ABSTRACT
Introduction: COVID19-associated cardio complications occur through different mechanisms including the inflammatory response causing severe issues such as ARDS, sepsis, and coagulopathy. Many points remain unclear regarding the impact of coagulation disorder in patients who are admitted with COVID19 infection. We present an analysis of the cardiovascular outcomes of coagulation disorders in COVID19-related hospitalizations. Method(s): The Nationwide Inpatient Sample database from 2020 was queried to identify COVID-19 patients. Subsequently, we classified COVID hospitalization based on the presence or absence of coagulation disorder. The primary outcome measure was in-hospital mortality. Secondary outcomes were in-hospital cardiovascular outcomes, ICU admissions, bleeding, Stroke, and resource utilization. Result(s): Out of 1,060,885 patients with a diagnosis of COVID, 43905 had coagulation disorder. On adjusted analysis, patients with COVID and coagulation disorder had significantly higher odds of MACCE (aOR 1.57, 95% CI 1.47-1.67, p<0.001), in-hospital mortality (aOR 1.56, 95% CI 1.46-1.67, p<0.001), cardiac arrest (aOR 1.38, 95% CI 1.28-1.57, P<0.001), acute MI (aOR 1.32, 95% CI 1.19-1.47, P<0.001), stroke (aOR 2.11, 95% CI 1.76-2.52, P<0.001), cardiogenic shock (aOR 2.19, 95% CI 1.78-2.70, P<0.001), MCS (aOR 3.98 CI 2.31-6.85 p<0.001), and bleeding (aOR 1.64 CI1.40-1.92 p<0.001) compared to patients without coagulation disorder. The length of stay (11.43 vs 7.27) and mean in-hospital cost was increased ($150,759.70 vs $75321.1) in patients with and without coagulation disorders. Conclusion(s): COVID patients with coagulation disorder have a significantly higher risk of MACCE, in-hospital mortality, cardiac arrest, AMI, stroke, shock, MCS, and bleeding. Large prospective trials are needed to further study these findings. [Formula presented]Copyright © 2023
ABSTRACT
Background: COVID rapidly became a multisystemic infection with varied cardiovascular complications including Acute Coronary Syndrome. Current literature is limited on the impact of COVID on ACS patients. Methods: We queried the national inpatient sample (NIS) from 2020 to identify patients who were admitted for ACS and stratified them based on the presence or absence of COVID. The adjusted odds ratios (aOR) of in-hospital outcomes and resource utilization were calculated using chi-square statistics in the software STATA v.17. Results: Out of 883940 patients analyzed, who were admitted for ACS, 3900 patients had COVID. On adjusted analysis, patients with COVID had significantly elevated In-Hospital mortality (aOR, 2.91 CI 2.25-3.79), MACCE (aOR 2.53, CI 1.90-3.10), cardiac arrest (aOR 3.34, CI 1.1-10.1) with longer length of stay (6.34 ± 0.39 vs 4.48 ± 0.02). Interestingly, the outcome PCA (aOR, 0.39 CI 0.33-0.46) showed significant improvement. Interestingly, mean costs were elevated in patients without COVID at $105,550.8 vs $98597.7 in patients without COVID. In terms of trends, as exposure increased through the year with the highest levels in December, the mortality also increased (April 18.52% vs 25.64%). Interestingly, the cardiac arrest percentage decreased from April 2020 (7.4%) to Dec 2020 (1.98%) as well as MCS in April 202 (11.11%)vs December 2020 (3.47%) in patients exposed to COVID. Conclusions: In patients admitted for ACS, the presence of COVID significantly increases the risk of MACCE, in-hospital mortality, and cardiac arrest. Prospective trials are necessary for the identification of risk factors to improve clinical outcomes in these patients. Key words: COVID, Sars-2 coronavirus. Coronavirus. ACS. Acute Coronary Syndrome. [Formula presented]