Patients with undetected heart failure have 5X greater COVID-19 death risk, study finds

Patients with early undetected heart failure who are hospitalized with COVID-19 are nearly five times more likely to die compared to patients with healthier heart measures, according to a study published May 10 in the American Heart Association's Hypertension journal.

To conduct the study, researchers evaluated first-phase ejection fraction, a new measure of the heart that is thought to be more sensitive to early, undetected heart damage than traditional measures. It's a measure of the left ventricular ejection fraction until the time of maximum ventricular contraction. 

The study involved 129 hospitalized COVID-19 patients in Wuhan, China, and 251 patients in South London who were treated between February and May 2020. Upon hospital admission, each patient had echocardiography. Researchers compared the echocardiography results to patients with similar health profiles who had the same test done before the pandemic. 

While there is no official "normal" value for first-phase ejection fraction, researchers considered any value below 25 percent as "impaired," based on previous research. The death risk among patients with a first-phase ejection fraction less than 25 percent was nearly five times higher than those with a value of 25 percent or above, findings showed.

Researchers found a comparable amount of patients with similar risk factors who did not have COVID-19 that also had low measurements, indicating the heart damage is the result of an existing chronic condition and not a COVID-19 infection. 

"Patients with impaired first-phase ejection fraction could be prioritized for vaccines and, if they get COVID-19, monitored closely at the early stages of their illness to prevent deterioration," said Dr. Phil Chowienczyk, study author and professor of cardiovascular clinical pharmacology at St. Thomas' Hospital in London. "The findings suggest that if we can prevent the very early chronic damage to the heart detected using first-phase ejection fraction imaging, then people will be much more likely to survive respiratory infections like COVID-19."



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