Hospitalizations for heart failure during the <scp>COVID</scp>‐19 pandemic: making sense of the known knowns, known unknowns, and unknown unknowns

Ambrosy, Andrew P.; Fitzpatrick, Jesse K.; Fudim, Marat

doi:10.1002/ejhf.1955

Cited by 5 publications

(12 citation statements)

References 16 publications

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“…1,22 Unfortunately, these facilities cannot replace protocols consisting of blood tests and specific analysis requiring specific bio-profile and metabolomic data. When possible, patient's visits have been replaced by home visits, when study staff to collect required blood samples 20,21 (Table 2).…”

Section: Impact Of Covid-19 Outbreak On Hf Outcome and Health Servicementioning

confidence: 99%

“…18,19 The reduced hospitalization rate should be interpreted in the general context of the pandemic because many of the symptomatic patients remained reluctant to come into the hospital even in the presence of early signs of decompensation because of fear of potential COVID-19 exposure. 20 It is unclear if a better self-care management when "staying home" did influence the rate of hospitalization in the subsequent surges of COVID pandemic. Current picture shows a trend to a higher incidence of HF hospitalizations as compared with the first wave of pandemic.…”

Section: Impact Of Covid-19 Outbreak On Hf Outcome and Health Servicementioning

confidence: 99%

“…The recent definition of HF highlights the importance of a combined laboratory and imaging criteria to identify cardiac structural abnormalities 108,109 . The pre‐HF phase elapses for long period, but cardiac or extracardiac triggers, supraventricular arrhythmia, hypoxaemia, worsening renal function, and COVID infection may precipitate the natural course and impair the haemodynamic status 20,24 . The long‐term consequences of COVID‐19 infection in Stages A and B of HF remains unclear, 110 although baseline characteristics may influence HF development.…”

Section: Introductionmentioning

confidence: 99%

“…Distinguishing between ARDS COVID‐19 and decompensated HF is difficult, and the presence of one does not preclude the other. However, identifying whether one or both is present will appropriately direct management in early phases 19,20 . The common symptoms of both diseases are dyspnoea and fatigue.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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The coronavirus 2019 (COVID-19) infection pandemic has affected the care of patients with heart failure (HF). Several consensus documents describe the appropriate diagnostic algorithm and treatment approach for patients with HF and associated COVID-19 infection. However, few questions about the mechanisms by which COVID can exacerbate HF in patients with high-risk (Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the type of HF occurring during infection is poorly investigated. The diagnostic differentiation and management should be focused on the identification of the HF phenotype, underlying causes, and subsequent tailored therapy. In this framework, the relationship existing between COVID and onset of acute decompensated HF, isolated right HF, and cardiogenic shock is questioned, and the specific management is mainly based on local hospital organization rather than a standardized model. Similarly, some specific populations such as advanced HF, heart transplant, patients with left ventricular assist device (LVAD), or valve disease remain under investigated. In this systematic review, we examine recent advances regarding the relationships between HF and COVID-19 pandemic with respect to epidemiology, pathogenetic mechanisms, and differential diagnosis. Also, according to the recent HF guidelines definition, we highlight different clinical profile identification, pointing out the main concerns in understudied HF populations.

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Section: Impact Of Covid-19 Outbreak On Hf Outcome and Health Servicementioning

confidence: 99%

Section: Impact Of Covid-19 Outbreak On Hf Outcome and Health Servicementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…Notably, there have been ongoing concerns that the novel coronavirus disease 2019 (COVID‐19) pandemic and the public health response (i.e., mitigation strategies) may have unintentionally limited access to community resources (e.g., fresh and nutritious food). 14 , 15 , 16 , 17 , 18 Thus, to address this public health issue, we conducted a remotely administered survey using previously derived and validated questionnaires to describe (1) food security, (2) dietary quality and composition, (3) nutritional understanding, and (4) attitudes towards research among high‐risk HF patients during the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Food security, diet quality, nutritional knowledge, and attitudes towards research in adults with heart failure during the COVID‐19 pandemic

Ambrosy

Malik

Leong

et al. 2022

Clinical Cardiology

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Background: The impact of the novel coronavirus disease 2019 (COVID-19) pandemic on diet and nutrition among older adults with chronic medical conditions have not been well-described. Methods:We conducted a survey addressing (1) food access, (2) diet quality and composition, (3) nutritional understanding, and (4) attitudes towards research among adults with heart failure (HF) within an integrated health system. Adults (≥18 years) with diagnosed HF and at least one prior hospitalization for HF within the last 12 months were approached to complete the survey electronically or by mail.Outcomes included all-cause and HF-specific hospitalizations and all-cause death was ascertained via the electronic health record.Results: Among 1212 survey respondents (32.5% of eligible patients) between May 18, 2020 and September 30, 2020, mean ± SD age was 77.9 ± 11.4 years, 50.1% were women, and median (25th-75th) left ventricular ejection fraction was 55% (40%-60%). Overall, 15.1% of respondents were food insecure, and only 65% of participants answered correctly more than half of the items assessing nutritional knowledge. Although most respondents were willing to participate in future research, that number largely declined for studies requiring blood draws (32.2%), study medication (14.4%), and/or behavior change (27.1%). Food security, diet quality, and nutritional knowledge were not independently associated with outcomes at 90 or 180 days. Conclusion:In a cohort of older adults with HF and multiple comorbidities, a significant proportion reported issues with food access, diet quality, and nutritional knowledge during the COVID-19 pandemic. Future research should evaluate interventions targeting these domains in at-risk individuals.

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Novel findings of respiratory rate increases using the multisensor HeartLogic heart failure monitoring algorithm in COVID-19-positive patients: a case series

Yapejian

Fudim

2021

European Heart Journal - Case Reports

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Background With the ongoing coronavirus disease 2019 (COVID-19) epidemic, remote monitoring of patients with implanted cardiac devices has become more important than ever, as physical distancing measures have placed limits on in-clinic device monitoring. Remote monitoring alerts, particularly those associated with heart failure trends, have proved useful in guiding care in regard to monitoring fluid status and adjusting heart failure medications. Case summary This report describes use of Boston Scientific’s HeartLogic algorithm, which is a multisensor device algorithm in implantable cardioverter-defibrillator devices that is proven to be an early predictor of heart failure decompensation by measuring several variables, including respiratory rate, nighttime heart rate, and heart sounds. We present three cases of patients who were actively surveilled by the various HeartLogic device algorithm sensors and were identified to have increasing respiratory rates high enough to trigger a HeartLogic alert prior to a positive COVID-19 diagnosis. Discussion We propose that the HeartLogic algorithm and its accompanying individual physiologic sensors demonstrate potential for use in identifying non-heart failure-related decompensation, such as COVID-19-positive diagnoses.

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Hospitalizations for heart failure during the COVID‐19 pandemic: making sense of the known knowns, known unknowns, and unknown unknowns

Abstract: This article refers to 'The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic' by D.I. Bromage et al.

Cited by 5 publications

References 16 publications

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

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

Food security, diet quality, nutritional knowledge, and attitudes towards research in adults with heart failure during the COVID‐19 pandemic

Novel findings of respiratory rate increases using the multisensor HeartLogic heart failure monitoring algorithm in COVID-19-positive patients: a case series

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