Relationship of pre-pandemic quality of life and avoiding vaccination against SARS-CoV-2 in patients with heart failure – a cohort study

Heart failure (HF) patients are vulnerable to a complicated course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of this research was to analyze the relationship between the decision not to be immunized against SARS-CoV-2, clinical, epidemiological factors and pre-pandemic health-related quality of life (HRQoL) of HF patients . Prior to the onset of the SARS-CoV-2 pandemic, hospitalized HF patients were enrolled as a prospective cohort and interviewed with World Health Organization Quality of Life Brief Version questionnaire. On October 30, 2021, the immunization status was verified. The association of vaccination hesitancy with epidemiological and clinical parameters, and pre-pandemic questionnaire results was tested. Subsequently, the independence from confounding factors, age, sex, New York Heart Association (NYHA) scale, and left ventricular ejection fraction (LVEF) was analyzed. Among 136 included patients, 77.9% were vaccinated. Unvaccinated patients were younger (51.2±13.2 vs 56.6±10.3; p=0.018) and more frequently had non-ischemic etiology of HF (73.3% vs. 46.7%; p=0.013). It was significant after adjustment for age, sex, NYHA class and LVEF. There was no association of overall HRQoL or domain scores with vaccination status. Younger age as a factor associated with vaccine avoidance in this population is consistent with data from the general population despite higher exposure to the severe course of the disease.