Department of Medicine, Section of Cardiovascular Medicine, Boston Medical Center, Boston University, MA (C.A.).
Department of Cardiology, Herlev and Gentofte Hospital, Denmark (C.A., M.L., A.H., C.M., G.G., M.S.).
Circ Heart Fail. 2020 Jun;13(6):e007274. doi: 10.1161/CIRCHEARTFAILURE.120.007274. Epub 2020 Jun 2.
The Danish government ordered a public lockdown on March 12, 2020, because of the coronavirus disease 2019 (COVID-19) pandemic. We investigated the immediate consequences of such a lockdown for patients with heart failure (HF).
Using the Danish nationwide administrative databases, we investigated the incidence of new-onset HF and hospitalizations for worsening HF before and after the lockdown (January 1 to March 11 versus March 12 to March 31) in 2020 versus 2019. We also investigated the mortality for all patients with HF and in COVID-19-infected patients with HF.
Rates of new-onset HF between January 1 and March 11 were comparable for 2020 and 2019 (1.83 versus 1.78 per 10 000 person-years; =0.19), while hospitalizations for worsening HF were slightly higher in 2020 versus 2019 (1.04 versus 0.93 per 1000 person-years; =0.02). In the lockdown period, rates of new-onset HF diagnoses (1.26 versus 2.25 per 1000 person-years) and of hospitalizations for worsening HF (0.63 versus 0.99 per 1000 person-years) were significantly lower in 2020 versus 2019 ( for both, <0.0001). Mortality was similar before and after the national lockdown for the population with HF. We observed 90 HF patients with diagnosed COVID-19 infection, of whom 37% (95% CI, 23%-50%) died within 15 days.
The number of patients hospitalized with worsening HF or diagnosed with new-onset HF was markedly reduced after lockdown but has not yet impacted mortality in HF patients at a population-based level. However, these data raise concerns for a potential undertreatment of HF currently that may impact prognosis in the longer term.
由于 2019 年冠状病毒病（COVID-19）大流行，丹麦政府于 2020 年 3 月 12 日下令全民封锁。我们调查了这种封锁对心力衰竭（HF）患者的直接影响。
使用丹麦全国性行政数据库，我们调查了 2020 年和 2019 年封锁前后（1 月 1 日至 3 月 11 日与 3 月 12 日至 3 月 31 日）新发 HF 和因 HF 恶化而住院的发生率。我们还调查了所有 HF 患者和 COVID-19 感染 HF 患者的死亡率。
2020 年 1 月 1 日至 3 月 11 日期间，新发 HF 发生率与 2019 年相当（每 10000 人年 1.83 比 1.78；=0.19），而 HF 恶化住院率在 2020 年略高于 2019 年（每 1000 人年 1.04 比 0.93；=0.02）。在封锁期间，2020 年新发 HF 诊断率（每 1000 人年 1.26 比 2.25）和 HF 恶化住院率（每 1000 人年 0.63 比 0.99）均显著低于 2019 年（均<0.0001）。HF 人群在全国封锁前后的死亡率相似。我们观察到 90 例确诊 COVID-19 感染的 HF 患者，其中 37%（95%CI，23%-50%）在 15 天内死亡。
封锁后，因 HF 恶化而住院或新发 HF 的患者人数明显减少，但尚未对 HF 患者的人群死亡率产生影响。然而，这些数据引起了对当前 HF 潜在治疗不足的关注，这可能会对长期预后产生影响。
