Heart failure
and COVID-19
COVID-19 has led to significant challenges across the country. The impact on an already overburdened health system has been particularly acute, with appointments and surgeries put on hold to mitigate the spread of coronavirus.29 Our research found that nearly four in 10 patients (38.4%) had a hospital or GP appointment for heart failure cancelled due to COVID-19,2 while over a third (33.4%) admitted they were avoiding going to the doctors to discuss the condition.2 Reports have suggested that the crisis could see the number of people waiting for NHS treatment double to 10 million by Christmas.30
COVID-19 has also led to issues with patients picking up their prescription for their heart failure medication. Over a fifth (20.5%)2 of patients struggled, while 18.9% said they’d had problems accessing their medication.2 This has led to a significant personal cost for some patients. Nearly three in 10 (29.3%) said their symptoms had got worse while 36.8%2 agreed their quality of life had suffered.2 Just over 43% of patients agreed their mental health had been negatively impacted as a direct result of living with heart failure during COVID-19.2
Patients with heart failure are at an increased risk of health complications due to an infection and experience worse outcomes as a result,16 so it is vital that heart failure care is not deprioritised due to the pandemic. Along with cancer, cardiovascular disease is emerging as a major area for concern.31 According to a survey by the Royal College of Physicians, 60% of doctors said they were concerned patients under their care had come to harm following diagnosis or treatment delays. They listed cardiology as one of the areas that had suffered most.32

Many countries across the world, including the UK, have seen cardiovascular emergency responses dwindle.33 Further research is ongoing into the relationship between COVID-19 and cardiovascular disease, including heart failure.34 But we do know that patients with cardiovascular disease are at increased risk of developing COVID-19 and of poor outcomes associated with the infection, such as admission to hospital or intensive care, or even dying.34 Experts are now warning of a ‘ticking time bomb’ with patients unable to attend crucial appointments and access medication.35

We are also seeing a rise in people with heart failure due to COVID-19.9 Patients hospitalised with COVID-19 are at increased risk of developing heart failure; recent research has found that heart failure and myocardial damage occur in at least 10% of patients hospitalised for COVID‐19.9 This rises to 25%–35% or more for critically ill patients or those with concomitant cardiac disease.9 This is likely to place greater strain on cardiology departments if increasing numbers of patients are not being diagnosed in primary care.