Heart failure with preserved ejection fraction: the impact of right heart failure on risk mortality in hospitalized COVID-19 patients: Cohort study

Abstract

Introduction: Heart failure is a clinical syndrome characterized by signs and symptoms of structural and/or functional alterations accompanied by impaired expulsion of blood or ventricular filling. COVID-19 contributes to circulatory failure and frequently induces or facilitates pulmonary artery thrombosis. HF can be a risk factor as well as a complication of COVID-19.

Aims: The purpose of this study was to evaluate the association between HFpEF isolate and RHF + HFpEF on mortality according to sex in hospitalized patients caused by COVID-19.
Methods: A prospective cohort study was performed on hospitalized COVID-19 patients from February 2021 to October 2022. Patients ≥18 years with COVID-19 and an echocardiogram during their hospitalization were included. We excluded patients with HIV, shock, and with missing data.

Results: A total of 105 patients were included in this study. The median age was 64 years (50-76), 32% (n=37) of the subjects were women. Patients with “HFpEF + RHF” were found to have an increased risk of death (HR 5.58; 95% CI 1.26-24.6, p=0.023) compared to those with HFpEF alone. A comparison of all patients with HFpEF vs “HFpEF + RHF” according to sex, revealed that women and men with “HFpEF + RHF” had greater mortality than those with HFpEF alone, (p=0.0129, p=0.081), respectively.

Conclusions: Heart failure is an important condition associated with poor prognosis irrespective of the cause of hospitalization. COVID-19 causes damage to the heart and is associated with “RHF and HFpEF”. Furthermore, there were found an increased incidence of “RHF and HFpEF” in women.