Objective: The objective of this study was to evaluate the risk of serious adverse outcomes in patients with Chronic Coronary Heart Failure (CHF) related COVID-19 by stratifying the co-morbidity status.

Subjects and Methods: This is a prospective cohort study based on 1,264 male and female aged 25-75 years old patients and 1,007 (74%) patients gave consent to participate. Demographics, clinical, biochemistry and microbiology information, the presence of disease.

Results: There was a significant difference between CHF versus controls with respect to age groups (p< 0.001), gender (p =0.039), BMI (p = 0.047), smoking cigarette (p = 0.022), nargile-sheesha smoking (p =0.033), Metabolic-Syndrome(ATP III) (p = 0.038), Metabolic-Syndrome(IDF) (p = 0.018), infection (p = 0.015), hypertension (p< 0.001), stroke (p< 0.001), COPD (p< 0.001), malignite (p = 0.006), diabetes (p = 0.032), cerebrovascular disease (CVD) (p = 0.010), and vitamin D levels (p = 0.027) respectively. Additionally, there were highly statistically significant differences between CHF versus control subjects regarding, hemoglobin (p< 0.001), HbA1C (p< 0.001), glucose (p= 0.008), vitamin D (mmol/L) (p = 0.011), vitamin B12 (p= 0.023), urea (mmol/L) (p< 0.001), albumin (p=0.033), total cholesterol (p=0.019), HDL, uric acid (p< 0.001), ferritin (p< 0.001), Fe (p = 0.006), TSH (p = 0.008), Creatinine Kinase -CK (p = 0.005), CK-MB (p= 0.022) , hematocrit (p< 0.001), monocytes (p = 0.021), Neutrophil (/mm3), (p = 0.034), Lymphocyte (p = 0.023), Platelet (p< 0.001), apartate transaminase-AST (p= 0.009), and alanine transaminase-ALT (p= 0.002), respectively. The regression analysis indicated that Systolic BP mmHg (p< 0.001), hypertension (p< 0.001), hematocrit (p< 0.001), Lymphocyte (p< 0.001), platelet (p< 0.001), uric acid (p< 0.001), ferritin (p = 0.003), infection (yes) (p = 0.007), Metabolic-Syndrome (IDF) (p = 0.008), vitamin D (p = 0.011)and BMI (p = 0.019), vitamin B12 (p = 0.023) and smoking (Yes) (p = 0.024) were considered as risk predictors of the CHF among COVID-19 patients.

Conclusion: This study determined that CHF disease was the most prevalent with co-morbidity hypertension, COPD and diabetes disease among COVID-19 patients. The history of CHF identifies patients with COVID-19 who are at high risk of in-hospital admission, due to complications and comorbid.