The Effects Of Coronavirus Pandemic Lockdown On Patients With Chronic Heart Failure

BACKGROUND: the coronavirus pandemic and the resulting restrictive measures have beenassociated with social isolation and limited access to health care especially forpatients with chronic diseases. In Tunisia, the lockdown was implemented for 6 weeks, we sought by this study to evaluate the impact of the coronavirus outbreak and lockdown on patients with chronic heart failure. PATIENTS AND METHODS: After the lockdown ended; 184 patients included in the Tunisian registry of heart failure (NATURE HF) from two centers: Medenine and Ariana, were interviewe by phone and invited to answer an 18-point questionnaire to assess the impact of the lockdown on their health state and on the management of their disease. RESULTS: In total, 274 patients were contacted and responses were available for 184 patients. Responders were mostly followed up at Medenine hospital (n=143; 77.7%); had mean age 66.87 ±13.5 years and a sex ratio 1.5. The majority of patients were treated for ischemic cardiomyopathy (55.4%) and reduced ejection fraction (51.5%). The aggravation of heart failure signs was common (32%) and 20.7 % felt their health state was poorer than before lockdown. Few patients had used telemedicine to get a medical advice or distance control (23.3%); the unique used method was the telephone call. The rate of patients who had missed their regular visits due to lockdown was 34.2%. Adherence to salt restriction was reduced in 39.7% and treatment cessation was noted in 24.5%. Difficulty obtaining heart failure medications during the lockdown was19% . One forth of patients considered that the COVID-19 pandemic had affected the management of their disease and 22.4% reported feeling in danger during the closure period. The most barrier measures used at first intention were hand washing (32.1%) and social distancing (29.9%). CONCLUSION: The COVID19 pandemic lockdown had a negative impact on patients with chronic heart failure. During the lockdown, symptoms aggravation and medication non- adherence were common. Telemedicine was used in only 23% of cases.