HFpEF burden in patients with COVID-19 calls for action

A systematic review into the effects of COVID-19 on survival in heart failure with preserved ejection fraction (HFpEF) patients showed that HFpEF co-morbidity in COVID-19 infection may reduce the survival chances of these patients. These findings imply that improved care is needed for patients with HFpEF during the ongoing pandemic [1].

“Patients with pre-existing cardiovascular comorbidities show worse outcomes after a COVID-19 infection,” postulated Ms Jieling Chen (Gaithersburg, USA) [2]. The current study is the first systematic review designed to understand the burden and unmet needs of patients with HFpEF who are infected with COVID-19. For this analysis, 12 publications were included, 10 retrospective studies, 1 prospective study, and 1 study of which the perspective was unknown. In 9 studies, hospitalised patients with HFpEF were assessed, whereas 3 studies had investigated patients with HFpEF in-hospital and in the outpatient setting.

The findings of 4 studies demonstrated that patients with HFpEF may be at increased risk of in-hospital mortality following a COVID-19 infection compared to non-HFpEF patients. Hospitalised patients with COVID-19, but without HFpEF, had a mortality rate of 10.8-27.2%. In patients with HFpEF and hospitalised for COVID-19, this rate ranged from 23.0% to 50.2%. The corresponding mortality rate for patients with HFrEF lay between 18.6% and 46.5%. Furthermore, the risk of hospitalisation for COVID-19 may be larger in patients with HF than in patients without HF, as was shown by 3 studies. In addition, the increased risk of hospitalisation appeared to be similar in patients with HFpEF and patients with HFrEF. Also, 3 studies indicated that the need for mechanical ventilation/intubation was equal for patients with HFpEF and those with HFrEF.

Ms Chen argued that these findings imply that the burden of HFpEF in patients with COVID-19 is high and that better care and treatment are needed for patients with HFpEF as the pandemic continues.

1. Chen J, et al. Effects of pre-existing heart failure with preserved ejection fraction (HFpEF) on the outcomes of patients with COVID-19: a systematic review. LBT 3, Heart Failure 2022, 21–24 May, Madrid, Spain.


2. Patel P, et al. Am Heart J Plus 2022;13:100111

 

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Posted on 25 May, 2022