“In the meantime, patients with heart failure of all ages should be seen as a high risk group and should be advised to maintain a social pace and wear a face mask to prevent infection, ”Amardeep Dastidar, study author and consultant intervention cardiologist at Bristol NHS Trust Farm and Bristol Heart Institute in Bristol, United Kingdom, said in a statement.
The symptoms that develop suddenly and severely are a sign of congestive heart failure, requiring hospital admission, intravenous medication, and intensive examination.
The study analyzed transmission rates and 30-day mortality for patients with severe heart failure during the pandemic. The investigators included 283 patients admitted to the Cardiology Department of North Bristol NHS Trust. Chronic heart failure and severe damage were detected in two-thirds of patients.
The date of the first COVID-related death in the United Kingdom, 2 March 2020, was the end date that divided patients into the pre-COVID group (January 7-March 2) and the group after COVID (3 March) -April 27), which identified patients admitted at the time of the pandemic.
During the pandemic, there was a staggering 27% non-statistically significant drop in hospital admission for coronary heart failure, from 164 patients before the pandemic to 119 patients after (P. = .06).
“We suggest that, as has been reported in other cardiac emergencies, the reduction in admissions for hungry HF may reflect public concern about social distance during national lockouts and attendance concerns. hospitals combined with the avoidance of primary care-led primary care, ”the inspectors wrote in the report.
Moreover, the 30-day mortality rate of admitted patients was nearly twice as high in the COVID-19 group compared with the pre-COVID group: 21% vs. 11% (risk ratio, 1.9; 95% CI 1.09–3.3).
The researchers examined factors that may have contributed to the higher mortality rate during the pandemic. Old age (HR, 1.04; P. = .03) and hospital admission (HR, 2.1; P. = .017) during the pandemic associated with death after adjustment for other complication factors.
When patients who were positive for COVID-19 were excluded from the study, there was no difference in mortality between the two study groups, suggesting that patients with congestive heart failure had a worse prognosis. when they also had COVID-19.
“This may suggest a direct or likely interaction to worse outcomes for patients with congestive heart failure with over-the-counter COVID disease,” Dastidar said.
The researchers noted that their findings are in line with a similar study conducted in London, which had a much higher case volume during the first wave of the pandemic compared to Bristol. However, they also noted a German study that showed a lower mortality rate of 7% compared to the current study.
“Continue further and, given the reported regional disparities, data from other centers as well as data from the community HF service would be required to fully evaluate this interaction and to truly understand the effects of pandemic on an emergency card. demonstrations, ”wrote the inspectors.
Resources
Doolub G, Wong C, Hewitson L, et al. Impact of COVID-19 on patient referral within cardiac failure: A single-center experience from the south-west of the UK. ESC heart failure. Published online: January 6, 2021. doi: 10.1002 / ehf2.13158