COVID-19 Research Explores History of HF Associated With Mortality; Drive-Through Pacing Clinics

History of heart failure (HF) may be associated with higher risk of mechanical ventilation and mortality among patients hospitalized for COVID-19, regardless of left ventricular ejection fraction (LVEF), according to an article published Oct. 28 in the Journal of the American College of Cardiology.

Jesus Alvarez-Garcia, MD, PhD, et al., conducted a retrospective analysis of 6,439 patients admitted for COVID-19 at one of five Mount Sinai Health System hospitals in New York City from Feb. 27 to June 26, 2020. Clinical characteristics and outcomes were captured from electronic health records. For patients identified as having a history of HF by ICD 9/10 codes, manual chart abstraction informed etiology, functional class and LVEF.

Results showed that compared to non-HF patients, those with previous HF experienced longer length of stay (8 vs. 6 days), increased risk of mechanical ventilation (22.8% vs. 11.9%; adjusted) and mortality (40.0% vs. 24.9%; adjusted).

In addition, outcomes among HF patients were found to be similar irrespective of LVEF or renin-angiotensin-aldosterone inhibitor use.

“If these findings are confirmed in other populations, history of HF may help guide triage upon hospital presentation, and potentially dictate aggressive therapies in the treatment of COVID-19,” the authors conclude.

Meanwhile, according to other COVID-19 research published Oct. 28 in JACC: Clinical Electrophysiology, drive-through pacing clinics may be feasible and effective, with some advantages over remote monitoring during the COVID-19 pandemic.

Zaki Akhtar, MBBS, et al., analyzed 316 patients attending a drive-through pacing clinic through a questionnaire that quantified satisfaction. Participants with prior experience of the conventional pacing clinic were asked to compare both services.

Results showed that comparing the drive-through and conventional clinics, patients awarded average excellent scores for signposting (5.36 vs. 5.5), staff introductions (5.89 vs. 5.84), maintaining patient dignity (5.94 vs. 5.94), consultation thoroughness (5.93 vs. 5.95), and answering all queries (5.89 vs. 5.85).

Furthermore, responders expressed greater satisfaction with the provided instructions for the conventional clinic (5.59 vs. 5.7) but were happier with the punctuality of the drive-through (5.93 vs. 5.84, respectively). In the subset who experienced both types of device follow-up, most patients preferred the drive-through (57.1%) over the conventional format, while the remainder (21.2%) had no preference.

The researchers conclude that the drive-through format minimizes the risk of contracting COVID-19 without compromising care.

Clinical Topics: Cardiovascular Care Team, COVID-19 Hub, Dyslipidemia, Lipid Metabolism, Novel Agents

Keywords: Aldosterone, Renin, COVID-19, Angiotensins, Stroke Volume, International Classification of Diseases, Retrospective Studies, Electronic Health Records, Triage, Follow-Up Studies, Respiration, Artificial

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