engleski

Clinical characteristics of patients with acute heart failure during the COVID-19 pandemic

Introduction: Heart failure (HF) is the reason for the ever increasing number in hospitalization. Elderly age, comorbidities and currently ongoing COVID-19 pandemic result in fewer hospitalizations, more severe clinical presentation and more deaths in times of pandemic. Aim: To compare the relations between different clinical parameters of 133 patients hospitalized at the Clinic for Cardiovascular Diseases, Clinical Hospital Centre Rijeka, Croatia in the period between January 1, 2021 and April 1, 2021. and cross-reference it with the data from the 150 patients in the same quarterly period in 2019. To determine heart-focused anxiety and anxiety symptoms, depressive symptoms and intolerance of uncertainty using standardized psychological questionnaire in patients hospitalized for HF in 2021. Results: There were no statistically significant differences in age, gender, body mass index, NYHA class, heart rate and left ventricular ejection fraction between patients hospitalized during the 2021 pandemic compared to the 2019 pre- pandemic group. There was statistically significant higher blood pressure (p<0.01) and more patients with diabetes mellitus (p<0.05) at the time of the pandemic, while peripheral artery disease was statistically significantly more frequent before the pandemic (p<0.01). Laboratory parameters between the two study groups regarding serum urea, creatinine, troponin and NT-proBNP concentrations and the estimated glomerular filtration rate were not statistically significantly different, except for sodium, which was statistically significantly higher at the time of the pandemic (p=0.046). During the pandemic period 74 of the 133 hospitalized patients answered standardized psychological questionnaire. 20.3% patients had moderate and 5.4% severe anxiety (N=19), also 28.4% had moderate depression and 10.8% moderately severe depression or severe depression (N=29), while intolerance of uncertainty was found in 16.2% (N=12) and cardiac anxiety in 18.9% (N=14). There was no statistically significant difference in mortality for the two study periods (p=0.14). Of the total number of patients treated for HF during the COVID-19 pandemic, 11 (8.3%) had a history of SARS-CoV-2 infection. Conclusion: By comparing our two study groups we have found no statistically significant deterioration in most clinical parameters between the two groups, which indicates appropriate quality health care and preparedness of the health system for the hospitalized HF patients during the challenges posed by the pandemic. Anxiety and depression were not negligible in patients with HF hospitalised during the COVID-19 pandemic.

heart failure ; COVID-19 pandemic ; treatment ; prognosis

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