Impact of Chronic Heart Failure on Clinical Outcomes in COVID-19 Patients

Abstract

Background: The relationship between chronic heart failure (CHF) and COVID-19 is complex, with COVID-19 exacerbating the clinical course of CHF due to systemic inflammation, myocardial injury, and thrombotic complications. CHF patients face worse outcomes, including prolonged hospitalization, increased mortality, and heightened inflammatory responses when infected with COVID-19. While studies on this topic are available globally, there is a lack of localized data from Georgia, where cardiovascular disease (CVD) is a leading cause of mortality. Objectives: This study analyzed the clinical outcomes, inflammatory markers, and cardiac injury in CHF patients hospitalized with COVID-19 in Georgia. The goal was to identify key factors contributing to poor outcomes in this cohort, including prolonged hospital stays, inflammation, myocardial injury, and thrombotic risks. Methods: A cohort of 100 hospitalized patients aged 40-80 with confirmed COVID-19 infection and cardiovascular disease was studied at Chapidze Heart Hospital in Tbilisi, Georgia. Data was collected on clinical symptoms, laboratory tests (including IL-6, CRP, D-dimer, and troponin), and imaging scores. Patients were categorized into two groups: those with CHF and those without CHF. The severity of the disease, length of hospitalization, and levels of inflammatory markers and biomarkers were analyzed using descriptive statistics, ANOVA, and Mann-Whitney U tests. Results: Patients with CHF had significantly more extended hospital stays (11.8 vs. 8.34 days, p=0.0076) than non-CHF patients. Higher levels of IL-6, CRP, ferritin, and D-dimer were observed in CHF patients, indicating a more pronounced inflammatory and hypercoagulable state. Additionally, CHF patients exhibited higher troponin levels, signifying increased myocardial injury and more severe hypoxemia was observed in later stages of hospitalization. Conclusions: CHF is a significant predictor of poor outcomes in COVID-19 patients, with increased inflammation, myocardial injury, thrombotic complications, and hypoxemia contributing to a more severe clinical course. These findings emphasize the need for targeted management, including anti-inflammatory treatments, anticoagulation strategies, and cardiovascular support to improve clinical outcomes in this high-risk group.