The effect of concomitant COVID-19 infection on outcomes in patients hospitalized with heart failure

AIMS: Patients with cardiovascular disease appear particularly susceptible to severe COVID-19 disease, but the impact of COVID-19 infection on patients with heart failure (HF) is not known. This study aimed to quantify the impact of COVID-19 infection on mortality in hospitalized patients known to have HF. METHODS AND RESULTS: We undertook a retrospective analysis of all patients admitted with a pre-existing diagnosis of HF between 1 March and 6 May 2020 to our unit. We assessed the impact of concomitant COVID-19 infection on in-hospital mortality, incidence of acute kidney injury, and myocardial injury. One hundred and thirty-four HF patients were hospitalized, 40 (29.9%) with concomitant COVID-19 infection. Those with COVID-19 infection had a significantly increased in-hospital mortality {50.0% vs. 10.6%; relative risk [RR] 4.70 [95% confidence interval (CI) 2.42-9.12], P < 0.001} and were more likely to develop acute kidney injury [45% vs. 24.5%; RR 1.84 (95% CI 1.12-3.01), P = 0.02], have evidence of myocardial injury [57.5% vs. 31.9%; RR 1.81 (95% CI 1.21-2.68), P < 0.01], and be treated for a superadded bacterial infection [55% vs. 32.5%; RR 1.67 (95% CI 1.12-2.49), P = 0.01]. CONCLUSIONS: Patients with HF admitted to hospital with concomitant COVID-19 infection have a very poor prognosis. This study highlights the need to regard patients with HF as a high-risk group to be shielded to reduce the risks of COVID-19 infection.