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17 June 2020

Researchers examine the impact of COVID-19 on acute heart failure

A team from the School of Cardiovascular Medicine & Sciences have examined the impact of COVID-19 on acute heart failure hospitalisation rates, clinical characteristics and management of patients admitted to a tertiary Heart Failure Unit during the peak of the pandemic.

Acute heart faliure

Heart failure is when a defect in the structure or function of the heart results in increased pressure in the cardiac chambers, resulting in symptoms of breathlessness and ankle swelling. When these symptoms rapidly deteriorate, reflecting an inability for the heart to pump blood at a rate commensurate to the needs of the body, it is called acute heart failure (AHF).

AHF is a life-threatening condition that typically mandates admission to hospital for urgent treatment. The disease is associated with poor outcomes, with up to 10% in-hospital mortality and one-year mortality of around 30%.

Since the start of the COVID-19 pandemic, there has been a decline in the number of patients presenting to hospital with many acute medical conditions, including heart attack. A team, led by Dr Daniel Bromage and Dr Antonio Cannata, recently investigated whether this was also the case for AHF.

The study found that AHF admissions to King’s College Hospital NHS Foundation Trust significantly decreased during the peak of the pandemic, between 2 March and 19 April. This was compared to both a pre-COVID-19 cohort and corresponding time periods in previous years. In addition, patients hospitalised during the COVID-19 pandemic had more severe symptoms of AHF at admission.

We were aware of a low number of admissions with acute heart failure and were able to demonstrate this using our National Heart Failure Audit data. Understanding the epidemiology of cardiovascular diseases, included heart failure, is an essential part of managing pandemics like this, although we all hope not to see anything similar again.

Dr Daniel Bromage, Clinical Lecturer, School of Cardiovascular Medicine & Sciences

Overall, it remains unclear whether fewer patients developed AHF during this period, or whether patients did not present to hospital while the national lockdown and social distancing restrictions were in place. However, from a public health perspective, it is imperative to ascertain whether this will be associated with worse long-term outcomes.

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Daniel Bromage

Clinical Senior Lecturer & Honorary Consultant Cardiologist