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Referrals for Acute Heart Failure Dropped During COVID-19

FRIDAY, Jan. 15, 2021 -- In the eight weeks following the first reported U.K. death due to COVID-19, there was a decrease in referral of patients with acute heart failure, with a corresponding significant increase in mortality, according to a study published online Jan. 6 in ESC Heart Failure.

Gemina Doolub, from the North Bristol National Health Service Trust in the United Kingdom, and colleagues evaluated the impact of the COVID-19 pandemic on hospitalization and mortality due to acute heart failure. Referrals to the acute heart failure team were examined during a 16-week period spanning the COVID-19 pandemic (Jan. 7 to April 27, 2020).

The researchers noted a substantial, but not statistically significant, decline in referrals, with 164 referrals in the eight weeks before the first U.K. COVID-19 death (BC; March 2, 2020) compared with 119 referrals in the subsequent eight weeks (AC; 27 percent decrease). The 30-day case fatality rate was increased from 11 to 21 percent in the BC and AC groups, respectively (risk ratio, 1.9). Univariable predictors of mortality included admission creatinine, age, and AC cohort status. Only age and AC cohort status remained significant predictors of mortality in a multivariable analysis (hazard ratios, 1.04 and 2.10, respectively). The increased mortality was driven by COVID-19-positive status in a sensitivity analysis.

"Our results support prioritizing heart failure patients for COVID-19 vaccination once it is available," a coauthor said in a statement.

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