24% of heart failure patients hospitalized with COVID-19 die

Nearly one in four hospitalized COVID-19 patients with a recent history of heart failure die, according to a new study published in JACC: Heart Failure.

“Patients with underlying heart failure, in whom maladaptive activation of the renin-angiotensin system is common, may be particularly susceptible to COVID-19 complications,” wrote lead author Ankeet S. Bhatt, MD, division of cardiovascular medicine at Brigham and Women’s Hospital and Harvard Medical School, and colleagues. “Myocardial injury and worsening ventricular function associated with COVID-19 infection have also been reported. There are currently limited data examining clinical outcomes in patients with a history of heart failure hospitalized with COVID-19; therefore, we investigated clinical characteristics, resource use, and in-hospital outcomes in patients with heart failure hospitalized with COVID-19 in a large, administrative U.S. health care database.”

Bhatt et al. focused on data from more than 1.2 million heart failure patients who were treated from January 2019 to March 2020, tracking which patients were also hospitalized from April to September 2020. All data came from the Premiere Healthcare Database, which includes information from more than 1,000 healthcare providers throughout the United States.

Overall, the team found, more than 130,000 heart failure patients from the original cohort were also hospitalized from April to September 2020. While 18% of those patients were hospitalized for issues related to acute heart failure, 6.4% were hospitalized due to COVID-19. All other patients received care for a wide variety of reasons.

The in-hospital mortality rate for heart failure patients hospitalized due to COVID-19 (24.2%) was much higher than it was for patients hospitalized for acute heart failure (2.6%) or other reasons (4.6%).  

Also, patients who were male or morbidly obese were more likely to die while being treated.

“Novel risk mitigation strategies may be needed to care for these high-risk patients, including expanded access to virtual care and telemonitoring,” the authors wrote. “Efforts to optimize HF status including medication optimization and annual influenza vaccination will be important priorities as the COVID-19 pandemic continues. 

The full analysis is available here.

Read about other studies detailing the connection between heart failure and COVID-19 here and here.