Acute Cardiac Events During COVID-19-Associated Hospitalizations
Rebecca C Woodruff1, Shikha Garg2, Mary G George1
1COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Acute cardiac events are common in hospitalized COVID-19 patients, especially those with prior heart disease. These events increase the risk of intensive care unit admission and in-hospital death.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- COVID-19 (Coronavirus Disease 2019) is frequently associated with cardiac complications.
- Understanding the cardiac impact of SARS-CoV-2 infection is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of acute cardiac events in adults hospitalized with COVID-19.
- To identify risk factors and outcomes associated with these cardiac events.
Main Methods:
- A probability sample of 8,460 adults hospitalized with laboratory-confirmed SARS-CoV-2 infection was analyzed.
- Data were collected from January 2021 to November 2021 through medical chart abstraction.
- Prevalence of acute cardiac events was calculated, stratified by history of underlying cardiac disease, and associated risk factors and outcomes were examined.
Main Results:
- 11.4% of hospitalized adults experienced an acute cardiac event.
- Prevalence was significantly higher in those with pre-existing cardiac disease (23.4%) compared to those without (6.2%).
- Acute ischemic heart disease and acute heart failure were the most common events; patients with events had increased risk of ICU admission and in-hospital death.
Conclusions:
- Acute cardiac events are a significant concern during COVID-19 hospitalizations, particularly for individuals with underlying cardiac conditions.
- These events are linked to more severe disease outcomes, including higher mortality.
- Enhanced clinical evaluation and monitoring are recommended for high-risk patients during hospitalization for COVID-19.
Background:
COVID-19 is associated with cardiac complications.
Objectives:
The purpose of this study was to estimate the prevalence, risk factors, and outcomes associated with acute cardiac events during COVID-19-associated hospitalizations among adults.
Methods:
During January 2021 to November 2021, medical chart abstraction was conducted on a probability sample of adults hospitalized with laboratory-confirmed SARS-CoV-2 infection identified from 99 U.S. counties in 14 U.S. states in the COVID-19-Associated Hospitalization Surveillance Network. We calculated the prevalence of acute cardiac events (identified by International Classification of Diseases-10th Revision-Clinical Modification codes) by history of underlying cardiac disease and examined associated risk factors and disease outcomes.
Results:
Among 8,460 adults, 11.4% (95% CI: 10.1%-12.9%) experienced an acute cardiac event during a COVID-19-associated hospitalization. Prevalence was higher among adults who had underlying cardiac disease (23.4%; 95% CI: 20.7%-26.3%) compared with those who did not (6.2%; 95% CI: 5.1%-7.6%). Acute ischemic heart disease (5.5%; 95% CI: 4.5%-6.5%) and acute heart failure (5.4%; 95% CI: 4.4%-6.6%) were the most prevalent events; 0.3% (95% CI: 0.1%-0.5%) experienced acute myocarditis or pericarditis. Risk factors varied by underlying cardiac disease status. Patients with ≥1 acute cardiac event had greater risk of intensive care unit admission (adjusted risk ratio: 1.9; 95% CI: 1.8-2.1) and in-hospital death (adjusted risk ratio: 1.7; 95% CI: 1.3-2.1) compared with those who did not.
Conclusions:
Acute cardiac events were common during COVID-19-associated hospitalizations, particularly among patients with underlying cardiac disease, and are associated with severe disease outcomes. Persons at greater risk for experiencing acute cardiac events during COVID-19-associated hospitalizations might benefit from more intensive clinical evaluation and monitoring during hospitalization.
More Related Videos
Related Concept Videos
01:30Introduction Cardiac Emergencies
01:30Acute Coronary Syndrome I: Introduction
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:14Myocarditis III: Medical Management