Excess of heart failure-related deaths during the 2020 COVID-19 pandemic in Unites States

BACKGROUND: HF can be encountered at different stages in the course of COVID-19 disease. However, data regarding the HF-related mortality during COVID-19 pandemic are scant OBJECTIVE: We investigate the heart failure (HF)-related mortality rate in the US among patient with or without COVID-19 infection during the first two pandemic waves in 2020 and to compare them to those of previous years (2014–2019). METHODS: Age-adjusted mortality rates (AAMR) per 100.000 person-years, with relative 95% confidence interval (CI) were determined using the free-available dataset for Multiple cause-of-death, provided by the Center for Disease Control. RESULTS: Throughout the 2020, the first year of the COVID-19 pandemic, 522.848 HF-related deaths were registered (461.594 and 61.254 in subjects without and with COVID-19 infection, respectively). The overall HF-related AAMR was 124.6 (65% CI 123.4–125.6), reflecting an increased HF-related mortality of 13.2% and 25.9% compared to 2019 and 2018 (p < 0.0001). HF-related AAMR was 111.0 (95% CI: 110.7–111.4) and 14.8 (95% CI: 14.6–14.9) per 100.000 population for decedents without and with COVID-19 disease, respectively. The proportionate mortality of HF in COVID-19 patients was 11.7%. HF-related AAMR in COVID-19 patients was higher in men (18.0 per 100.000, 95% CI: 17.8–18.2), in patients aged more 65 years (104.0 per 100.000, 95% CI: 103.1–104.9), in African Americans (22.5 per 100.000, 95% CI: 22.0–22.3) and in those living in rural counties (18.4 per 100.000, 95% CI: 18.0–18.7). CONCLUSIONS: A significant increase in the HF-related mortality during the 2020 was observed synchronously with the COVID-19 pandemic