Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020

Mohammed Yousufuddin, Mohamad H. Yamani, Kianoush B. Kashani, Ye Zhu, Zhen Wang, Ashok Seshadri, Katherine R. Blocker, Jessica L. Peters, Jewell M. Doss, Dhauna Karam, Kanika Khandelwal, Umesh M. Sharma, Daniel V. Dudenkov, Tahir Mehmood, Sandeep R. Pagali, Sanjeev Nanda, Ahmed D. Abdalrhim, Nichole Cummings, Sagar B. Dugani, Michael SmerinaLarry J. Prokop, Lawrence R. Keenan, Sumit Bhagra, Arshad Jahangir, Philippe R. Bauer, Gregg C. Fonarow, Mohammad Hassan Murad

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To 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 Methods: The 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. Results: The 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). Conclusion: The 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.

Original languageEnglish (US)
Pages (from-to)31-47
Number of pages17
JournalMayo Clinic proceedings
Volume98
Issue number1
DOIs
StatePublished - Jan 2023

ASJC Scopus subject areas

  • General Medicine

Fingerprint

Dive into the research topics of 'Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020'. Together they form a unique fingerprint.

Cite this