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

Chatrath, Nikhil; Kaza, Nandita; Pabari, Punam A.; Fox, Kevin; Mayet, Jamil; Barton, Carys; Cole, Graham D.; Plymen, Carla M.

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.