COVID-19 infection associated with increased mortality in patients with acute heart failure

Patients with acute heart failure are nearly twice as likely to die if infected with COVID-19, according to a study published today. ESC heart failure, Journal of the European Society of Cardiology (ESC). A small, single-center study emphasizes the need to take special precautions to prevent patients with heart failure from becoming infected with COVID-19.

“Our results support prioritization heart Failure patient “When the COVID-19 vaccine becomes available,” said Dr. Amaldeep Dustydal, a senior researcher who is a consultant intervention cardiologist at the North Bristol NHS Trust and the Bristol Heart Institute in the United Kingdom. Heart failure patients People of all ages should be considered a high-risk group and should be advised to wear face masks to maintain social distance and prevent infection. “

Heart failure refers to the progressive weakening of the pumping function of the heart with symptoms of shortness of breath, swelling of the ankles, and malaise.Sudden exacerbation of severe symptoms Acute heart failure-this is First aid You need to be admitted to the hospital for intravenous medication and intensive monitoring.

This study investigated referral rates for acute heart failure during pandemics and at 30-day mortality. The analysis included 283 patients with acute heart failure who were admitted to the cardiology department of the North Bristol NHS Trust. Two-thirds of the patients had chronic heart failure, showing acute exacerbations.First UK date Coronavirus There are two deaths on March 2, 2020, before COVID (January 7 to March 2; 8 weeks) and after COVID (March 3 to April 27; 8 weeks; ie during a pandemic). It was a cutoff for defining a group.

During the pandemic, hospitalization for acute heart failure was significantly reduced, but not statistically significant. A total of 164 patients were hospitalized in the 8 weeks prior to COVID, compared to 119 patients after COVID. This is a 27% reduction (p = 0.06).

“This finding may reflect Public concerns About social distance at the start of the national blockade, delays in reporting symptoms, and anxiety about hospitalization, “Dr. Dustydal said. “In support of these explanations, our data show that referrals increased during the last few weeks of the blockade. According to British media reports, patients were treated by doctors as needed. You are advised to see a doctor. “

The 30-day mortality rate for patients with acute heart failure almost doubled during the pandemic. Approximately 11% of patients in the pre-COVID group died within 30 days, compared to 21% in the post-COVID group. The relative risk is 1.9 (95% confidence interval 1.09-3.3).

Researchers have investigated the factors that may have contributed to the increased mortality rate during a pandemic. Older age and hospitalization during the pandemic were associated with death after adjusting for other factors that could affect the relationship, with hazard ratios of 1.04 and 2.1, respectively. When patients with a positive COVID test were excluded from the analysis, there was no difference in mortality between the groups before and after COVID, indicating a poor prognosis for both patients with acute heart failure and COVID-19.

“This may indicate a direct interaction or susceptibility to worse acute consequences. heart failure Patients with duplicate COVID infections, “said Dr. Dastidar. “It is noteworthy that despite the very low COVID infection rates in our area during the study, the association with higher mortality rates was still clear.”

Dr. Dastidar pointed out that routine testing for COVID-19 infection had not been conducted at the time of the study. He states: “If the COVID test was conducted more widely to further support our findings, it would be beneficial to review more recent hospitalizations. This was a single-center study, so a national analysis survey was conducted. It is worth checking the results. We are keen to look at longer-term data to look for patterns of prognosis in the later stages of this patient population. ”