Luo Zhangxing, Jiao Yun, Ma Binwu
Department of Geriatrics, The Second People's Hospital of Lanzhou Lanzhou 730046, Gansu, China.
Am J Transl Res. 2025 Feb 15;17(2):1416-1427. doi: 10.62347/ATQD2701. eCollection 2025.
The coronavirus disease 2019 (COVID-19) pandemic has significantly worsened the health and quality of life of vulnerable populations, particularly elderly patients with heart failure. This study aimed to assess the effect of COVID-19 infection on the quality of life in elderly patients with heart failure during the pandemic.
This retrospective case-control study included elderly heart failure patients admitted to the Second People's Hospital of Lanzhou between December 2022 and December 2023, all of whom were diagnosed during the ongoing COVID-19 pandemic. All patients underwent COVID-19 nucleic acid testing upon admission. Among the 96 heart failure patients who tested positive for COVID-19 and the 68 who tested negative, multiple validated instruments were used to assess both physical and mental health quality of life. These instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), 36-Item Short Form Health Survey physical component summary score (SF-36 PCS), 6-Minute Walking Test (6MWT), Geriatric Depression Scale-15 (GDS-15), Self-Rating Anxiety Scale (SAS) Total, Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment-Short Form (MNA-SF), and the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) Scale.
Heart failure patients who tested positive for COVID-19 exhibited significantly lower blood pressure, SF-36 scores, and 6MWT distances compared to those who tested negative (P<0.05). Additionally, the COVID-19-positive group had higher MLHFQ scores, older average age, a greater proportion of patients in NYHA class III-IV, more frequent electrolyte imbalances, elevated D-dimer, C-reactive protein (CRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and longer hospital stays (P<0.05). These patients also exhibited higher levels of anxiety (SAS total), poorer sleep quality (PSQI), and greater frailty (FRAIL Scale) compared to their COVID-19-negative counterparts (P<0.05). In addition, heart failure patients with COVID-19 infection reported more severe symptoms of dyspnea and fatigue (P<0.05). Both age and COVID-19 infection were identified as significant factors negatively affecting the quality of life in this patient population.
COVID-19 infection significantly exacerbates the decline in quality of life in elderly patients with heart failure. This highlights the urgent need for strengthened, comprehensive treatment and targeted mental health support for this vulnerable group.
2019年冠状病毒病（COVID-19）大流行显著恶化了弱势群体的健康和生活质量，尤其是老年心力衰竭患者。本研究旨在评估COVID-19感染对大流行期间老年心力衰竭患者生活质量的影响。
这项回顾性病例对照研究纳入了2022年12月至2023年12月期间在兰州市第二人民医院住院的老年心力衰竭患者，所有患者均在COVID-19大流行期间确诊。所有患者入院时均接受了COVID-19核酸检测。在96例COVID-19核酸检测呈阳性的心力衰竭患者和68例检测呈阴性的患者中，使用了多种经过验证的工具来评估身心健康生活质量。这些工具包括明尼苏达心力衰竭生活问卷（MLHFQ）、36项简短健康调查身体成分总结评分（SF-36 PCS）、6分钟步行试验（6MWT）、老年抑郁量表-15（GDS-15）、自评焦虑量表（SAS）总分、匹兹堡睡眠质量指数（PSQI）、微型营养评定简表（MNA-SF）以及疲劳、抵抗力、活动能力、疾病和体重减轻（FRAIL）量表。
与检测呈阴性的患者相比，COVID-19核酸检测呈阳性的心力衰竭患者血压、SF-36评分和6MWT距离显著更低（P<0.05）。此外，COVID-19阳性组MLHFQ评分更高、平均年龄更大、纽约心脏协会（NYHA）III-IV级患者比例更高、电解质失衡更频繁、D-二聚体、C反应蛋白（CRP）和N末端脑钠肽前体（NT-proBNP）水平升高，住院时间更长（P<0.05）。与COVID-19阴性患者相比，这些患者还表现出更高水平的焦虑（SAS总分）、更差的睡眠质量（PSQI）和更大的虚弱程度（FRAIL量表）（P<0.05）。此外，感染COVID-19的心力衰竭患者报告的呼吸困难和疲劳症状更严重（P<0.05）。年龄和COVID-19感染均被确定为对该患者群体生活质量产生负面影响的重要因素。
COVID-19感染显著加剧了老年心力衰竭患者生活质量的下降。这凸显了对这一弱势群体加强综合治疗和提供针对性心理健康支持的迫切需求。
