Cardiovascular Consequences of Covid-19 Infection in Older Adults With a History of Heart Failure

Abstract

Background COVID-19 frequently affects the cardiovascular system. Advanced age and pre-existing heart failure HF are considered risk factors for a poor prognosis. However, the cardiovascular consequences of COVID-19 in older adults with a history of HF have not been clearly depicted. Methods A retrospective review was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD codes, patients aged 65–75 and Elixhauser Comorbidity Score(ECI)>4 with a history of HF admitted for COVID-19 were identified. This cohort was propensity score matched with a group of patients without HF by age, gender, other cardiovascular diseases, and ECI. Records from both groups were reviewed for new onset of cardiovascular-related conditions, including myocardial infarction(MI), arrhythmias, and hypertension, within one year following the admission. Pearson’s chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results 4,014 members in each group were identified. A history of HF was associated with an increased risk of MI(RR=1.18, CI95% =1.005–1.37, p=0.04), and arrhythmias (RR=1.17, CI95% =1.08–1.26, p < 0.00001). No differences present in risk of myocarditis(RR=0.05, CI95%=0.12–1.99, p=50) across groups. Conclusion Older adults with a history of HF are more likely to experience MI and arrhythmias over a year after hospitalization for COVID-19.