Publication date: Dec 21, 2024

Background: Coronavirus Disease 2019 (COVID-19), triggered by SARS-CoV-2, has represented a global pandemic associated with an elevated rate of mortality, mainly among older individuals. The extensive pulmonary involvement by the viral infection might have precipitated pre-existing chronic conditions in this vulnerable population, including heart failure (HF). Materials and Methods: The aim of this retrospective, observational study was to assess the impact of COVID-19 in patients with a prior diagnosis of HF referred to the Emergency Department of the Agostino Gemelli University Hospital between March 2020 and January 2023. A total of 886 HF patients (444 men and 442 women, mean age of 80 +/- 10 years) were identified. Patients were matched in a 1:1 ratio by gender, age, number of comorbidities (excluding HF), and vaccination status, using a propensity score matching (PSM) procedure. We compared the outcomes of 189 patients with a concomitant diagnosis of HF with those of 189 matched controls without HF. Results: Among patients with HF, there was a significantly higher prevalence of valvular disease (p = 0. 004), atrial fibrillation (p = 0. 003), use of anticoagulants (p = 0. 001), chronic obstructive pulmonary diseases (p = 0. 03), and chronic kidney disease (p = 0. 001). In contrast, hypertension was more prevalent among controls than HF patients (p = 0. 04). In addition, controls exhibited higher lymphocytes counts and a higher PaO/FiO ratio compared to HF patients. During hospitalization, patients with HF were more frequently treated with high-flow nasal cannulas (p = 0. 01), required more frequent admission to an intensive care unit (ICU) (p = 0. 04), and showed a significantly higher mortality rate (p 0. 0001) than controls. Conclusions: HF is an independent risk factor for ICU admission and death in COVID-19 patients.

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