, G3: 55.3%, G4: 38.3%). In-hospital mortality rose significantly in patients aged 65 and older; G3: 334 (34.7%) and G4: 156 (45.6%) (p value: <0.001). Conclusions: In Latin American COVID-19 patients, older age correlates with more comorbidities, cardiovascular complications, and higher in-hospital and 30-day mortality, indicating age as an independent mortality factor.

Background: Heart transplantation (HT) remains the definitive treatment for advanced heart failure that is refractory to both medical and invasive therapies. Although global registries offer extensive data on survival outcomes, there is a relative paucity of information regarding HT outcomes in Latin America (LATAM), particularly in Colombia. Methods: This study analyzed adult patients who underwent HT between 1995 and 2024, using data obtained from an institutional HT registry (RETRAC) in Cali, Colombia. Survival outcomes were evaluated using Kaplan–Meier curves and Cox proportional hazards models. Results: We included 260 patients who underwent HT in this 29-year cohort from a LATAM country. The median age at transplantation was 51 years, and 77.7% were male. The primary etiologies were idiopathic/dilated cardiomyopathy (IDC) (41.3%), ischemic cardiomyopathy (IC) (27.0%), and valvular heart disease (VHC) (9.7%). The most prevalent comorbidities were hypertension (HTN) (48.3%), diabetes mellitus (DM) (18.9%), and chronic kidney disease (CKD) (13.1%). The overall median survival following HT was 7.4 years. One-year survival was 74.6% (n = 194), five-year survival was 56.9% (n = 147), and ten-year survival was 46.9% (n = 122). Survival differed significantly by age and sex, with patients aged <40 years demonstrating the highest median survival (8.4 years) and those aged ≥60 years the lowest (2.2 years) (p = 0.038). The 40- to 49-year age group exhibited the most pronounced reduction in survival; however, this effect was attenuated after adjustment. Among patients under 40 years, females had significantly higher mortality compared to males (p = 0.0078), with younger males exhibiting better survival. Additionally, patients transplanted between 2016 and 2020 had higher survival rates. CKD was identified as a significant independent risk factor for increased mortality (hazard ratio (HR) = 1.79; 95% CI: 1.15–2.79; p = 0.01). Conclusions: HT patients in Colombia exhibit demographic and clinical profiles comparable to global cohorts; however, they demonstrate lower survival rates and poorer clinical outcomes compared to international registries, such as the International Society for Heart and Lung Transplantation registry. Nonetheless, clinical outcomes are more favorable than those reported in other studies from the LATAM region. CKD emerged as a significant independent predictor of mortality. These findings highlight the need for region-specific strategies aimed at improving HT outcomes in LATAM.

BACKGROUND Previous investigations related to the factor structure of the Patient Health Questionnaire (PHQ-9) have yielded inconclusive results, and there is little consensus about the optimal arrangement of its components. OBJECTIVE This study aim to examine the psychometric properties of the nine-item Patient Health Questionnaire (PHQ-9) in a sample of long-term survivors of severe COVID-19. METHODS The PHQ-9 was administered to 177 patients who were categorized as having suffered previous severe COVID-19 and were followed up to 20 months after this event. Exploratory and confirmatory factor and reliability analyses were performed. RESULTS The one-factor model of PHQ-9 was determined to best fit the sample and demonstrated good psychometric properties and high internal consistency. The factor loadings for the two-factor structure were not consistent with theoretical frameworks of depression and demonstrated lower internal consistency. Subsequent confirmatory analysis indicated a good model fit for the one-factor model CONCLUSIONS The single-factor PHQ-9 was shown to be a valid and reliable instrument for assessing depression in the current sample of patients with history severe COVID-19, followed up to 20 months after this event

Pre-existing (chronic) atrial fibrillation (AF) has been identified as a risk factor for cardiovascular complications and mortality in patients with COVID-19; however, evidence in Latin America (LATAM) is scarce. This prospective and multicenter study from the CARDIO COVID 19–20 database includes hospitalized adults with COVID-19 from 14 countries in LATAM. A parsimonious logistic regression model was used to identify the main factors associated with mortality in a simulated case-control setting comparing patients with a history of AF to those without. In total, 3260 patients were included, of which 115 had AF. The AF group was older, had a higher prevalence of comorbidities, and had greater use of cardiovascular medications. In the model, AF, chronic kidney disease, and a respiratory rate > 25 at admission were associated with higher in-hospital mortality. The use of corticosteroids did not reach statistical significance; however, an effect was seen through the confidence interval. Thus, pre-existing AF increases mortality risk irrespective of other concomitant factors. Chronic kidney disease and a high respiratory rate at admission are also key factors for in-hospital mortality. These findings highlight the importance of comorbidities and regional characteristics in COVID-19 outcomes, in this instance, enhancing the evidence for patients from LATAM.