COVID-19 infection exhibits a range of clinical manifestations, varying from asymptomatic cases to severe multi-organ damage and death. While its primary impact is on the respiratory system, additional complications beyond the respiratory system have been documented over time.1 COVID-19 can give rise to various cardiovascular complications, such as myocarditis, acute coronary syndrome, heart failure (HF), arrhythmia, and cardiogenic shock. Around 20-30% of hospitalized COVID-19 patients experience cardiovascular manifestations, which have been linked to worse outcomes.2

Several risk factors, such as age, race, laboratory values, and comorbidities, are associated with severe disease and mortality in COVID-19.3 Individuals with HF have a higher risk of poor outcomes and mortality when infected with SARS-CoV-2 due to their reduced immunity and general frailty. The increased metabolic demand caused by COVID-19 infection can lead to diminished cardiac function, resulting in either new-onset HF or acute decompensation of chronic HF.

Hospitalized HF patients during the pandemic exhibited greater illness severity and severe peripheral edema, which is known to be associated with unfavorable outcomes in acute HF.4 In this study, we aimed to investigate the relationship between COVID-19 infection, HF admissions, and mortality using a population-level analysis of the national inpatient sample database.