The impact ofCOVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic
The impact ofCOVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic
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DOI：
10.1002/ejhf.1925
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发表时间：
2020-07-04
影响因子：
18.2
通讯作者：
McDonagh, Theresa A.
中科院分区：
文献类型：
--
作者：
Bromage, Daniel I.;Cannata, Antonio;McDonagh, Theresa A.
目的 研究 COVID-19 对大流行高峰期间伦敦三级心力衰竭病房收治的急性心力衰竭 (AHF) 住院率、临床特征和患者管理的影响。方法和结果 将 2020 年 3 月 2 日至 4 月 19 日期间向英格兰和威尔士国家心力衰竭审计报告的伦敦国王学院医院的数据与新冠疫情前队列以及 2017 年至 2019 年相应时间段的绝对住院率进行了比较。此外，我们对 COVID-19 大流行期间住院的患者与 2019 年同期就诊的患者的临床特征和入院期间的管理进行了详细比较。与所有其他纳入时间段相比，研究期间观察到 AHF 入院率显着降低。 COVID-19大流行期间入院的患者出现纽约心脏协会III级或IV级症状的比例较高（96% vs. 77%，P = 0.03）和严重外周水肿（39% vs. 14%，P = 0.01）。我们没有观察到住院患者管理方面的任何差异，包括射血分数降低的心力衰竭的护理地点和药物管理。结论 COVID-19 大流行期间，我中心 AHF 住院率显着下降，但住院患者入院时症状更为严重。需要进一步研究来调查在国家封锁和社交距离限制实施期间，急性心力衰竭的发病率是否有所下降，或者患者是否没有到医院就诊。从公共卫生的角度来看，必须确定这是否会导致更糟糕的长期结果。
Aims To examine the impact of COVID-19 on acute heart failure (AHF) hospitalization rates, clinical characteristics and management of patients admitted to a tertiary Heart Failure Unit in London during the peak of the pandemic. Methods and results Data from King's College Hospital, London, reported to the National Heart Failure Audit for England and Wales, between 2 March-19 April 2020 were compared both to a pre-COVID cohort and the corresponding time periods in 2017 to 2019 with respect to absolute hospitalization rates. Furthermore, we performed detailed comparison of patients hospitalized during the COVID-19 pandemic and patients presenting in the same period in 2019 with respect to clinical characteristics and management during the index admission. A significantly lower admission rate for AHF was observed during the study period compared to all other included time periods. Patients admitted during the COVID-19 pandemic had higher rates of New York Heart Association III or IV symptoms (96% vs. 77%,P = 0.03) and severe peripheral oedema (39% vs. 14%,P = 0.01). We did not observe any differences in inpatient management, including place of care and pharmacological management of heart failure with reduced ejection fraction. Conclusion Incident AHF hospitalization significantly declined in our centre during the COVID-19 pandemic, but hospitalized patients had more severe symptoms at admission. Further studies are needed to investigate whether the incidence of AHF declined or patients did not present to hospital while the national lockdown and social distancing restrictions were in place. From a public health perspective, it is imperative to ascertain whether this will be associated with worse long-term outcomes.