Unvaccinated patients three times more likely to die of COVID-19

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Heart failure patients who are unvaccinated against COVID-19 are three times more likely to die if infected with the virus compared to fully boosted heart failure patients, according to new research out of Mount Sinai Heart.

The study, published June 9 in the Journal of Cardiac Failure, is the first to look at COVID-19 vaccination status and outcomes in patients with this cardiovascular condition and shows how dramatic the protective effects are in this high-risk patient population.

The research is important since many heart failure patients are hesitant to get the COVID-19 vaccine due to fear of myocarditis, or inflammation of the heart muscle. This condition is a rare side effect of the Pfizer-BioNTech and Moderna vaccines but a more common complication of COVID-19 infection.

Fear of receiving the vaccine was the primary reason the study was launched, the Mount Sinai team said, and until the study was conducted, there was little evidence of the cardiovascular benefits of receiving a shot. Now, specific data shows a much higher risk of death for unvaccinated patients.

WHAT'S THE IMPACT?

Researchers conducted a retrospective study to analyze the impact of COVID-19 vaccination status in the heart failure patient population. They looked at electronic records of 7,094 patients from the Mount Sinai Health System with a heart failure diagnosis – not including heart transplant and left ventricular assist device patients – who had office visits, emergency department visits or hospitalizations between January 1, 2021, and January 24, 2022.

Of that group, 2,200 (31%) were fully vaccinated with two doses; 1,053 (14.8%) were fully vaccinated and had also received one booster, the recommended guidance from the Centers for Disease Control and Prevention at that time; 645 (9.1%) were partially vaccinated with only one dose; and 3,196 (45%) were unvaccinated. That unvaccinated proportion was about double the proportion of unvaccinated adults in the general New York City population.

The team compared survival rates and numbers of admissions to the hospital and intensive care units between the groups, looking at both all-cause mortality and mortality associated with concurrent, documented SARS-CoV-2 infection. 

They found the unvaccinated and partially vaccinated patients were three times more likely to die from COVID-19-related illness than fully vaccinated and boosted patients. The data goes on to show that unvaccinated and partially vaccinated patients were 15% more likely to be hospitalized if infected with the virus and nearly twice as likely to be admitted to the ICU when compared to fully vaccinated and boosted patients.

Dr. Anurhada Lala, director of heart failure research and an associate professor of medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai, said 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."

THE LARGER TREND

The findings provide further evidence of the safety and health benefits of receiving the COVID-19 vaccine.

Yet, vaccine hesitancy is still an issue. Swermo's COVID-19 Real Time Barometer showed last year that more than 72% of physicians say patients continue to voice concerns over vaccine side effects. Still others have reported ongoing misinformation discouraging people from getting vaccines. And close to 30% of physicians reported encountering patients who have skipped their second dose due to unpleasant side effects from the first dose or because of concerns over side effects.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com