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COVID-19 in patients with heart failure: the new and the old epidemic

Nicolò Sisti1, Serafina Valente2, Giulia Elena Mandoli2

  • 1Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy nic.sisti@gmail.com.

Postgraduate Medical Journal
|August 1, 2020
PubMed

Insights

Patients with heart failure face increased risks from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19). Special care and therapy adjustments are crucial for managing these high-risk cardiovascular patients.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Critical Care Medicine

Background:

  • Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rapidly spread globally, causing the coronavirus disease 2019 (COVID-19) pandemic.
  • Patients with pre-existing cardiovascular diseases, particularly chronic heart failure, exhibit a high prevalence among COVID-19 cases.
  • The combination of COVID-19 and heart failure is associated with a poor prognosis and elevated risk of intensive care unit (ICU) mortality.

Purpose of the Study:

  • To highlight the clinical challenges posed by COVID-19 in patients with heart failure.
  • To underscore the mechanisms by which SARS-CoV-2 impacts myocardial function and exacerbates heart failure.
  • To emphasize the need for specialized care and management strategies for heart failure patients during the COVID-19 pandemic.

Main Methods:

  • This study is a review and clinical perspective based on current literature and clinical observations.
  • Analysis of the interplay between SARS-CoV-2 infection and cardiovascular pathophysiology in heart failure patients.
  • Discussion of potential therapeutic adjustments and monitoring protocols.

Main Results:

  • SARS-CoV-2 infection can precipitate myocardial injury and acute decompensation in patients with chronic heart failure.
  • The viral infection presents unique challenges, potentially worsening cardiac function through various pathophysiological pathways.
  • Effective management requires a re-evaluation of existing medical therapies and vigilant monitoring, especially during ventilatory support.

Conclusions:

  • COVID-19 poses a significant threat to patients with heart failure, increasing morbidity and mortality.
  • A multidisciplinary approach is essential, involving careful assessment of cardiac status and adaptation of treatment plans.
  • Prompt recognition and tailored management are critical for improving outcomes in this vulnerable patient population.

Keywords:
CARDIOLOGYHeart failure

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