Heart failure during the COVID-19 pandemic: clinical, diagnostic, management, and organizational dilemmas

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• The COVID-19 pandemic has significantly disrupted heart failure (HF) patient care.
• Existing guidelines address HF diagnosis and treatment during COVID-19, but knowledge gaps persist regarding disease mechanisms and specific HF phenotypes.
• The precise impact of COVID-19 on different stages and types of heart failure remains poorly understood.

Approach:

• This systematic review examines recent literature on the epidemiology, pathogenetic mechanisms, and differential diagnosis of heart failure in the context of the COVID-19 pandemic.
• It analyzes the relationship between COVID-19 infection and various HF presentations, including acute decompensated HF, right HF, and cardiogenic shock.
• The review also focuses on identifying distinct clinical profiles and addressing concerns in understudied HF populations.

Key Points:

• COVID-19 can exacerbate heart failure through incompletely understood mechanisms.
• Diagnostic differentiation and management require identifying the HF phenotype, etiology, and tailoring therapy.
• Standardized management models are lacking, with care often depending on local hospital organization.

Conclusions:

• Further research is needed to elucidate the mechanisms by which COVID-19 affects heart failure.
• Tailored therapeutic strategies are crucial for managing diverse HF phenotypes during COVID-19.
• Specific populations, including advanced HF, heart transplant recipients, LVAD patients, and those with valve disease, require focused investigation and management strategies.