Authors: Javed Ashraf , Iffat Aqeel

Abstract

Background and Objective: Congestive Heart failure (CHF) is an increasing clinical syndrome with frequent exacerbation requiring a very close follow-up to prevent hospitalization. Due to current lockdown situation related to coronavirus disease 2019 (COVID-19) pandemic, CHF patients suffered by having limited access to their physicians and therefore are more vulnerable and at higher risk for CHF exacerbations requiring CCU admission. There is no data so far in Pakistan using telemedicine to manage CHF patients. The present study aimed to use telemedicine to manage CHF patients at home, keeping them safe from COVID-19 in order to prevent exacerbation of CHF. Methods: A descriptive study was carried out at Shalamar Hospital, Lahore. A total of 31 established CHF patients were enrolled to manage them at home via telemedicine after taking the approval from Institutional Review Board. Patients were followed via telemedicine every two weeks for a total period of 8 weeks. Data was analyzed in SPSS version 20. Mean with standard deviation was calculated for quantitative variables like age. Frequency and percentages were calculated for qualitative variables. For determining any significant difference between the stratified groups, the Chi-Square test was applied hence taking Pvalue ≤ 0.05 as significant. Results: Among 31 patients, mean age was 54.4 ± 11.121 years. A total of 60% were males. Average Left Ventricle Ejection Fraction (LVEF) of 26.9% was seen. Patients were followed on defined CHF monitoring parameters including weight changes, new or worsening ankle edema or breathing difficulty. Patients were trained to record and report their daily vitals. A total of 14 patients reported CHF symptoms and 11patients required adjustment of diuretic dose with successful management. Only two patients ended up being admitted in Coronary Care Unit (CCU) for CHF exacerbation and at 8 weeks there was no significant change in the weight gain or renal functions as a result of medicine adjustment due to telemedicine. Conclusion: Telemedicine during current lockdown related to COVID-19 pandemic is an effective strategy to manage CHF patients at home while keeping them safe from Corona virus infection.

Keywords: COVID-19, Congestive Heart failure (CHF), Left ventricle ejection fraction, New York Heart Failure (NYHF) class.