Acute heart failure patients at greater risk if infected with Covid: Study

Prashasti Awasthi Mumbai | Updated on January 07, 2021

Research supports prioritising such patients for vaccination

According to research published in ESC Heart Failure, a journal of the European Society of Cardiology (ESC), patients with acute heart failure nearly double their risk of dying if they are infected with Covid-19.

The study highlights the need for patients with heart failure to take extra precautions to avoid catching Covid-19.

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

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He added: “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 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.

The study stated that two-thirds of the patients had chronic heart failure and 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; i.e. during the pandemic).

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There was a substantial, but statistically non-significant, drop in admissions for acute heart failure during the pandemic. A total of 164 patients were admitted in the eight weeks before-Covid compared to 119 patients after-Covid — a 27 per cent reduction, the study added.

Poorer prognosis

Dr Dastidar said: “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.”

"In support of these explanations, our data demonstrate an increase in referrals during the later weeks of lockdown in line with UK media reports encouraging patients to seek medical attention if needed,” he further added.

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.

The researchers noted that 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.

“This may suggest a direct interaction or susceptibility to worse outcomes for acute heart failure patients with superimposed Covid infection,” said Dr Dastidar. “It is noteworthy that our region had very low rates of Covid infection during the study and yet a connection with higher mortality was still apparent.”

Published on January 07, 2021

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