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COVID-19 and Heart Failure with Preserved and Reduced Ejection Fraction Clinical Outcomes among Hospitalized Patients

Adeel Nasrullah1, Karthik Gangu2, Harmon R Cannon3

  • 1Division of Pulmonology and Critical Care, Allegheny Health Network, Pittsburg, PA 15212, USA.

Viruses
|March 30, 2023
PubMed

Insights

Patients with acute heart failure exacerbation and COVID-19 face significantly higher in-hospital mortality and complications like mechanical ventilation and kidney failure compared to those without COVID-19. This highlights the severe impact of concurrent COVID-19 infection on heart failure outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Heart failure exacerbations are a leading cause of morbidity and mortality.
  • Limited large-scale studies exist on outcomes of acute heart failure (CHF) with concurrent COVID-19.
  • Understanding these outcomes is critical for patient management and public health strategies.

Purpose of the Study:

  • To compare clinical outcomes in patients hospitalized with acute CHF with and without COVID-19 infection.
  • To identify risk factors and disparities associated with higher mortality in this patient population.
  • To inform clinical practice and resource allocation for managing CHF patients during the COVID-19 pandemic.

Main Methods:

  • Utilized the National Inpatient Sample (NIS) database for a large-scale retrospective study.
  • Identified 2,101,980 patients with acute CHF, including 75,215 with COVID-19.
  • Employed multivariate logistic regression, adjusting for demographics, comorbidities, and hospital characteristics.

Main Results:

  • Patients with acute CHF and COVID-19 had significantly higher in-hospital mortality (25.78% vs. 5.47%).
  • Higher rates of vasopressor use, mechanical ventilation, sudden cardiac arrest, and acute kidney injury were observed in the COVID-19 group.
  • Elderly patients, African Americans, and Hispanic individuals experienced higher mortality rates.

Conclusions:

  • Concurrent COVID-19 infection dramatically increases in-hospital mortality for acute CHF exacerbations.
  • COVID-19 exacerbates end-organ dysfunction, including kidney failure and cardiac arrest, in heart failure patients.
  • Disparities in mortality exist among different demographic groups, warranting targeted interventions.

Keywords:
COVID-19HFpEFHFrEFNational Inpatient Sample databaseUnited Statescongestive heart failuremortality

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