Physicians' Academy for Cardiovascular Education

Patients with HF hospitalized with COVID-19 at high risk for poor outcomes

Prognostic Impact of Prior Heart Failure in Patients Hospitalized With COVID-19

Literature - Alvarez-Garcia J, Lee S, Arjun Gupta A, et al. - J Am Coll Cardiol. 2020;76:2334-2348 doi: 10.1016/j.jacc.2020.09.549. Epub 2020 Oct 28.

Introduction and methods

Of patients hospitalized with COVID-19, those with pre-existing HF are at highest potential risk for complications due to underlying comorbidities such as frailty and renal dysfunction [1]. Yet, data on progress and outcomes of these patients are limited [2-5]. Also, it is unknown whether the clinical course is different according to LVEF or treatment with RAAS inhibitors.

This study evaluated the electronic health records of patients with COVID-19 with and without a history of HF and reported the clinical profile, hospital course and associated outcomes of these patients retrospectively.

The cohort study collected data from patients (≥ 18 years, n=6,439) who were admitted to one of the five Mount Sinai Healthcare System hospitals in New York City due to COVID-19 from February 27, 2020 to June 26, 2020. Patients with a history of HF were stratified by LVEF: HFrEF (LVEF ≤40%, n=128), HFmrEF (LVEF 41-49%, n=44), and HFpEF (LVEF ≥50%, n=250). Demographics, laboratory measurements, disease diagnosis, comorbidities, and outcomes were collected. The outcomes included in-hospital mortality, need for intensive care unit (ICU), intubation with mechanical ventilation, length of stay (LOS), and hospital discharge. Patients were followed-up until July 18, 2020.

Main results


Patients with a history of HF who were admitted to hospital for COVID-19 had an increased risk for need of ICU care, intubation with mechanical ventilation, and in-hospital death compared to patients without HF, irrespective of LVEF or RAAS inhibitor treatment.


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Find this article online at J Am Col Cardiol.

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