Risk of death nearly doubles when hospitalized COVID-19 patients have a history of heart failure

Hospitalized COVID-19 patients may experience significantly worse outcomes if they have a history of heart failure, according to a new analysis published in the Journal of the American College of Cardiology.

“Among patients hospitalized with COVID-19, patients with heart failure represent a population at the highest potential risk for complications due to a high prevalence of underlying frailty or renal dysfunction among other comorbidities,” wrote lead author Jesus Alvarez-Garcia, MD, PhD, Icahn School of Medicine at Mount Sinai in New York City, and colleagues. “Yet data as to the clinical course and outcomes of COVID-19 among patients with a history of heart failure are scarce.”

To try and uncover additional evidence in this area, the authors retrospectively reviewed data from more than 6,400 patients treated at one of five hospitals maintained by a single New York City-based health system. All patients were treated from Feb. 27 to June 26, 2020, and the mean patient age was 63.5 years old.

Patients with preexisting heart failure experienced a longer median length of stay, the authors reported. The median length of stay was eight days for the heart failure group and six days for all other patients. Patients also faced an increased risk of mechanical ventilation (22.8% vs. 11.9%) and mortality (40% vs. 24.9%).

When looking specifically at patients with preexisting heart failure, left ventricular ejection fraction did not appear to directly impact outcomes in any way. Heart failure with reduced ejection fraction, however, was associated with a greater risk of cardiogenic shock or heart-failure related readmission within 30 days.

“If these findings are confirmed in other populations, history of HF may help guide triage upon hospital presentation and potentially dictate aggressive therapies in the treatment of COVID-19,” the authors concluded.

Read the full study here.