COVID-19 mortality three times lower in vaccinated vs. unvaccinated patients with HF
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For patients with HF, COVID-19 vaccination was associated with lower risk for hospitalization, ICU admission or death compared with those partially or unvaccinated, researchers reported.
According to data published in the Journal of Cardiac Failure, these associations remained true even if the patient tested positive for SARS-CoV-2.
“I launched this study because our heart failure patients often express fear of getting the COVID-19 vaccine after hearing reports of vaccine-related myocarditis, which would cause another cardiac setback for them. Until now, it has been difficult to explain to these patients how the cardiovascular benefits of vaccination substantially outweigh the risks of complications to them, because we didn’t have concrete evidence to show the substantial risks of being unvaccinated, as few studies have focused on this specific high-risk population and COVID-19 vaccinations,” Anuradha (Anu) Lala, MD, associate professor of medicine (cardiology) and population health and science policy at Icahn School of Medicine at Mount Sinai and deputy editor of the Journal of Cardiac Failure, said in a press release. “Having specific data showing patients with heart failure who don’t have their full vaccine series are at a much higher risk of death, ICU admission, and general hospitalization — even after accounting for factors that might be related to an individual’s decision to become vaccinated — is helpful.”
To better understand the association between COVID-19 vaccination status and hospitalizations, ICU admission and mortality, researchers conducted a retrospective cohort that included 7,094 patients with HF diagnosis (mean age, 73 years; 48% women) within the Mount Sinai Health System between Jan. 1, 2021, and Jan. 24, 2022.
Within this cohort of patients with HF, 9.1% were partially vaccinated, 31% were fully vaccinated, 14.8% were boosted and 45.1% were unvaccinated.
The researchers noted that individuals who were boosted and fully vaccinated were slightly older, more likely to be white, with Medicare insurance, had higher rates of other CVDs (P < .001), obesity (P = .008), hypertension, pulmonary disease, diabetes, and former smoking (P < .001).
During a mean follow-up of 276.5 days, 12.7% of the cohort had died, of which 73.4% were partially or entirely unvaccinated.
Patients who were boosted experienced the lowest mortality risk (HR = 0.36; 95% CI, 0.3-0.43), followed by those who were fully vaccinated and (HR = 0.33; 95% CI, 0.23-0.48) compared with patients who were unvaccinated (P for all < .001).
Researchers reported no difference in mortality among patients who were partially vaccinated compared with those unvaccinated (HR = 0.87; 95% CI, 0.68-1.12; P = .28).
Moreover, patients with HF who were vaccinated or boosted were less likely to be admitted to the hospital (incidence rate ratio [IRR] = 0.68; 95% CI, 0.65-0.71; P < .001) or the ICU (IRR = 0.63; 95% CI, 0.58-0.68; P < .001) compared with partially vaccinated or unvaccinated individuals.
In secondary analysis, researchers evaluated whether COVID-19 status had any modifying effects on outcomes in HF and observed that among patients with positive SARS-CoV-2 test, vaccination was associated with lower risk for hospitalization (HR = 0.83; 95% CI, 0.78-0.89; P = .02), ICU admission (IRR = 0.57; 95% CI, 0.37-0.86; P = .009) and mortality (HR = 0.35; 95% CI, 0.12-0.97; P = .045).
“The findings further emphasize that heart failure patients need to take vaccines seriously, since they have worse outcomes if infected with COVID-19, and stresses the importance of receiving the full COVID-19 vaccination dosage, especially since our previous work shows those with heart failure are 2.5 times more likely to die from the virus,” Lala said in the release. “I have used these results to help educate reluctant patients, and in many cases this has been effective in encouraging them and getting them to follow through with full vaccination. The hope is that cardiologists will use these results as a tool to help their patients and improve their chances of survival.”
Reference:
- Heart failure patients unvaccinated against COVID-19 are three times more likely to die from it than boosted heart failure patients. www.mountsinai.org/about/newsroom/2022/heart-failure-patients-unvaccinated-against-covid-are-three-times-more-likely-to-die-from-it-than-boosted-heart-failure-patients. Published June 9, 2022. Accessed June 9, 2022.
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