Pathway transformation and heart failure: the role of the laboratory

The role of pathologists and laboratory scientists is crucial, for patients to be diagnosed, for clinicians to manage their treatment, and for enabling the flow of patients through hospitals. Working in a laboratory can sometimes feel somewhat removed from the NHS frontline where healthcare professionals manage patients across the pathway every day. However, in many ways, laboratories are the central, consistent point on any patient journey. Now, more than ever, the SARS-CoV-2 coronavirus pandemic has placed diagnostic testing at the forefront of public consciousness, and the critical role of laboratories has been thrust into the spotlight.

Coronavirus and COVID-19 disease have compelled the NHS to reconfigure services like never before,¹ with many services – especially laboratory testing – having to change to accommodate the deluge of coronavirus and COVID-19 testing, the volume of which looks likely only to keep increasing. The fallout from this reconfiguration is impacting a number of pathways, but the effect on cardiovascular disease is a particular cause for concern.² Not only has the risk of developing heart failure increased as a result of COVID-19,³ patients with heart failure are at an increased risk of health complications due to SARS-CoV-2 infection and experience worse outcomes.⁴

While we have realised the value of testing in dealing with the pandemic, what about testing for the impact of COVID-19 on heart health? I have been working on a new report entitled Heart Failure: The Hidden Costs of Late Diagnosis⁵ in collaboration with the Pumping Marvellous Foundation, the UK’s leading patient-led heart failure charity. It has involved analysing NHS HES data from 2018/19, and 625 responses to a survey of patients about the diagnostic pathway for heart failure.