Each dataset utilized in this study has its own strengths and limitations and only a combination of datasets or linkage analysis can give a comprehensive overview of the impact of COVID-19 on heart failure services, and serve to validate our findings using more than one dataset. In summary, the NHFA dataset is the national heart failure dataset that was used to describe clinical characteristics, pharmacotherapy, and mortality during index admission and its linkage with ONS dataset provided further information about mortality during 30-day after admission and cause of death. The NHFA captures approximately 70% of total heart failure admissions captured in HES, which is an administrative dataset of all hospital admissions in the UK that we used to describe the overall rate of hospitalizations for heart failure. However, HES as an administrative dataset, lacks granular details around processes of care, and treatments of heart failure. Therefore, we used a combination of these two databases, to better define clinical pathways, treatments, admission rates and outcomes.

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