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Research
Long-term conditions

Heart failure and COVID-19: synergism of two inflammatory conditions?

02 January 2021
Long-Term Conditions
02 January 2021
Volume 26 · Issue 1

Abstract

Heart failure as a comorbidity in the older population with COVID-19 poses an additional threat to those affected. Patients with both COVID-19 and heart failure share similar risk factors, which result in magnification of pathological outcomes. These include a common inflammatory pathology and related coagulopathy. Both illnesses pose a risk of arrhythmia. Polypharmacy further complicates safe drug administration and worsens the risk of medication-induced arrhythmia. Additionally, both conditions present challenges regarding attaining and maintaining an appropriate nutritional state. Exploration of the interplay between these factors demonstrates the gravity of the co-existence of these conditions and helps understand the difficulties faced when caring for this patient group. Although care provided to COVID-19 patients is primarily related to symptom presentation, based on the analysis conducted, there are some recommendations for practice in relation to evidence and guidelines when managing heart failure patients in primary care within the context of the COVID-19 pandemic.

The number of COVID-19-related deaths surpassed 1 million at the time of writing (World Health Organization (WHO), 2020). Together with pre-existing respiratory illness, cardiac disease and its associated risk factors are significant risk factors linked to COVID-19-related mortality (Shoar et al, 2020). The disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first recognised as a respiratory infection. However, a better understanding of the manner in which the virus enters and affects the body suggests that its effects are more widespread and significantly influence the cardiovascular system directly and indirectly (Gavriatopoulou et al, 2020; Goha et al, 2020; Liu et al, 2020). This paper will examine the pathogenesis of COVID-19 and relate this to patients with heart failure. This examination will then be used as to identify important aspects of management relevant to primary care.

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Inflammation
COVID-19
Heart failure
Polypharmacy
Nutritional state