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

1Ghufran Adnan, Karachi, Pakistan

Background:
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

Method(s):
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.

Result(s):
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.

Conclusion(s):
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.