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Curr Probl Cardiol
. 2023 Sep 14;102087.
doi: 10.1016/j.cpcardiol.2023.102087. Online ahead of print. Short-Term Outcomes of Cardiac Arrhythmias among COVID-19 Patients- A Propensity Matched National Study
Shafaqat Ali 1 , Resha Khanal 2 , Maria Najam 3 , Sadaf Fakhra 4 , Nouraldeen Manasrah 5 , Bijeta Keisham 6 , Faryal Farooq 7 , Sanchit Duhan 6 , Yasar Sattar 8 , Hameem Changezi 9 , Chadi Alraies 10
Affiliations
The risk of arrhythmia is high in patients with COVID-19. The current literature is limited in understanding the clinical impact of arrhythmias and the extent of healthcare utilization in COVID-19 patients. The Nationwide In-patient Sample Database (NIS) from 2019-2020 was queried to identify COVID-19 patients who developed arrhythmias versus those without. Multivariate regression for adjusted odds ratios (aOR) and propensity score matching (PSM) were done to compare outcomes among both cohorts. 1,664,240 patients (weighted) were hospitalized with COVID-19 infection, 380,915 (22.89%) of whom were diagnosed with an arrhythmia. After propensity matching COVID-19 with arrhythmias had higher rates of in-hospital mortality (22.4% vs. 13.5%, P <0.001), acute kidney injury (AKI) (PSM 39.4% vs. 35.7%, P<0.001), acute heart failure (AHF) (18.2% vs. 12.6%, P<0.001), acute stroke (0.76% vs. 0.57%, P<0.001), cardiogenic shock (1.38% vs. 0.5%, P<0.001), cardiac arrest (5.26% vs. 2.3%, P<0.001) acute myocardial infarction (AMI) (12.8% vs. 7.8%, P<0.001), intracerebral hemorrhage (0.63% vs. 0.45%, P<0.001), major bleeding (2.6% vs. 1.8%, P <0.001) and endotracheal intubation (17.04% vs. 10.17% <0.001) compared to arrhythmias without COVID-19. This cohort also had lower odds of receiving interventions such as cardiac pacing (aOR 0.15 95%Cl 0.13-0.189 P<0.001), cardioversion (aOR 0.43 95% CI 0.40-0.46, P<0.001), and defibrillator (aOR 0.087 95% Cl 0.061-0.124, P<0.001) compared to arrhythmia patients without COVID-19. Cardiac arrhythmias associated with COVID-19 resulted in longer length of hospital stay (LOS) and higher total costs of hospitalizations. Arrhythmias associated with COVID-19 had worse clinical outcomes with an increased rate of in-hospital mortality, longer LOS, and higher total cost. These patients also had lower odds of receiving interventions during the index hospitalization.
Keywords: COVID-19; Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2, SARS CoV2, Arrhythmia.
. 2023 Sep 14;102087.
doi: 10.1016/j.cpcardiol.2023.102087. Online ahead of print. Short-Term Outcomes of Cardiac Arrhythmias among COVID-19 Patients- A Propensity Matched National Study
Shafaqat Ali 1 , Resha Khanal 2 , Maria Najam 3 , Sadaf Fakhra 4 , Nouraldeen Manasrah 5 , Bijeta Keisham 6 , Faryal Farooq 7 , Sanchit Duhan 6 , Yasar Sattar 8 , Hameem Changezi 9 , Chadi Alraies 10
Affiliations
- PMID: 37716538
- DOI: 10.1016/j.cpcardiol.2023.102087
The risk of arrhythmia is high in patients with COVID-19. The current literature is limited in understanding the clinical impact of arrhythmias and the extent of healthcare utilization in COVID-19 patients. The Nationwide In-patient Sample Database (NIS) from 2019-2020 was queried to identify COVID-19 patients who developed arrhythmias versus those without. Multivariate regression for adjusted odds ratios (aOR) and propensity score matching (PSM) were done to compare outcomes among both cohorts. 1,664,240 patients (weighted) were hospitalized with COVID-19 infection, 380,915 (22.89%) of whom were diagnosed with an arrhythmia. After propensity matching COVID-19 with arrhythmias had higher rates of in-hospital mortality (22.4% vs. 13.5%, P <0.001), acute kidney injury (AKI) (PSM 39.4% vs. 35.7%, P<0.001), acute heart failure (AHF) (18.2% vs. 12.6%, P<0.001), acute stroke (0.76% vs. 0.57%, P<0.001), cardiogenic shock (1.38% vs. 0.5%, P<0.001), cardiac arrest (5.26% vs. 2.3%, P<0.001) acute myocardial infarction (AMI) (12.8% vs. 7.8%, P<0.001), intracerebral hemorrhage (0.63% vs. 0.45%, P<0.001), major bleeding (2.6% vs. 1.8%, P <0.001) and endotracheal intubation (17.04% vs. 10.17% <0.001) compared to arrhythmias without COVID-19. This cohort also had lower odds of receiving interventions such as cardiac pacing (aOR 0.15 95%Cl 0.13-0.189 P<0.001), cardioversion (aOR 0.43 95% CI 0.40-0.46, P<0.001), and defibrillator (aOR 0.087 95% Cl 0.061-0.124, P<0.001) compared to arrhythmia patients without COVID-19. Cardiac arrhythmias associated with COVID-19 resulted in longer length of hospital stay (LOS) and higher total costs of hospitalizations. Arrhythmias associated with COVID-19 had worse clinical outcomes with an increased rate of in-hospital mortality, longer LOS, and higher total cost. These patients also had lower odds of receiving interventions during the index hospitalization.
Keywords: COVID-19; Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2, SARS CoV2, Arrhythmia.