Ghufran1, Osman Faheem1, Ghufran1, Jamshed Ali1, Pirbhat Shams1

1Ghufran Adnan, Karachi, Pakistan

COVID-19 pandemic has severely disrupted the healthcare system of Pakistan. Respiratory infections are one of the common precipitating factors of patient presentation with decompensated heart failure. There is a paucity of data on whether heart failure presentation reduces or increases during COVID. The study aims to investigate these changes in cardiology consultations and compare the pre-COVID-19 and COVID-19 era

We collected data retrospectively of consecutive patients who visited the emergency department (ED) with acute heart failure during March-July 2019 (non-COVID period) and March-July 2020 (COVID period). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, and procedure.

We calculated the difference of 315 patients between the COVID and non-COVID periods in acute heart failure presentations to the Emergency Department using the Chi-square test. Out of 173 patients (55%) are female with a mean age of 63(SD=15). There was a significant drop (↓20%) in the patient presentation during the COVID period. However, an increase in presentation of patients with comorbidities such as Hypertension (↑14%, p=0.04), prior Ischemic heart disease (19%, p<0.01), and prior PCI or CABG (↑11%, p=0.04) was observed during the COVID period. There was an increment in patients admitted to CCU (↑3%) and discharged from emergency care (↑6%) with acute heart failure during the COVID period. Cardiac imaging (↓19%, P<0.01) was done significantly less during the COVID period.

A remarkable decline was observed in patients presenting with acute heart failure during the COVID period. Telemedicine services need to be enhanced in low to middle-income countries to provide timely care and reduce the future burden of non-communicable disease.