Acute Decompensated Heart Failure in Patients With and Without COVID-19 — The Experience of a Romanian Center

Abstract

Abstract Objective Our goal was to characterize a cohort of heart failure patients with and without COVID-19 in terms of demographics, comorbid conditions, treatment regimens, lab test results and outcome. Methods We performed a retrospective, unicentric, cohort study on consecutive patients admitted to our department between September and December 2021. Results We enrolled a total of 76 HF patients – 65.3% COVID-19 (+). The median age was 72 years with a female predominance (59.2%). The median length of hospitalization was 13 days, longer for COVID-19 (+). Only 20.7% of all patients were fully vaccinated. COVID-19 (+) patients had higher ICU admission rates and mortality (in-hospital and at follow-up). The most common associated conditions were HTN (78.9%), T2DM (38.2%), cancer (18.4%), CAD (17.1%), late-stage CKD (16.7%), AF (14.5%) and stroke (11.8%). Patients with a history of stroke were more likely to require ICU management. At-home treatment with ACEi/ARB/ARNi made no difference for COVID-19 severity (p = 0.393), mechanical ventilation (p = 0.101) or mortality (in-hospital: p = 0.316; follow-up: p = 0.563); however, ICU admission rates were lower in these patients (p = 0.023). Conclusion Heart failure with preserved ejection fraction and low symptom severity were common findings among COVID-19 positive patients. However, COVID-19 positive patients were hospitalized for longer, required more ICU care and had higher mortality both in-hospital and at follow-up.