TAKOTSUBO SYNDROME IN COVID-19 AND INFLUENZA INFECTIONS: A COMPARATIVE SYSTEMATIC REVIEW OF CLINICAL CHARACTERISTICS AND OUTCOMES

ABSTRACT

SESSION TITLE Outcomes Across COVID-19 SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/19/2022 1115 am - 1215 pm PURPOSE: Coronavirus disease 2019 (COVID-19) and influenza infections are associated with systemic inflammatory reactions that predispose to Takotsubo cardiomyopathy (TTS). Studies have investigated the epidemiology and clinical features of TTS in COVID-19 and influenza infection, however, there are limited data comparing TTS between patients with COVID-19 and influenza. METHODS: We searched PubMed/Medline, Web of Science, SCOPUS, EMBASE, and Google Scholar until November 1st, 2021, for case reports, case series, and observational cohort studies using these keywords takotsubo syndrome/takotsubo cardiomyopathy, stress-induced cardiomyopathy, and broken heart syndrome combined with the terms COVID-19 and/or SARS-CoV-2, flu and/or influenza. All the published case reports included in the final analysis were in English and were categorized into patients with ‘COVID-19 + TTS’ and ‘Flu + TTS’. RESULTS: We identified 37 studies describing 64 patients with COVID-19+TTS and 10 case reports describing 10 patients with Flu + TTS. The mean age of patients in the COVID-19 + TTS was similar to the influenza group (69 years). Although women were more disproportionately affected by TTS in both groups, COVID-19 + TTS patients had a higher proportion of men than the Flu + TTS group (44% vs 30%) and previously reported incidence of TTS in men in the general population. Compared to patients with Flu + TTS, COVID-19 + TTS had a longer mean time from testing positive to developing TTS (7.3 days vs. 3.1 days), higher incidence rates of acute respiratory distress syndrome (77% vs. 40%), hypoxemic respiratory failure (86% vs. 60%), more likely to require invasive mechanical ventilation (63% vs. 40%) and higher in-hospital mortality rates (36%, n=23 vs 10%, n=1) CONCLUSIONS: Our systematic review highlights some important differences in the presentation and outcomes of TTS in patients with COVID-19 compared to seasonal influenza. Patients with COVID-19 + TTS had higher rates of respiratory complications and excess all-cause mortality compared to Flu + TTS. In contrast to the general population and patients infected with influenza, TTS tends to affect more men with COVID-19 infection. CLINICAL IMPLICATIONS Hospitalized patients with COVID-19 who develop TTS appear to have a more severe disease course and poorer outcome compared to hospitalized patients with Flu+TTS. The study findings provide additional knowledge comparing complications between COVID-19 and influenza infections and may contribute to the continued efforts to manage the COVID-19 pandemic. DISCLOSURES no disclosure on file for Temidayo Abe;No relevant relationships by Thomas Allingham No relevant relationships by Omovefe Edika No relevant relationships by Hammad Khalid No relevant relationships by Ifeoma Ogbuka No relevant relationships by Titilope Olanipekun No relevant relationships by Richard Snyder No relevant relationships by Abhinav Vedire No relevant relationships by Nicholas Wilson