Impact of COVID-19 on Patients Hospitalized with ST-Segment Elevation Myocardial Infarction in the United States during the Early Pandemic: An Analysis of Outcomes, Care Delivery, and Racial Disparities in Mortality

Majeed, Harris; Gangu, Karthik; Shekhar, Rahul; Sagheer, Shazib; Garg, Ishan; Shuja, Hina; Bobba, Aniesh; Chourasia, Prabal; Avula, Sindhu Reddy; Sheikh, Abu Baker

doi:10.3390/idr15010006

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…The finding that 3% of hospital admissions with a diagnosis of STEMI had additional analysis of COVID-19 is important. Similar finding in the analysis that was focused on STEMI admissions and concomitant COVID-19 disease in NIS database for the year 2020, reported similar prevalence of COVID-19 in their cohort which was 3.4%, a result similar to ours thus validating our findings [12].…”

Section: Discussionsupporting

confidence: 92%

The impact of COVID-19 and the COVID-19 pandemic on hospitalized patients with STEMI in the United States: insights from the National Inpatient Sample

Kwok,

Qureshi,

Will

et al. 2023

Coronary Artery Disease

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Background It is unclear how COVID-19 pandemic affected care and outcomes among patients who are diagnosed with ST-elevation myocardial infarction (STEMI) in the USA. Methods We analyzed the data from National Inpatient Sample from 2016 to 2020 and assessed the impact of COVID-19 infection and the COVID-19 pandemic (year 2020) on in-hospital mortality, length of stay (LOS) and hospitalization costs.P Results There were 1 050 905 hospitalizations with STEMI, and there was an 8.2% reduction in admissions in 2020. Patients with COVID-19 versus those without had significantly greater in-hospital mortality (45.2% vs. 10.7%; P < 0.001). In 2020, 3.0% of hospitalizations had a diagnosis of COVID-19, and the mortality was 11.5% compared to 10.7% for patients admitted in 2016–2019 period. There was a significantly increased mortality (OR 6.25, 95% CI 5.42–7.21, P < 0.001), LOS (coefficient 3.47, 95% CI 3.10–3.84, P < 0.001) and cost (coefficient 10.69, 95% CI 8.4–12.55, P < 0.001) with COVID-19 infection compared with no infection. There was a borderline difference in mortality (OR 1.04, 95% CI 1.00– 1.09, P = 0.050) but LOS (coefficient −0.21, 95% CI−0.28 to −0.14, P < 0.001) and costs (3.14, 95% CI 2.79 to 3.49, P < 0.001) were reduced in 2020 compared to 2016–2019 period. Conclusions In conclusion, in patients hospitalized with STEMI, COVID-19 infection was associated with increased mortality, LOS, and cost but during the pandemic year of 2020 there was a small trend for increased mortality for patients with a diagnosis of STEMI.

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Section: Discussionsupporting

confidence: 92%

The impact of COVID-19 and the COVID-19 pandemic on hospitalized patients with STEMI in the United States: insights from the National Inpatient Sample

Kwok,

Qureshi,

Will

et al. 2023

Coronary Artery Disease

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“…Existing research strongly suggests that COVID‐19 infection worsens the outcomes of various cardiovascular diseases, including myocardial infarctions and acute ischemic strokes, with patients infected with COVID‐19 experiencing significantly higher mortality rates. 15 , 16 , 17 , 18 Furthermore, during the pandemic, preventive measures potentially affected acute ischemic stroke management, leading to treatment delays and subsequently influencing early adverse outcomes in patients with acute ischemic stroke. 19 However, the impact of COVID‐19 on hemorrhagic stroke, specifically ICH, is less well studied and primarily derived from smaller, single‐center studies.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage

