Patients hospitalized with COVID-19 may be at risk of developing heart failure (HF) even if they do not have a previous history of cardiovascular disease or cardiovascular risk factors, according to a study published April 26 in the Journal of the American College of Cardiology. While these instances are rare, clinicians should be aware of this potential complication as it may prompt more monitoring of HF symptoms among patients hospitalized with COVID-19.

Jesús Álvarez García, MD, PhD, et al., sought to describe the point-prevalence and associated outcomes of new HF diagnoses in patients hospitalized with COVID-19. The authors examined electronic medical records of 6,439 admitted and confirmed COVID-19-positive adult patients between Feb. 27 and June 26, 2020, at Mount Sinai Health System hospitals in New York. The mean age was 64 years and 45% were women.

Results showed that 37 patients (0.6%) with no prior history of HF developed new cases of HF during their hospitalization for COVID-19. Of those new HF patients, eight (22%) had no previous cardiovascular disease or risk factors, while 14 (38%) had a history of cardiovascular disease and 15 (40%) had no cardiovascular disease but at least one risk factor for it.

The eight patients with no prior history were younger, mostly male, and had lower body mass index and fewer comorbidities. These eight patients also had more instances of cardiogenic shock. All new HF patients were in the hospital for a similar amount of time, seven days on average, and survival rates were similar among both groups.

"We need to learn more about how SARS-CoV-2 may directly affect the cardiovascular system and precipitate new HF – as to whether it is an indirect effect of critical illness or direct viral invasion," says Anu Lala, MD, FACC, lead researcher of the study. "Importantly, though symptoms of HF – namely shortness of breath – can mimic symptoms associated with COVID-19, being alerted to the findings of this study may prompt clinicians to monitor for signs of congestion more consistent with HF than COVID-19 alone."

Clinical Topics: Cardiovascular Care Team, COVID-19 Hub, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Cardiovascular Diseases, SARS-CoV-2, Shock, Cardiogenic, Survival Rate, Body Mass Index, Critical Illness, Electronic Health Records, Prevalence, New York, COVID-19, Risk Factors, Heart Failure, Hospitalization, Cardiovascular System, Cardiology, Hospitals, Dyspnea

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