Experts link COVID-19 infection with higher death rate in heart failure patients 

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Patients with acute heart failure nearly double their risk of dying if they get COVID-19, a new research published in ESC Heart Failure, a journal of the European Society of Cardiology (ESC), has revealed.

“Our results support prioritising heart failure patients for COVID-19 vaccination once it is available,” study lead investigator, Dr. Amardeep Dastidar, a consultant interventional cardiologist at North Bristol NHS Trust and Bristol Heart Institute, United Kingdom, said.

The study also highlighted the need for patients with heart failure to take extra precautions to avoid catching COVID-19.

“In the meantime, heart failure patients of all ages should be considered a high-risk group and be advised to maintain social distance and wear a face mask to prevent infection,” the report said.

According to Dastidar, “this finding may reflect public concerns about social distancing at the start of the national lockdown, delayed reporting of symptoms, and anxiety regarding hospital attendance.”

Heart failure refers to progressive weakening of the heart’s pump function with symptoms of breathlessness, ankle swelling and fatigue.

The study examined referral rates for acute heart failure during the pandemic and 30-day mortality. The analysis included 283 patients with acute heart failure admitted to the cardiology department of North Bristol NHS Trust.

Two-thirds of the patients had chronic heart failure presented with an acute deterioration. The date of the first UK coronavirus death, March 2, 2020, was the cut-off to define two groups: before-COVID (January 7 to March 2; eight weeks) and after-COVID (March 3 to April 27; eight weeks; during the pandemic).

The researchers examined what factors may have been responsible for the higher death rate during the pandemic. Older age and admission during the pandemic were linked with death after adjusting for other factors that could influence the relationship, with hazard ratios of 1.04 and 2.1.

When patients with a positive COVID test were removed from the analysis, there was no difference in mortality between the before- and after-COVID groups – indicating that patients with both acute heart failure and COVID-19 had a poorer prognosis.

The 30-day mortality rate of patients with acute heart failure nearly doubled during the pandemic. Some 11 per cent of patients in the before-COVID group died within 30 days compared to 21 per cent of the after-COVID group – a relative risk of 1.9 (95 per cent confidence interval 1.09–3.3).  

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