Renedo,

Leasure,

Young

et al. 2024

JAHA

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Background Patients with ischemic stroke and concomitant COVID‐19 infection have worse outcomes than those without this infection, but the impact of COVID‐19 on hemorrhagic stroke remains unclear. We aimed to assess if COVID‐19 worsens outcomes in intracerebral hemorrhage (ICH). Methods and Results We conducted an observational study of ICH outcomes using Get With The Guidelines Stroke data. We compared patients with ICH who were COVID‐19 positive and negative during the pandemic (March 2020–February 2021) and prepandemic (March 2019–February 2020). Main outcomes were poor functional outcome (defined as a modified Rankin scale score of 4 to 6 at discharge), mortality, and discharge to a skilled nursing facility or hospice. The first stage included 60 091 patients with ICH who were COVID‐19 negative and 1326 COVID‐19 positive. In multivariable analyses, patients with ICH with versus without COVID‐19 infection had 68% higher odds of poor outcome (odds ratio [OR], 1.68 [95% CI, 1.41–2.01]), 51% higher odds of mortality (OR, 1.51 [95% CI, 1.33–1.71]), and 66% higher odds of being discharged to a skilled nursing facility/hospice (OR, 1.66 [95% CI, 1.43–1.93]). The second stage included 62 743 prepandemic and 64 681 intrapandemic cases with ICH. In multivariable analyses, patients with ICH admitted during versus before the COVID‐19 pandemic had 10% higher odds of poor outcomes (OR, 1.10 [95% CI, 1.07–1.14]), 5% higher mortality (OR, 1.05 [95% CI, 1.02–1.08]), and no significant difference in the risk of being discharged to a skilled nursing facility/hospice (OR, 0.93 [95% CI, 0.90–0.95]). Conclusions The pathophysiology of the COVID‐19 infection and changes in health care delivery during the pandemic played a role in worsening outcomes in the patient population with ICH.

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“…Hospitalizations and mortality for other respiratory infections were significantly decreased during the pandemic ( 31 ). The effect of COVID-19 on STEMI ( 32 ) and stoke ( 33 ) outcomes have also been demonstrated, resulting in higher in-patient mortality, length of stay and cost of hospitalization. Kapuria et al found that patients with COVID-19 and cirrhosis had 3 times higher mortality than those without COVID-19 ( 34 ) and Pal et al found sex and racial disparities in hospitalizations and in rates of adverse outcomes ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 waves in an urban setting 2020–2022: an electronic medical record analysis

Chen,

Gawel,

Desai

et al. 2024

Front. Public Health

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BackgroundGlobal and national surveillance efforts have tracked COVID-19 incidence and clinical outcomes, but few studies have compared comorbid conditions and clinical outcomes across each wave of the pandemic. We analyzed data from the COVID-19 registry of a large urban healthcare system to determine the associations between presenting comorbidities and clinical outcomes during the pandemic.MethodsWe analyzed registry data for all inpatients and outpatients with COVID-19 from March 2020 through September 2022 (N = 44,499). Clinical outcomes were death, hospitalization, and intensive care unit (ICU) admission. Demographic and clinical outcomes data were analyzed overall and for each wave. Unadjusted and multivariable logistic regressions were performed to explore the associations between age, sex, race, ethnicity, comorbidities, and mortality.ResultsWaves 2 and 3 (Alpha and Delta variants) were associated with greater hospitalizations, ICU admissions, and mortality than other variants. Chronic pulmonary disease was the most common comorbid condition across all age groups and waves. Mortality rates were higher in older patients but decreased across all age groups in later waves. In every wave, mortality was associated with renal disease, congestive heart failure, cerebrovascular disease, diabetes, and chronic pulmonary disease. Multivariable analysis found that liver disease and renal disease were significantly associated with mortality, hospitalization, and ICU admission, and diabetes was significantly associated with hospitalization and ICU admission.ConclusionThe COVID-19 registry is a valuable resource to identify risk factors for clinical outcomes. Our findings may inform risk stratification and care planning for patients with COVID-19 based on age and comorbid conditions.

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Impact of COVID-19 on Patients Hospitalized with ST-Segment Elevation Myocardial Infarction in the United States during the Early Pandemic: An Analysis of Outcomes, Care Delivery, and Racial Disparities in Mortality

Cited by 10 publications

References 24 publications

The impact of COVID-19 and the COVID-19 pandemic on hospitalized patients with STEMI in the United States: insights from the National Inpatient Sample

The impact of COVID-19 and the COVID-19 pandemic on hospitalized patients with STEMI in the United States: insights from the National Inpatient Sample

COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage

COVID-19 waves in an urban setting 2020–2022: an electronic medical record analysis

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