Temporal trends in decompensated heart failure and outcomes during COVID‐19: a multisite report from heart failure referral centres in London

Abstract

Aims Admission rates for acute decompensated heart failure declined during COVID‐19. However, the impact of this reduction on hospital mortality is unknown. We describe temporal trends in the presentation of patients with acute heart failure (HF) and their in‐hospital outcomes from two referral centres in London during the COVID‐19 pandemic. Methods and results A total of 1372 patients hospitalized for HF in two referral centres in South London between 7 th January and 14 th June 2020, were included in the study and compared to the same time period in 2019. The primary outcome was all‐cause in‐hospital mortality. HF hospitalizations were significantly reduced during the COVID‐19 pandemic, compared to 2019 (p<0.001). Specifically, we observed a temporary reduction in hospitalizations during the COVID‐19 peak, followed by a return to 2019 levels. Patients admitted during the COVID‐19 pandemic had similar demographic characteristics compared to the same period in 2019. However, in‐hospital mortality was significantly higher in 2020 compared to 2019 (p=0.015). Hospitalization in 2020 was independently associated with worse in‐hospital mortality (hazard ratio [HR] 2.23, 95% Confidence Interval [CI] 1.34 – 3.72; p=0.002). Conclusion During the COVID‐19 pandemic there was a reduction in HF hospitalizations and higher in‐hospital mortality. Hospitalisation for HF in 2020 is independently associated with more adverse outcomes. Further studies are required to investigate the predictors of these adverse outcomes to help inform potential changes to the management of HF patients while some constraints to usual care remain. This article is protected by copyright. All rights reserved.

December 2020 at a glance: focus on COVID‐19, comorbidities and palliative care

“…Similarly, a study conducted in London showed a reduction in HF hospitalizations during the pandemic period, compared to the previous year. Although patients had similar characteristics to those of the patients hospitalized in 2019, in‐hospital mortality was significantly higher in 2020 than in 2019 ( P = 0.015) and hospitalization in 2020 was independently associated with increased in‐hospital mortality 2 …”

Cardiac magnetic resonance imaging during the COVID-19 pandemic: A southern Italian single-center experience

“…A relevant information from this study is that, taking into the account the mean number of abnormal CMR studies observed at our department during the previous three-years period and during the pandemic, 48 % of abnormal tests may have been missed during the lockdown. Bath et al [ 17 ] explored trends in hospitalizations for acute cardiovascular conditions before and during the first wave of COVID-19 pandemic in a large, tertiary care institution, observing a strong decline in acute cardiovascular admission and a shortening in hospitalization length. Similarly, Pang et al [ 18 ], in a recent paper stated that their center experienced a reduction in the number of echocardiograms, stress echo, nuclear medicine procedures, calcium score, coronary computed tomography angiography and CMR during pandemic compared to the corresponding months of 2019.…”

Reduction in heart failure admissions with concomitant respiratory viral infections during the novel coronavirus disease-2019 pandemic: Unintended consequence of public health measures in Singapore

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