The consequences of confinement on patients followed at the heart failure treatment unit (UTIC): Experience of the cardiology department – CHU Ibn Rochd-Casablanca

隔离对心力衰竭治疗中心(UTIC)患者的影响:卡萨布兰卡伊本·鲁什德大学医院心脏科的经验

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Abstract

INTRODUCTION: The SARS-COV-2 infection originated in December 2019 in Wuhan, China. Then, it spread rapidly. On March 11, 2020, the WHO officially declared the COVID-19 pandemic and the first case in Morocco was declared on March 2, 2020. In the absence of effective treatment against SARS-CoV-2, social distancing and containment measures are the most effective means of combating the pandemic to date. Nevertheless, these last measures can have repercussions in particular on heart failure patients. OBJECTIVE: Evaluate the impact of confinement on patients followed in the heart failure treatment unit at the Ibn Casablanca cardiology department. METHOD: We chose a random sample of patients followed in UTIC. We collected their demographic data as well as the evolution of their symptoms, their clinical and biological parameters, and their lifestyles at the start of confinement and 1 year later. RESULTS: We included 100 random patients. The average age of our population is 50 years ± 11.32. The average BMI (body mass index) is 31.40 kg/m(2) ± 7.43. We found a significant average weight gain of 4.31 kg (P < 0.000) with an increase in BMI of 6.85 kg/m(2) (P < 0.005). The sedentary rate shows an increase of 40% (P < 0.0001) and 63.9% of the patients increased their salt intake by more than 4 g/d. We noted an aggravation of symptoms of heart failure. Thus, 10.6% of patients with stage 2 dyspnea progressed to NYHA stage 3 (32.4 vs. 40.5%), while the percentage of patients with OMIs increased by 21.5%. We noticed a diet gap with an increase in salt intake (more than 4 g per day) in more than half of this subpopulation (58.3%) during the confinement period. Eleven deaths for end-stage heart failure, 38 hospitalizations for heart failure episodes including 12 patients following a deviation from diet and treatment, 10 from an arrhythmia, 8 from an ischemic attack, 6 from a pulmonary embolism and 2 patients following a SARS-CoV-2 infection. CONCLUSION: According to the results of our study, the sanitary confinement has had significant repercussions on the patients followed for heart failure, hence the need to restructure our healthcare system and the development of remote therapeutic education.

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