Article Text
Abstract
Introduction Near the beginning of the COVID-19 pandemic, a reduction in ST elevation myocardial infarction (STEMI) presentation was reported. We hypothesise that this may lead to a substantial increase in heart failure (HF) admissions and an increase in HF mortality.
Methods Consecutive admissions with HF to Blackpool Victoria hospital were categorised into three groups: pre- COVID era (defined as 01/08/2019 to 31/01/2020), first COVID wave (01/02/2020 to 31/07/2021) and the third group is second COVID wave (01/08/2021 to 31/01/2021). Inpatient mortality was the primary end point. Patients were followed up for 60 days. Secondary end point was readmissions within 60 days.
Results There were 1178 consecutive episodes of admissions with heart failure (first diagnostic position) over 18 months. 140 inpatient deaths occurred (11.8% in-hospital mortality). Three-hundred and forty one consecutive episodes of HF admissions during the 6 months of the pre- COVID era were seen. A substantial increase in number of HF presentations was observed in the first wave (422 episodes). During the second wave, this remained high compared with the pre-COVID era- 415 episodes. In the pre-COVID era, 35/341(10%) died as inpatient. During the first wave, mortality remained 10% (41/422). However, there was statistically significant increase in mortality with the second wave, 64/415 died (15%) [p=0.036 comparing pre-COVID vs second wave; p=0.013 comparing the first and second wave]. In the pre-COVID era, 27% of patients were re-admitted within 60 days. By contrast 24% were admitted within 60 days during the first COVID wave and 19% during the second COVID wave (overall p=0.04). Post-hoc analysis showed there was significantly lower readmission between pre-COVID era and the 2nd wave. (p=0.015) [Table 1].
Conclusion The number of consecutive episodes of HF admissions has increased compared with the pre-COVID era. There were no changes in mortality between the pre-COVID era and the first wave however there was a statistically significant increase in mortality with the second wave.
Conflict of Interest None