Longer Hospitalizations and Higher In-Hospital Mortality for Acute Heart Failure during the COVID-19 Pandemic in
Małgorzata Ostrowska1, Michał Kasprzak1, Wioleta Stolarek1
1Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland.
Insights
The COVID-19 pandemic impacted cardiology departments, reducing admissions and increasing acute heart failure (AHF) mortality, especially in larger centers. Combined AHF and COVID-19 cases showed extremely high mortality regardless of hospital size.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic has caused significant collateral damage beyond direct mortality.
- Understanding its impact on cardiovascular care, specifically acute heart failure (AHF), is crucial.
Purpose of the Study:
- To compare the influence of the COVID-19 pandemic on hospital admissions and in-hospital mortality in large versus small cardiology departments in Poland.
- To analyze outcomes for patients with AHF and COVID-19.
Main Methods:
- A retrospective subanalysis of the COV-HF-SIRIO 6 multicenter study.
- Inclusion of patients hospitalized in 24 Polish cardiology departments between January 2019 and December 2020.
- Focus on patients with acute heart failure (AHF), with and without COVID-19.
Main Results:
- Total hospitalizations decreased by 29.2% in larger and 27.3% in smaller departments (2020 vs. 2019).
- AHF hospitalizations reduced by 21.8% and 25.1%, respectively.
- In-hospital mortality for AHF was higher in larger departments (10.7%) versus smaller ones (3.2%).
- In-hospital mortality for AHF with COVID-19 was extremely high (31.3% vs. 31.6%).
Conclusions:
- Larger cardiology departments experienced longer hospital stays and higher in-hospital mortality for AHF during the pandemic.
- Reduced admissions and very high mortality for AHF with COVID-19 occurred irrespective of department size.
- The pandemic significantly affected cardiovascular care delivery and patient outcomes in Poland.
Background:
The coronavirus disease-2019 (COVID-19) pandemic is surging across Poland, leading to many direct deaths and underestimated collateral damage. We aimed to compare the influence of the COVID-19 pandemic on hospital admissions and in-hospital mortality in larger vs. smaller cardiology departments (i.e., with 2000 vs. 2000 hospitalizations per year in 2019).
Methods:
We performed a subanalysis of the COV-HF-SIRIO 6 multicenter retrospective study including all patients hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, focusing on patients with acute heart failure (AHF) and COVID-19.
Results:
Total number of hospitalizations was reduced by 29.2% in larger cardiology departments and by 27.3% in smaller cardiology departments in 2020 vs. 2019. While hospitalizations for AHF were reduced by 21.8% and 25.1%, respectively. The length of hospital stay due to AHF in 2020 was 9.6 days in larger cardiology departments and 6.6 days in smaller departments (p 0.001). In-hospital mortality for AHF during the COVID-19 pandemic was significantly higher in larger vs. smaller cardiology departments (10.7% vs. 3.2%; p 0.001). In-hospital mortality for concomitant AHF and COVID-19 was extremely high in larger and smaller cardiology departments accounting for 31.3% vs. 31.6%, respectively.
Conclusions:
During the COVID-19 pandemic longer hospitalizations and higher in-hospital mortality for AHF were observed in larger vs. smaller cardiology departments. Reduced hospital admissions and extremely high in-hospital mortality for concomitant AHF and COVID-19 were noted regardless of department size.
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