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Increased Inpatient Mortality for Cardiovascular Patients During the First Wave of the COVID-19 Epidemic in New York.
Mountantonakis, Stavros E; Makker, Parth; Saleh, Moussa; Coleman, Kristie M; Husk, Gregg; Jauhar, Rajiv; Singh, Varinder; Epstein, Laurence M; Kuvin, Jeffrey.
  • Mountantonakis SE; Department of Cardiology Northwell Health Manhasset NY.
  • Makker P; Department of Cardiology Northwell Health Manhasset NY.
  • Saleh M; Department of Cardiology Northwell Health Manhasset NY.
  • Coleman KM; Department of Cardiology Northwell Health Manhasset NY.
  • Husk G; Department of Cardiology Northwell Health Manhasset NY.
  • Jauhar R; Department of Cardiology Northwell Health Manhasset NY.
  • Singh V; Department of Cardiology Northwell Health Manhasset NY.
  • Epstein LM; Department of Cardiology Northwell Health Manhasset NY.
  • Kuvin J; Department of Cardiology Northwell Health Manhasset NY.
J Am Heart Assoc ; 10(16): e020255, 2021 08 17.
Article in English | MEDLINE | ID: covidwho-1356988
ABSTRACT
Background The acuity and magnitude of the first wave of the COVID-19 epidemic in New York mandated a drastic change in healthcare access and delivery of care. Methods and Results We retrospectively studied patients admitted with an acute cardiovascular syndrome as their principal diagnosis to 13 hospitals across Northwell Health during March 11 through May 26, 2020 (first COVID-19 epidemic wave) and the same period in 2019. Three thousand sixteen patients (242 COVID-19 positive) were admitted for an acute cardiovascular syndrome during the first COVID-19 wave compared with 9422 patients 1 year prior (decrease of 68.0%, P<0.001). During this time, patients with cardiovascular disease presented later to the hospital (360 versus 120 minutes for acute myocardial infarction), underwent fewer procedures (34.6% versus 45.6%, P<0.001), were less likely to be treated in an intensive care unit setting (8.7% versus 10.8%, P<0.001), and had a longer hospital stay (2.91 [1.71-6.05] versus 2.87 [1.82-4.95] days, P=0.033). Inpatient cardiovascular mortality during the first epidemic outbreak increased by 111.1% (3.8 versus 1.8, P<0.001) and was not related to COVID-19-related admissions, all cause in-hospital mortality, or incidence of out-of-hospital cardiac deaths in New York. Admission during the first COVID-19 surge along with age and positive COVID-19 test independently predicted mortality for cardiovascular admissions (odds ratios, 1.30, 1.05, and 5.09, respectively, P<0.0001). Conclusions A lower rate and later presentation of patients with cardiovascular pathology, coupled with deviation from common clinical practice mandated by the first wave of the COVID-19 pandemic, might have accounted for higher in-hospital cardiovascular mortality during that period.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / Hospital Mortality / COVID-19 / Hospitalization / Inpatients Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: J Am Heart Assoc Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / Hospital Mortality / COVID-19 / Hospitalization / Inpatients Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: J Am Heart Assoc Year: 2021 Document Type: Article