Living with Heart Failure during the Coronavirus Pandemic: A Qualitative Study

INTRODUCTION: Heart Failure (HF) affects 6.2 million adults in the United States and its incidence increases with age. HF is the leading cause of hospitalization among older adults, with the highest readmission rates when compared to other chronic conditions representing significant economic and health impact. Psychological distress including depression is prevalent in HF patients and has been shown to contribute to negative outcomes. The COVID-19 pandemic has had important implications for HF patients by heightening the risk of infection and HF acute exacerbations, as well as distancing patients from their support network impacting their wellbeing and quality of life. This study aimed to explore psychosocial experiences of those living with HF during the COVID-19 pandemic. METHODS: Qualitative research study that collected information with semi-structured interviews delivered by phone and a demographics and mental health history survey mailed to patients. 30 Patients were recruited from February to May 2021. All interviews were transcribed and coded using NVivo. RESULTS: Mean age was 72.6, 73% male, and 27% female. 27% reported previous or current depression diagnosis and 23% considered symptoms to be somewhat related to HF; 17% reported anxiety diagnosis that occurred either in the past or presently with 10% considering symptoms somewhat related to HF. There were 4 major categories identified. 1. Access to Medical Services, included themes about ability to connect with providers throughout the pandemic and adjustment to novel care models; challenges with hospitalizations that lacked family support and presence; and delay in emergency care. 2. Social Life and Routines, included the most common themes described by patients and the difficulties experienced within this category. Themes about the pivotal role of socialization and social support that were lost during the pandemic commonly emerged. Additionally, the resulting changes to family structures and routines, as well as themes related to the challenges of accessing public services like restrooms. 3. Fears and Health Consequences, included themes about the fear of COVID-19 infection, the potential health consequences, and the importance of prioritizing health and follow medical advice. Most participants described a sense of relief and hope once the vaccine became available. 4. Emotional Response, included themes related to mood decline and experiences of fear and frustration. Positive themes emerged related to masking which was normalized and helpful to those immunocompromised. Moreover, some described the benefits of connecting with others either using technology or spending more physical time at home because of the quarantine. CONCLUSIONS: HF patients have high healthcare needs, often experience psychological distress, and the COVID-19 pandemic presented important challenges to this population. Based on patients’ experiences, the pandemic impacted acces to care, contributed to illness exacerbations, hospitalizations, and psychological distress, as well as interrupted social connections which are an important source of wellbeing in a population that carries several physical limitations as a result of their underlying condition. THIS RESEARCH WAS FUNDED BY: Institutional/Departmental Funding.