COVID-19 vaccination in patients with heart failure: a position paper of the Heart Failure Association of the European Society of Cardiology
Giuseppe Rosano 1, Ewa A Jankowska 2, Robin Ray 3, Marco Metra 4, Magdy Abdelhamid 5, Stamatis Adamopoulos 6, Stefan D Anker 7, Antoni Bayes-Genis 8, Yury Belenkov 9, Tuvia B Gal 10, Michael Böhm 11, Ovidiu Chioncel 12, Alain Cohen-Solal 13, Dimitrios Farmakis 14, Gerasimos Filippatos 15, Arantxa González 16, Finn Gustafsson 17, Loreena Hill 18, Tiny Jaarsma 19, Fadi Jouhra 3, Mitja Lainscak 20, Ekaterini Lambrinou 21, Yury Lopatin 22, Lars H Lund 23, Davor Milicic 24, Brenda Moura 25, Wilfried Mullens 26, Massimo F Piepoli 27, Piotr Ponikowski 2, Amina Rakisheva 28, Arsen Ristic 29, Gianluigi Savarese 23, Petar Seferovic 30, Michele Senni 31, Thomas Thum 32, Carlo G Tocchetti 33, Sophie Van Linthout 34, Maurizio Volterrani 35, Andrew J S Coats 36
Patients with heart failure (HF) who contract SARS-CoV-2 infection are at a higher risk of cardiovascular and non-cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID-19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety, and efficacy of COVID-19 vaccines for patients with HF.
This document provides guidance to all healthcare professionals regarding the implementation of a COVID-19 vaccination scheme in patients with HF. COVID-19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID-19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF, and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID-19 need to continue precautionary measures, including the use of facemasks, hand hygiene, and social distancing. Knowledge on strategies preventing SARS-CoV-2 infection (including the COVID-19 vaccination) should be included in the comprehensive educational programs delivered to patients with HF.
Keywords: COVID-19; Heart failure; SARS-CoV-2; Vaccination.