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Observational Study
. 2025 Nov 14;61(11):2037.
doi: 10.3390/medicina61112037.

The Epidemiological and Clinical Profiling of Heart Failure-A Retrospective and Comparative Analysis of Cases Before, During, and After the COVID-19 Pandemic in a Romanian Emergency County Clinical Hospital

Maria Cristina Tătar  1   2 , Martin Manole  3 , Iuliu Gabriel Cocuz  4   5 , Alexandru-Constantin Ioniță  3
Affiliations
Observational Study

The Epidemiological and Clinical Profiling of Heart Failure-A Retrospective and Comparative Analysis of Cases Before, During, and After the COVID-19 Pandemic in a Romanian Emergency County Clinical Hospital

Maria Cristina Tătar et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Heart failure (HF) represents a clinical syndrome characterized by symptoms and signs such as fatigue, dyspnea, edema of the lower limb, or pulmonary rales. It usually occurs in elderly individuals due to decreased cardiac pumping function and/or increased diastolic ventricular filling pressures. The COVID-19 pandemic deeply altered many daily life habits, and one of the most affected groups of people were those with chronic diseases because of their need for regular medical follow-up. Furthermore, SARS-CoV-2 infection itself has been shown to exacerbate cardiovascular diseases (CVDs). Materials and Methods: This retrospective, observational, and comparative study aimed to characterize and compare patients with chronic heart failure hospitalized in the Cardiology Department of Medical Clinic II, Mureș County Emergency Clinical Hospital, in Târgu Mureș, Romania, between January and December 2019 (pre-pandemic), January and December 2021 (pandemic), and January and December 2023 (post-pandemic). Results: A total of 406 patients were analyzed: 202 patients hospitalized in 2019, 101 patients hospitalized in 2021, and 103 patients hospitalized in 2023. Women with HF were significantly older (median age 72 years) than men (median age 65 years; p < 0.001). During the pandemic, the median length of hospitalization increased (8 days vs. 7 days in the other periods). The pandemic period was also associated with a decrease in left ventricular ejection fraction (LVEF), as reflected by a higher incidence of patients with HF with reduced ejection fraction (42% during the pandemic; p < 0.01). Conclusions: During and after the pandemic, men exhibited significantly higher rates of right and left bundle branch blocks, as well as chronic obliterating artery disease of the lower limb. Left ventricular function declined during the pandemic in both men and women. Throughout the years, we observed distinct patterns between male and female patients regarding associated diseases or behaviours, suggesting lifestyle and psychological changes due to the COVID-19 pandemic.

Keywords: COVID-19; NT-proBNP; gender specificity; heart failure.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Entry mechanism of SARS-CoV-2 into the cardiac cells (original figure created by Manole Martin with Biorender) [12].
Figure 2
Figure 2
Pathophysiological mechanisms involved in heart failure (original figure created by Manole Martin with BioRender) [13].
Figure 3
Figure 3
Comparative analysis by year of patients’ characteristics. (A). Gender distribution by year. (B). Admission type distribution by year.
Figure 4
Figure 4
BMI category comparison graphical analysis.
Figure 5
Figure 5
NYHA class comparative distribution through the studied periods.
Figure 6
Figure 6
Graphical comparative analysis of LVEF values by year.
Figure 7
Figure 7
Graphical comparative analysis of LVEF classes by year.
See this image and copyright information in PMC

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