Acute COVID-19 Management in Heart Failure Patients: A Specific Setting Requiring Detailed Inpatient and Outpatient Hospital Care

The relationship existing between heart failure (HF) and COVID-19 remains questioned and poorly elucidated. Many reports suggest that HF events are reduced during pandemics, although other studies have demonstrated higher mortality and sudden death in patients affected by HF. Several vascular, thrombotic, and respiratory features may deteriorate stable HF patients; therefore, the infection may directly cause direct myocardial damage, leading to cardiac function deterioration. Another concern is related to the possibility that antiviral, anti-inflammatory, and corticosteroid agents commonly employed during acute COVID-19 infection may have potentially deleterious effects on the cardiovascular (CV) system. For these reasons, HF patients deserve specific management with a tailored approach in order to avoid arrhythmic complications and fluid retention events. In this review, we describe the complex interplay between COVID-19 and HF, the evolving trend of infection with related CV events, and the specific management strategy to adopt in this setting.

Automated summary

The relationship between heart failure (HF) and COVID-19 is still uncertain. Some reports suggest decreased HF events during pandemics, while others show higher mortality and sudden death in HF patients. The infection may directly cause myocardial damage and certain medications used for COVID-19 may have negative effects on the cardiovascular system. HF patients require tailored management to prevent complications and fluid retention. This review discusses the complex interplay between COVID-19 and HF, the evolving trend of infection with related cardiovascular events, and specific management strategies.