Abstract
Introduction Previous studies suggest a potential link between COVID-19 and cardiovascular diseases, particularly heart failure (HF), but causal relationships remain unclear. This study uses bidirectional Mendelian randomization (MR) to investigate these associations.Materials and methods We selected genome-wide association study (GWAS) datasets detailing COVID-19 phenotypes as exposures, while traits associated with HF and its risk factors constituted the outcomes. Our primary estimation method involved utilizing the inverse-variance weighted technique for it could provide a precise estimation by giving more weight to studies with less variance. Alongside, we deployed the weighted median, MR-Egger, MR-PRESSO global test, and Cochran’s Q statistic to address biases, detect and correct for pleiotropy, and assess heterogeneity. Furthermore, we conducted bidirectional MR analysis to ascertain the directional causality.Results Based on the bidirectional MR analysis, our findings indicate a higher likelihood of developing into HF among hospitalized COVID-19 patients, as well as an increased propensity for HF development in individuals with all COVID-19 patients. Furthermore, the presence of HF increases the prevalence of COVID-19, escalates the severity of COVID-19, and raises the hospitalization rate in those affected by COVID-19. COVID-19 does not directly escalate the incidence of the risk factors of HF, but type 2 diabetes mellitus (T2DM) could increases the hospitalization and severity rates of COVID-19 patients. Meanwhile, chronic kidney disease (CKD) contributes to increased hospitalization rates among COVID-19 patients.Conclusion This study provides evidence of a bidirectional causal link among COVID-19 and HF and its risk factors. These findings suggest clinical implications for early detection and management of HF in COVID-19 patients and highlight the need for targeted healthcare resources.