Clinical characteristics and outcomes of adults with a history of heart failure in ambulatory patients with COVID-19

INTRODUCTION: Several comorbidities have been associated with an increased risk of severity and mortality in coronavirus disease 2019 (COVID-19). The TASC GP study (Tunisian Anticoagulation Survey in COVID-19 patient General Practice experience) is an observational, multicenter survey in ambulatory patients with COVID-19. OBJECTIVE: The purpose of this sub study analysis was to evaluate clinical characteristics and outcomes in ambulatory patients with COVID-19 infection and a history of heart failure (HF) METHOD: We examined between July 2021 and October 2021 ambulatory patients with COVID-19. Baseline characteristics and mortality rates were compared between those with history of HF and those without history of HF. RESULTS: The study population included 3,406 patients. History of HF was reported in 121 patients (3.5%). Compared to patients without history of HF, patients with HF were older 71.1 ± 14.3 years vs. 51 ± 15.2 years (P < 0.001), had more hypertension 88.4% vs. 28.5% (P < 0.001), diabetes 63% vs. 21.8% (P < 0.001), ischemic heart disease (52.1% vs. 2.8% P < 0.001) and had higher heart rates (92.5 ± 18.6 bpm vs. 88.4 ± 14.6 bpm P < 0.003). They had more severe forms of COVID-19 (26.7% vs. 6.9%; P < 0.0013) and lower saturation of Oxygen (92.7 ± 3.5% vs. 95.6 ± 2.9% P < 0.0010). They had higher inflammatory markers (white blood counts 26040.6 ± 44896.9 elts/mm(3) vs. 11872.3 ± 23368 elts/mm(3)P < 0.001; CRP 87.5 ± 66.8 mg/L vs. 50.6 ± 92.4 mg/L P = 0.003). Hospitalization and mortality rates were higher among patients with history of HF (18.3% vs. 3.3% P < 0.001; 7.9% vs. 1.2% P < 0.001). CONCLUSION: Patients with heart failure are at increased risk for hospitalization, poor outcome, and death from COVID-19. Patients with HF hospitalized with COVID-19 are at high risk for complications, with higher rates of mortality. This may be in large part due to age and comorbid conditions.