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. 2020 Jun;22(6):978-984.
doi: 10.1002/ejhf.1925. Epub 2020 Jul 4.

The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic

Daniel I Bromage  1   2 , Antonio Cannatà  1   2 , Irfan A Rind  2 , Caterina Gregorio  3 , Susan Piper  2 , Ajay M Shah  1   2 , Theresa A McDonagh  1   2   4
Affiliations

The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic

Daniel I Bromage et al. Eur J Heart Fail. 2020 Jun.

Abstract

Aims: To examine the impact of COVID-19 on acute heart failure (AHF) hospitalization rates, clinical characteristics and management of patients admitted to a tertiary Heart Failure Unit in London during the peak of the pandemic.

Methods and results: Data from King's College Hospital, London, reported to the National Heart Failure Audit for England and Wales, between 2 March-19 April 2020 were compared both to a pre-COVID cohort and the corresponding time periods in 2017 to 2019 with respect to absolute hospitalization rates. Furthermore, we performed detailed comparison of patients hospitalized during the COVID-19 pandemic and patients presenting in the same period in 2019 with respect to clinical characteristics and management during the index admission. A significantly lower admission rate for AHF was observed during the study period compared to all other included time periods. Patients admitted during the COVID-19 pandemic had higher rates of New York Heart Association III or IV symptoms (96% vs. 77%, P = 0.03) and severe peripheral oedema (39% vs. 14%, P = 0.01). We did not observe any differences in inpatient management, including place of care and pharmacological management of heart failure with reduced ejection fraction.

Conclusion: Incident AHF hospitalization significantly declined in our centre during the COVID-19 pandemic, but hospitalized patients had more severe symptoms at admission. Further studies are needed to investigate whether the incidence of AHF declined or patients did not present to hospital while the national lockdown and social distancing restrictions were in place. From a public health perspective, it is imperative to ascertain whether this will be associated with worse long-term outcomes.

Keywords: Acute heart failure; COVID-19; Coronavirus; Hospitalization; Management; National Heart Failure Audit.

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Figures

Figure 1
Figure 1
Weekly admissions for heart failure pre‐ and post‐COVID‐19 and in corresponding time periods in 2017 to 2019.
Figure 2
Figure 2
Numbers and trends of heart failure hospitalization by year. CI, confidence interval; IRR, incidence rate ratio.
Figure 3
Figure 3
Numbers and trends of heart failure diagnoses in the second diagnostic position by year.
See this image and copyright information in PMC

Comment in

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