Efficacy and safety of COVID-19 vaccines in patients with chronic heart failure

Virus infection is a well-established factor responsible for acute decompensation and re-hospitalization in patients with chronic heart failure (CHF). With the rapid evolution and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), heart failure patients have become a high-risk and susceptible group in the context of this pandemic. CHF patients are more vulnerable to SARS-CoV-2 infection and more likely to progress to severe and critical cases. SARS-CoV-2 infection can also cause cardiovascular complications, such as myocarditis/myocardial injury, arrhythmia and pulmonary embolism, thereby exacerbating the worsening of chronic heart failure and increasing the risk of new-onset heart failure. All the approved vaccines for emergency use have been proven to be effective and safe to prevent symptomatic infections and critical cases of coronavirus disease 2019 (COVID-19) and effectively reduce the hospitalization rate and mortality. Although vaccine-related adverse events such as myocarditis, deep vein thrombosis or thrombocytopenia have been reported, the overall incidence remains low. Therefore, patients with CHF should receive COVID-19 vaccine as soon as possible and it is necessary to make a careful risk-benefit assessment before vaccination and implement timely medical aids in case of rare but severe adverse events.