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Incidence and Impact of Takotsubo Syndrome in Hospitalized Patients With COVID-19
Pengyang Li1, Ao Shi2, Xiaojia Lu3
1Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia.
Insights
Takotsubo syndrome is a rare but severe complication in patients hospitalized with COVID-19. This condition significantly increases the risk of death, cardiac arrest, and cardiogenic shock.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Takotsubo syndrome (TTS) is increasingly recognized, with prior reports suggesting its occurrence in COVID-19 patients.
- However, limited data exist on the incidence and clinical impact of TTS in this specific patient population.
Purpose of the Study:
- To assess the incidence of takotsubo syndrome in patients hospitalized with COVID-19.
- To evaluate the impact of takotsubo syndrome on clinical outcomes and healthcare resource utilization among hospitalized COVID-19 patients.
Main Methods:
- A retrospective cohort study utilized the National Inpatient Sample 2020 database.
- Patients with a primary diagnosis of COVID-19 were identified using ICD-10 codes, with subgroups categorized by the presence or absence of takotsubo syndrome.
- Propensity score matching was employed to compare outcomes between the two groups, adjusting for demographic and comorbidity differences.
Main Results:
- The study identified 211,448 patients with COVID-19, of whom 171 (0.08%) had concomitant takotsubo syndrome.
- Patients with COVID-19 and takotsubo syndrome were older, more frequently female, and had higher rates of anxiety, depression, and COPD.
- Post-matching analysis revealed significantly higher in-hospital mortality (30% vs. 14%), cardiac arrest (7.6% vs. 2.8%), cardiogenic shock (12.4% vs. 0.4%), longer hospital stays, and greater total charges in the takotsubo syndrome group.
Conclusions:
- Takotsubo syndrome represents a rare yet severe in-hospital complication for patients diagnosed with COVID-19.
- The presence of takotsubo syndrome in COVID-19 patients is associated with substantially worse clinical outcomes and increased healthcare costs.
Background:
Takotsubo syndrome has been reported in patients with COVID-19, although minimal data are available. This investigation assessed the incidence and impact of takotsubo syndrome on patients hospitalized with COVID-19.
Methods:
A retrospective cohort study was conducted using International Statistical Classification of Diseases, Tenth Revision, codes to identify patients with a primary diagnosis of COVID-19 with or without takotsubo syndrome in the National Inpatient Sample 2020 database. Outcomes between groups were compared after propensity score matching for patient and hospital demographics and comorbidities.
Results:
A total of 211,448 patients with a primary diagnosis of COVID-19 were identified. Of these, 171 (0.08%) had a secondary diagnosis of takotsubo syndrome. Before matching, patients with COVID-19 and takotsubo syndrome, compared with patients without takotsubo syndrome, were older (68.95 vs 64.26 years; P < .001); more likely to be female (64.3% vs 47.2%; P < .001); and more likely to have anxiety (24.6% vs 12.8%; P < .001), depression (17.5% vs 11.4%; P = .02), and chronic obstructive pulmonary disease (24.6% vs 14.7%; P < .001). The takotsubo syndrome group had worse outcomes than the non-takotsubo syndrome group for death (30.4% vs 11.1%), cardiac arrest (7.6% vs 2.1%), cardiogenic shock (12.9% vs 0.4%), length of hospital stay (10.7 vs 7.5 days), and total charges ($152,685 vs $78,468) (all P < .001). After matching and compared with the non-takotsubo syndrome group (n = 508), the takotsubo syndrome group (n = 170) had a higher incidence of inpatient mortality (30% vs 14%; P < .001), cardiac arrest (7.6% vs 2.8%; P = .009), and cardiogenic shock (12.4% vs 0.4%; P < .001); a longer hospital stay (10.7 vs 7.6 days; P < .001); and higher total charges ($152,943 vs $79,523; P < .001).
Conclusion:
Takotsubo syndrome is a rare but severe in-hospital complication in patients with COVID-19.
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