Key result
Cardiomyopathy is linked to a ~226% higher COVID-19 hospitalization rate versus the general population.
Why the study?
To evaluate the prevalence and hospitalisation rate of COVID-19 in DCM and HCM patients, evaluate the indirect pandemic impact, and assess national cardiomyopathy-related hospital admissions.
Observational (n=12,890)
Yes
The COVID-19 pandemic disproportionately increased hospitalization risk for infected cardiomyopathy patients while indirectly causing physical health deterioration and a significant drop in routine cardiomyopathy admissions.
Cardiomyopathy patients with COVID-19 warrant closer surveillance; leaves open whether targeted strategies reduce hospitalizations.
OBJECTIVES: (1) To evaluate the prevalence and hospitalisation rate of COVID-19 infections among patients with dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) in the Royal Brompton and Harefield Hospital Cardiovascular Research Centre (RBHH CRC) Biobank. (2) To evaluate the indirect impact of the pandemic on patients with cardiomyopathy through the Heart Hive COVID-19 study. (3) To assess the impact of the pandemic on national cardiomyopathy-related hospital admissions. METHODS: (1) 1236 patients (703 DCM, 533 HCM) in the RBHH CRC Biobank were assessed for COVID-19 infections and hospitalisations; (2) 207 subjects (131 cardiomyopathy, 76 without heart disease) in the Heart Hive COVID-19 study completed online surveys evaluating physical health, psychological well-being, and behavioural adaptations during the pandemic and (3) 11 447 cardiomyopathy-related hospital admissions across National Health Service (NHS) England were studied from NHS Digital Hospital Episode Statistics over 2019-2020. RESULTS: A comparable proportion of patients with cardiomyopathy in the RBHH CRC Biobank had tested positive for COVID-19 compared with the UK population (1.1% vs 1.6%, p=0.14), but a higher proportion of those infected were hospitalised (53.8% vs 16.5%, p=0.002). In the Heart Hive COVID-19 study, more patients with cardiomyopathy felt their physical health had deteriorated due to the pandemic than subjects without heart disease (32.3% vs 13.2%, p=0.004) despite only 4.6% of the cardiomyopathy cohort reporting COVID-19 symptoms. A 17.9% year-on-year reduction in national cardiomyopathy-related hospital admissions was observed in 2020. CONCLUSION: Patients with cardiomyopathy had similar reported rates of testing positive for COVID-19 to the background population, but those with test-proven infection were hospitalised more frequently. Deterioration in physical health amongst patients could not be explained by COVID-19 symptoms, inferring a significant contribution of the indirect consequences of the pandemic. TRIAL REGISTRATION NUMBER: NCT04468256.
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Hammersley et al. (2022) conducted an observational in Cardiomyopathy (n=12,890). Cardiomyopathy vs. General UK population or subjects without heart disease was evaluated on Hospitalisation rate among those infected with COVID-19 (p=0.002). Patients with cardiomyopathy had a similar COVID-19 infection rate to the general population but a significantly higher hospitalization rate among those infected (53.8% vs 16.5%, p=0.002).
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