Coronavirus disease vaccination in heart failure: No time to waste

Roncalli, Jérôme; Roubille, François; Lamblin, Nicolas; Girerd, Nicolas; Mouquet, Frédéric; Chapet, Nicolas; Roubille, Camille; Berthelot, Emmanuelle; Galois, Katie; Battistella, Pascal; Jondeau, Guillaume; Tartiere, Jean Michel; Aguilhon, Sylvain; Gueffet, Jean Pierre; Salvat, Muriel; Damy, Thibaud; Galinier, Michel

doi:10.1016/j.acvd.2021.04.004

Cited by 7 publications

(8 citation statements)

References 18 publications

(20 reference statements)

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“…An expert panel from the Heart Failure group of the French Society of Cardiology recently strongly recommended COVID-19 vaccination in patients with chronic HF because this population is vulnerable [ 44 ]. Indeed, HF has been clearly identified as a risk factor for poor outcome, particularly in decompensated patients or in patients with poor functional status.…”

Section: Current Recommendations For Vaccinationmentioning

confidence: 99%

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Vaccination for Respiratory Infections in Patients with Heart Failure

Girerd

Chapet

Roubille³

et al. 2021

JCM

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Bronchopulmonary infections are a major trigger of cardiac decompensation and are frequently associated with hospitalizations in patients with heart failure (HF). Adverse cardiac effects associated with respiratory infections, more specifically Streptococcus pneumoniae and influenza infections, are the consequence of inflammatory processes and thrombotic events. For both influenza and pneumococcal vaccinations, large multicenter randomized clinical trials are needed to evaluate their efficacy in preventing cardiovascular events, especially in HF patients. No study to date has evaluated the protective effect of the COVID-19 vaccine in patients with HF. Different guidelines recommend annual influenza vaccination for patients with established cardiovascular disease and also recommend pneumococcal vaccination in patients with HF. The Heart Failure group of the French Society of Cardiology recently strongly recommended vaccination against COVID-19 in HF patients. Nevertheless, the implementation of vaccination recommendations against respiratory infections in HF patients remains suboptimal. This suggests that a national health policy is needed to improve vaccination coverage, involving not only the general practitioner, but also other health providers, such as cardiologists, nurses, and pharmacists. This review first summarizes the pathophysiology of the interrelationships between inflammation, infection, and HF. Then, we describe the current clinical knowledge concerning the protective effect of vaccines against respiratory diseases (influenza, pneumococcal infection, and COVID-19) in patients with HF and finally we propose how vaccination coverage could be improved in these patients.

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Section: Current Recommendations For Vaccinationmentioning

confidence: 99%

“…Although a relationship between thrombotic events and COVID-19 vaccines has been suggested, the benefit/risk ratio remains largely favorable for vaccination. Patients with chronic HF are at great risk for COVID-19 infection and these patients should be prioritized for vaccination [ 44 ].…”

Section: Current Recommendations For Vaccinationmentioning

confidence: 99%

Vaccination for Respiratory Infections in Patients with Heart Failure

Girerd

Chapet

Roubille³

et al. 2021

JCM

Self Cite

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“…Observational data highlight increased risk of severe complications, including death among patients with heart failure (HF) hospitalized with COVID-19. 1 , 2 , 3 , 4 While vaccination against COVID-19 has been proven highly effective for preventing adverse outcomes in the general population, concern over potential cardiovascular sequelae may contribute to vaccine hesitancy, particularly amongst patients with pre-existing cardiac disease. 5 , 6 , 7 , 8 , 9 We sought to evaluate the impact of COVID-19 vaccination among patients with HF on all-cause hospitalization and mortality across a large New York City health system.…”

Section: Introductionmentioning

confidence: 99%

Association of Reduced Hospitalizations and Mortality Rates Among COVID-19-Vaccinated Patients With Heart Failure

Johnson¹,

Patel²,

Thapi³

et al. 2022

Journal of Cardiac Failure

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“…Experts strongly recommend that patients with chronic heart failure, including PAH/ CTEPH patients should receive COVID-19 vaccination as soon as possible [16,17]. Other authors recommend prioritization of COVID-19 vaccination in patients with cardiovascular disease, according to the stage of the main disease and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination

Wieteska¹,

Szmit²,

Florczyk³

et al. 2021

Vaccines

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The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19.

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Coronavirus disease vaccination in heart failure: No time to waste

Cited by 7 publications

References 18 publications

Vaccination for Respiratory Infections in Patients with Heart Failure

Vaccination for Respiratory Infections in Patients with Heart Failure

Association of Reduced Hospitalizations and Mortality Rates Among COVID-19-Vaccinated Patients With Heart Failure

COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination

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