In-hospital mortality in heart failure in Germany during the Covid-19 pandemic

The Covid-19 pandemic affects care for cardiovascular conditions, but data on heart failure (HF) are scarce. This study aims to analyse HF care and in-hospital outcomes during the pandemic in Germany.

A total of 9452 HF admissions were studied using claims data of 65 Helios hospitals; 1979 in the study period (13 March 30 April 2020) and 4691 and 2782 in two control periods (13 March to 30 April 2019 and 1 January to 12 March 2020). HF admissions declined compared with both control periods by 29-38%. Cardiac resynchronization therapy was implanted in 0.55% during the study period, 0.32% [odds ratio (OR) 1.66, 95% confidence interval (CI) 0.68-4.04, P = 0.27] in the previous year and 0.43% (OR 1.35, 95% CI 0.64-2.84, P = 0.43) in the same year control. Intensive care treatment was 6.22% during the study period, 4.49% in the previous year (OR 1.46, 95% CI 1.13-1.89, P < 0.01), and 5.27% in the same year control (OR 1.19, 95% CI 0.96-1.49, P = 0.12). Length of hospital stay was 7.0 ± 5.0 days in the study and 7.8 ± 5.6 (P < 0.01) and 7.3 ± 5.1 days (P = 0.07) in the control periods. In-hospital mortality was 7.0% in the study and 5.5% in both control periods (P < 0.05).

During the early phase of the Covid-19 pandemic in Germany, HF treatment pathways seem not to be affected, but hospital stay shortened and in-hospital mortality increased. As the pandemic continues, this early signal demands close monitoring and further investigation of potential causes.