Int J Heart Fail.  2021 Apr;3(2):138-145. 10.36628/ijhf.2021.0002.

Impact of COVID-19 Pandemic Lockdown in Decompensated Heart Failure Hospitalizations

Affiliations
  • 1Department of Heart Failure, Pulmonary Hypertension and Transplant, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
  • 2Department of Clinical Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
  • 3Department of Clinical Research, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina

Abstract

Background and Objectives
Coronavirus disease 2019 (COVID-19) pandemic lockdown may have collaterally affected the care of patients with acute decompensated heart failure (ADHF). We aimed to evaluate the impact of lockdown pandemic on hospitalizations for ADHF.
Methods
We conducted a single-center study, performing a retrospective analysis of prospectively collected data. We included consecutive adult patients with a primary diagnosis of ADHF admitted to a cardiovascular disease specialized hospital. We compared those patients admitted between March–June of 2019 (before COVID-19 [BC]) and 2020 (after COVID-19 [AC]), during mandatory lockdown.
Results
A total 79 corresponding to BC period and 60 to AC period were included, representing a decrease of 25% (interquartile range [IQR], 11–33). During the BC period, 31.6% of patients were referred from other centers compared to 15% during the pandemic (p=0.02). In the AC period patients were older (median age, 81[IQR, 73–87] years vs. 77 [IQR, 64–84] years, p=0.014). The etiology of HF, cause of decompensation, left ventricular function, and laboratory parameters were similar in both periods. The use of mechanical ventilation (13.9% vs. 3.3%, p=0.03) and circulatory support (7.6% vs. 0%, p=0.02) was higher in the BC period. During the BC period, 5 emergency heart transplants were performed, and none in AC, (p=0.004). In-hospital mortality was similar in both periods (3.8% vs. 3.3%; p=0.80).
Conclusions
We observed a reduction in the number of hospitalizations and referral of patients for ADHF during COVID-19 pandemic.

Keyword

Heart failure; Coronavirus; COVID-19; Hospitalization; Mortality
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