1. Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020
- Author
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Yousufuddin, Mohammed, Yamani, Mohamad H, Kashani, Kianoush B, Zhu, Ye, Wang, Zhen, Seshadri, Ashok, Blocker, Katherine R, Peters, Jessica L, Doss, Jewell M, Karam, Dhauna, Khandelwal, Kanika, Sharma, Umesh M, Dudenkov, Daniel V, Mehmood, Tahir, Pagali, Sandeep R, Nanda, Sanjeev, Abdalrhim, Ahmed D, Cummings, Nichole, Dugani, Sagar B, Smerina, Michael, Prokop, Larry J, Keenan, Lawrence R, Bhagra, Sumit, Jahangir, Arshad, Bauer, Philippe R, Fonarow, Gregg C, and Murad, Mohammad Hassan
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Cardiovascular ,Heart Disease ,Patient Safety ,2.4 Surveillance and distribution ,Aetiology ,Good Health and Well Being ,Male ,Adult ,Humans ,Aged ,Pandemics ,Cohort Studies ,COVID-19 ,Hospitalization ,Patient Readmission ,Heart Failure ,Medical and Health Sciences ,Biomedical and clinical sciences - Abstract
ObjectiveTo compare clinical characteristics, treatment patterns, and 30-day all-cause readmission and mortality between patients hospitalized for heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic.Patients and methodsThe study was conducted at 16 hospitals across 3 geographically dispersed US states. The study included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with cumulative 8989 HF hospitalizations: 2341 hospitalizations during the COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator group. We used Poisson regression, Kaplan-Meier estimates, multivariable logistic, and Cox regression analysis to determine whether prespecified study outcomes varied by time frames.ResultsThe adjusted 30-day readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19 period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89). Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period (relative risk increase, 16%; number of admissions needed for one additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite significant differences in rates of index hospitalization, readmission, and mortality across the study time frames, the disease severity, HF subtypes, and treatment patterns remained unchanged (P>0.05).ConclusionThe findings of this large tristate multicenter cohort study of HF hospitalizations suggest lower rates of index hospitalizations and 30-day readmissions but higher incidence of 30-day mortality with broadly similar use of HF medication, surgical interventions, and devices during the COVID-19 pandemic compared with the pre-COVID-19 time frame.
- Published
- 2023