History of Heart Failure and COVID-19 Prognosis

The emergence of COVID-19 has brought with it a myriad of questions that require answers, and quickly. Among these pressing questions are those regarding the various risk factors that can contribute to negative outcomes among individuals who contract the virus.

A correlation between pre-existing heart problems and adverse outcomes in patients with COVID-19 has been presumed from nearly the beginning of the outbreak. Despite this presumption and the seemingly observable link between the two, there is very little scientific data to prove it.

This is especially true when the generalized idea of pre-existing heart conditions is broken down into smaller, more specific categories. One such category which may have a significant impact on COVID-19 prognosis is pre-existing heart failure. To develop a more comprehensive understanding of how this risk factor and COVID-19 infection interact, researchers designed a retrospective analysis of patients that fit the profile.

The Study

Between February 27 and June 26, 2020, in New York City, 6,439 patients were admitted to a Mount Sinai Health System hospital for COVID-19. Using the data gathered during these patients’ stays, researchers retrospectively analyzed their outcomes.

The characteristics and outcomes of note were in-hospital mortality, length of stay, mechanical ventilation, and need for intensive care. If patients did have a history of heart failure, etiology, functional class, and left ventricular ejection fraction were informed by manual chart abstraction.

Findings

Of the patients included in the study, 45% were women, 55% were men, and the mean age was 63.5.

Patients with a history of heart failure had an average stay of two extra days compared to those without (eight versus six), were more likely to require mechanical ventilation (22.8% versus 11.9%), and experienced mortality at an increased rate (40% versus 24.9%).

Among patients with previous heart failure, outcomes were comparable regardless of left ventricular ejection fraction or renin-angiotensin-aldosterone inhibiter use.

What it Means

The presence of pre-existing heart failure correlated with a higher risk of negative outcomes among COVID-19 patients. This was true regardless of left ventricular ejection fraction and applied to both mechanical ventilation and mortality.

With the presumption of a link between previous heart failure and a more dire COVID-19 prognosis scientifically proven, doctors and researcher now have the task of determining how to counteract this significant risk factor, uncover the underlying reasons why the link exists, and develop treatments to give such individuals a more positive prognosis.

This blog has been published in collaboration with Prairie Cardiology, the premier Cardiology group in Illinois. Prairie Cardiovascular is a national leader in providing high-quality, state-of-the-art heart and vascular care. Make an appointment with one of the providers today, through ACCESS Prairie program.