Impact of COVID-19 on Acute Myocardial Infarction: A National Inpatient Sample Analysis
Dhairya Nanavaty1, Rishav Sinha1, Diksha Kaul1
1Department of Internal Medicine, The Brooklyn Hospital Center, NY.
Insights
COVID-19 significantly increases mortality and complications for patients hospitalized with acute myocardial infarction (AMI). This diagnosis leads to worse outcomes, including longer hospital stays and higher costs.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- COVID-19 is linked to increased acute myocardial infarction (AMI) incidence and complications.
- Understanding the impact of SARS-CoV-2 on AMI patient outcomes is crucial.
Purpose of the Study:
- To evaluate the effect of a COVID-19 diagnosis on hospitalizations for acute myocardial infarction.
- To compare mortality, procedures, and complication rates between AMI patients with and without COVID-19.
Main Methods:
- Analysis of the National Inpatient Sample 2020 data for AMI hospitalizations.
- Stratification of patients into COVID-19 positive and negative cohorts.
- Comparison of outcomes using statistical tests and multivariate regression analysis.
Main Results:
- Over 555,000 AMI admissions were analyzed; 1.04% had concurrent COVID-19.
- COVID-19 patients had lower coronary angiography rates but higher thrombolysis use (STEMI).
- Higher rates of cardiac complications, mortality, and longer hospital stays were observed in AMI patients with COVID-19.
Conclusions:
- COVID-19 diagnosis is associated with a worse prognosis in acute myocardial infarction hospitalizations.
- In-hospital mortality and complication rates are significantly elevated for AMI patients with COVID-19.
- COVID-19 negatively impacts length of stay and total hospital costs for AMI admissions.
Abstract:
COVID-19 has been associated with a higher incidence of acute myocardial infarction and related complications. We sought to assess the impact of COVID-19 diagnosis on hospitalizations with an index admission of AMI. The National inpatient sample 2020 was queried for hospitalizations with an index admission of AMI, further stratified for admissions with and without COVID-19. The 2 groups' mortality, procedure, and complication rates were compared using suitable statistical tests. Multivariate regression analysis was further performed to study the impact of COVID-19 on mortality as the primary outcome and length of stay and total hospital cost as secondary outcomes. A total of 555,540 admissions for AMI were identified, of which 5818 (1.04%) had concomitant COVID-19. Hospitalizations in the COVID-19 cohort of both groups had a lower procedure rate for coronary angiography. Thrombolysis use was higher in the STEMI patients with COVID-19. Most cardiac complications in AMI patients were higher when infected with SARS-CoV-2. Multivariate regression analysis revealed that COVID-19 led to higher odds of mortality and total length of stay in AMI hospitalizations. COVID-19 portends a worse prognosis in hospitalizations with AMI. These admissions have a significantly higher mortality rate and increased complications.
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