HF hospitalizations: fewer but more severe cases during COVID-19

  • Bromage DI & al.
  • Eur J Heart Fail
  • 1 jun. 2020

  • de Emily Willingham, PhD
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Acute heart failure (HF) hospitalizations declined in hard-hit London during the first wave of the COVID-19 pandemic.
  • HF patients who were admitted had symptoms that were more severe than usual.

Why this matters

  • The authors are concerned that patients with less severe acute HF may have avoided the hospital out of fear of COVID-19, raising worries about later increased HF hospitalization and mortality.

Key results

  • Compared with pre-pandemic (2017-2019), acute HF admissions were significantly lower during the COVID-19 pandemic period:
    • E.g., n=78 in 2019 vs n=26 during the pandemic.
  • 2020 weekly admissions during the pandemic were significantly lower vs all years 2017-2019 and pre-pandemic 2020 (P<.01>
  • More admitted patients with HF also had more severe disease during vs pre-pandemic:
    • NYHA III or IV symptoms: 96% vs 77% (P=.03).
    • Severe peripheral edema: 39% vs 14% (P=.01).
  • Length of stay did not differ between 2019 and the 2020 pandemic period.
  • In-hospital mortality was low during each year.
  • 1 patient had COVID-19 as the primary diagnosis.

Study design

  • King’s College Hospital, London, data reported to the National Heart Failure Audit for England and Wales, March 2-April 19, 2020, compared with a pre-COVID cohort from 2020 and corresponding periods in 2017-2019.
  • Funding: None disclosed.

Limitations

  • Single center.
  • Small numbers in 2020 especially.
  • Observational.