There is increasing prevalence of diabetes, obesity, cardiovascular disease, and heart failure across most populations globally. The increase in diabetes includes both type 1 and type 2 diabetes. It is recognised by doctors that cardiovascular disease is commonly identified in patients with type 1 and type 2 diabetes, however recent research has revealed that heart failure is an under-recognised complication of diabetes.
There are two types of heart failure:
- Heart failure with preserved ejection fraction (HFpEF) – this is where the amount of blood squeezed out of the main chamber of the heart is over 50% (the volume is normal but the muscles of the chamber are less flexible).
- Heart failure with reduced ejection fraction (HFrEF) – this is where the amount of blood squeezed out of the main chamber of the heart is less than 50%.
The type of heart failure is diagnosed by a scan called an echocardiogram (ECHO). It is increasingly being recognised that diabetes and obesity increase the risk of HFpEF.
In addition, diabetes, obesity, and cardiovascular disease are associated with poorer results for patients with COVID-19 infections. Some common treatments for cardiovascular disease and diabetes (which were beneficial for heart failure) were stopped during early COVID-19 as there was concern around them causing increased harm from COVID-19 infection, however stopping these treatments may have resulted in worsening heart failure for some patients.
No large-scale studies have been reported for COVID-19 outcomes, by underlying type of Heart Failure, and considering underlying conditions such as diabetes and obesity.
The main aim of this study is to investigate what happened to patients who had COVID-19 infection with ECHO established HFpEF and HFrEF in comparison to people without heart failure. We will also evaluate the interaction with pre-existing diabetes (both type 1 and type 2 diabetes) as well as obesity.
This study will make use of the unique linkage between the National Institute for Cardiovascular Outcomes Research (NICOR) National Heart Failure Audit, and the primary care and secondary care data within NHS England’s Secure Data Environment, accessed via the CVD-COVID-UK/COVID-IMPACT Consortium. This data will help to the team to better understand the correlations between Heart failure, diabetes, obesity, cardiovascular disease, and COVID-19.
This project aims to provide insights within a short timeframe, highlighting these potential links between conditions. We will then develop and fund further critical research in this area which could change patient care.