SARS-CoV-2 vaccine hesitancy and its relationship with health-related quality of life in patients with heart failure - pilot cross-sectional study

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Abstract Introduction Heart failure (HF) is a complex disease which influences various aspects of life. The latest COVID-19 outbreak exposed that HF patients were at higher risk of severe outcomes and mortality after being infected with SARS-CoV-2. Therefore, vaccination against SARS-CoV-2 is particularly recommended in that group. However, vaccine hesitancy is a growing problem, and it also affects vulnerable HF patients. Health-related quality of life (HRQoL) may be related to the resignation from vaccination against SARS-CoV-2. Purpose The study aims to assess the relationship between avoiding vaccinations against SARS-CoV-2 and HRQoL using the World Health Organisation Quality of Life Brief questionnaire of Life Brief (WHOQOL-BREF) in patients with heart failure. Methods To evaluate the HRQoL, the WHOQOL-BREF questionnaire was used. 117 patients hospitalized with a diagnosis of HF in 2022 irrespectively of left ventricle ejection fraction (LVEF) at the cardiology department were interviewed. Additionally, a detailed medical history was collected. Until the beginning of 2022, all patients could receive the vaccine. Patients were divided into two groups - vaccinated against SARS-CoV-2 and unvaccinated. HRQoL domain scores and total HRQoL were compared between the mentioned groups using the U-Mann Whitney test. Results The mean age of enrolled patients was 55.3±17.4 years, 21.4% were women, and the mean LVEF was 30.3±14.4%. 13 (11.1%) patients were not vaccinated against SARS-CoV-2 at the time of the interview. There was no difference in total HRQoL (p=0.437) and individual domains scores: somatic (p=0.787), psychological (p=0.171), social (p=0.261) and environmental (p=0.834) between both study groups. Patients avoiding vaccination against SARS-CoV-2 compared to vaccinated patients were younger (39.7±13.8 years vs. 57.3±6.9 years, p<0.001) and had lower LVEF (23.8±14.0% vs. 31.3±14.3%; p=0.04). In the unvaccinated group of patients, the duration of HF was three times shorter (mean 4.3 vs.12.4 years, p=0.002). Conclusions The study revealed no differences in domains of the WHOQoL-BREF questionnaire and overall HRQoL between patients who decided to vaccinate and those with the opposite decision. Almost 90% of the patients with HF were vaccinated against SARS-CoV-2. Younger HF patients are more hesitant to vaccinate against SARS-CoV-2, which is consistent with the trend observed in HF patients [1] and the general population [2]. Further studies could better characterize the patients with heart failure who are vaccine-hesitant. Eventually, it could help develop more specific care to convince them to vaccinate.

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