Heart Failure Hospitalization Trends During the Early Phase of the COVID 19 Pandemic

PURPOSE: To quantify the change in heart failure (HF) hospitalizations observed in the early phase of the COVID-19 pandemic across a large, multi-center health care system. METHODS: MHealth Fairview encompasses four hospitals (one academic, three community-based) in the Minneapolis, Minnesota metro area. To compare HF hospitalization trends, two inpatient samples were created using HF discharges in the following time periods: pre COVID-19 (February 28, 2019-February 28, 2020) and post COVID-19 (April 1, 2020- May 15, 2020). March 2020 was excluded as this represented a transition point of the pandemic in the United States. Average number of discharges per day as well as demographics, diagnosis related group (DRG) codes, and inpatient mortality was then compared between the two inpatient HF samples. RESULTS: The pre COVID-19 group had 2,601 patients with an average of 7.1 (+/-3) discharges per day. The post COVID-19 group had 210 patients with an average of 4.7 (+/-1.7) discharges per day, which represented a 34% reduction in HF discharges (p <0.001). No statistically significant differences were observed between the pre and post COVID-19 inpatient samples with respect to age (76 vs. 75 years, p = 0.25), gender (46% vs. 48% male, p = 0.7), and DRG codes (DRG 291: 78% vs. 85% p = 0.15). Inpatient HF mortality pre and post COVID-19 was not significantly different (3% vs. 2.9%, p = 0.99). CONCLUSION: HF hospitalizations have decreased significantly during the early phase of the COVID-19 pandemic in this multi-center health care system, however the make-up of hospitalized patients remains similar. There is an urgent need to provide continued access to safe hospital care during the pandemic and to inform HF patients that inpatient care remains available.