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. 2022 Mar 1:350:125-129.
doi: 10.1016/j.ijcard.2021.12.042. Epub 2021 Dec 29.

Patients hospitalised with heart failure across different waves of the COVID-19 pandemic show consistent clinical characteristics and outcomes

Irfan A Rind  1 , Antonio Cannata  2 , Benedict McDonaugh  1 , Barbara Cassimon  1 , Clare Bannister  1 , Paul A Scott  1 , Susan Piper  1 , Daniel I Bromage  2 , Theresa A McDonagh  3
Affiliations

Patients hospitalised with heart failure across different waves of the COVID-19 pandemic show consistent clinical characteristics and outcomes

Irfan A Rind et al. Int J Cardiol. .

Abstract

Background: During the first wave of the COVID-19 pandemic, admissions for cardiovascular disease, including Heart Failure (HF), were reduced. Patients hospitalised for HF were sicker and with increased in-hospital mortality. So far, whether following waves had a different impact on HF patients is unknown.

Methods: All consecutive patients hospitalised for acute heart failure during three different COVID-19 related national lockdowns were analysed. The lockdown periods were defined according to Government guidelines as 23/3/2020 to 4/7/2020 (First Lockdown), 4/11/2020 to 2/12/2020 (Second Lockdown) and 5/1/2021 to 28/2/2021 (Third Lockdown).

Results: Overall, 184 patients hospitalised for HF were included in the study, 95 during the 1st lockdown, 30 during the 2nd lockdown and 59 during the 3rd lockdown. Across the three groups had comparable clinical characteristics, comorbidities and cardiovascular risk factors. Specialist in-hospital care was uninterrupted during the pandemic showing comparable mortality rates (p = 0.10). Although medical therapy for HF was comparable between the three lockdowns, a significantly higher proportion of patients received Angiotensin Receptor-Neprilysin Inhibitors (ARNI) in the second and third lockdowns (p < 0.001).

Conclusions: Although public health approaches changed throughout the pandemic, the clinical characteristics and outcomes of HF patients were consistent across different waves. For patients hospitalised in the subsequent waves, a more rapid optimization of medical therapy was observed during hospitalization. Particular attention should be devoted to prevent collateral cardiovascular damage during public health emergencies.

Keywords: Acute heart failure; COVID-19; Hospitalization; Lockdown; Management; Outcomes; Second wave.

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Figures

Fig. 1
Fig. 1
Weekly admission rates.
Fig. 2
Fig. 2
Kaplan-Meier survival curves for in-hospital mortality across the three study periods.
See this image and copyright information in PMC

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