key: cord-0719906-rxzzz500
authors: Nazir, Tahir
title: Heart failure related hospitalisation and management during COVID‐19 pandemic: are we ready to reflect?
date: 2020-06-10
journal: Eur J Heart Fail
DOI: 10.1002/ejhf.1931
sha: 38b45de7745933b2b2e4628556c2534833e3fc61
doc_id: 719906
cord_uid: rxzzz500

nan

northwest of England, where the peak of the pandemic was delayed by a couple of weeks compared to London, we have witnessed similar trends with regards to a decline in acute hospital admissions with cardiovascular pathologies including heart failure. These findings have corroborated with an observation by the Nuffield Trust which report 52% fewer attendances in the major A&E departments in London during the month of April 2020, compared to the same period last year [3].

Similar figures were recorded in the other regions in the UK including the northwest, too. The Kings Fund (UK) raised a concern that in parallel to the declining hospital admission rates, there has been a concurrent rise in the number of people dying at home, with approximately 80% of these extra deaths being unrelated to COVID-19 [4]. It is plausible that a proportion of this additional mortality is related to cardiovascular disorders including heart failure. According to a letter from England's chief medical officer addressed to general practitioners, patients with heart failure were considered to be at an increased risk of developing severe illness from COVID-19 and were advised to be 'particularly stringent in following social distancing measures' [5] . In our opinion, the UK government's strategy to prevent NHS from getting overwhelmed appeared to have worked well in keeping the pressure off health services; however, it might have been mis-interpreted by many that NHS was not open for any essential non-COVID business. Although, as authors highlight, the heart failure services have been running normally during the pandemic period; an apparent reluctance in accepting hospital admission, possibly due to genuine desire not to add extra stress on the health care institutions or a fear of picking up the contagion seems to be the key reason behind a decline in AHF related hospitalisation in UK. Hindsight is a great teacher, on reflection, we wonder whether we could have been more proactive in reaching out to our chronic heart failure patients during the pandemic.

Enhanced remote clinical monitoring utilising telephone consultations and novel digital health solutions with a view to offering guidance regarding symptom control, an early detection of decompensation and early instigation of goal directed therapy could have provided a robust telehealth framework for heart failure patients, during these difficult times.

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This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/ejhf.1931

The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic

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