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Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020.
Yousufuddin, Mohammed; Yamani, Mohamad H; Kashani, Kianoush B; Zhu, Ye; Wang, Zhen; Seshadri, Ashok; Blocker, Katherine R; Peters, Jessica L; Doss, Jewell M; Karam, Dhauna; Khandelwal, Kanika; Sharma, Umesh M; Dudenkov, Daniel V; Mehmood, Tahir; Pagali, Sandeep R; Nanda, Sanjeev; Abdalrhim, Ahmed D; Cummings, Nichole; Dugani, Sagar B; Smerina, Michael; Prokop, Larry J; Keenan, Lawrence R; Bhagra, Sumit; Jahangir, Arshad; Bauer, Philippe R; Fonarow, Gregg C; Murad, Mohammad Hassan.
  • Yousufuddin M; Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN. Electronic address: Yousufuddin.mohammed@Mayo.edu.
  • Yamani MH; Division of Cardiology, Mayo Clinic, Jacksonville, FL.
  • Kashani KB; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
  • Zhu Y; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
  • Wang Z; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
  • Seshadri A; Division of Psychiatry, Mayo Clinic Health System, Austin, MN.
  • Blocker KR; Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN.
  • Peters JL; Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN.
  • Doss JM; Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN.
  • Karam D; Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN.
  • Khandelwal K; Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN.
  • Sharma UM; Hospital Internal Medicine, Mayo Clinic, Phoenix, AZ.
  • Dudenkov DV; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL.
  • Mehmood T; Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN.
  • Pagali SR; Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN.
  • Nanda S; Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
  • Abdalrhim AD; Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
  • Cummings N; Division of Hospital Internal Medicine, St. Cloud Hospital, St. Cloud, MN.
  • Dugani SB; Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN.
  • Smerina M; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL.
  • Prokop LJ; Library and Public Services, Mayo Clinic, Rochester, MN.
  • Keenan LR; Division of Cardiology, Mayo Clinic Health System, Austin, MN.
  • Bhagra S; Division of Endocrinology, Mayo Clinic Health System, Austin, MN.
  • Jahangir A; Aurora Cardiovascular and Thoracic Services, Aurora St. Luke's Medical Center, Milwaukee, WI.
  • Bauer PR; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
  • Fonarow GC; Division of Cardiology, University of California Los Angeles, Los Angeles, CA.
  • Murad MH; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Preventive and Occupational Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc ; 98(1): 31-47, 2023 01.
Article in English | MEDLINE | ID: covidwho-2181429
ABSTRACT

OBJECTIVE:

To compare clinical characteristics, treatment patterns, and 30-day all-cause readmission and mortality between patients hospitalized for heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic. PATIENTS AND

METHODS:

The study was conducted at 16 hospitals across 3 geographically dispersed US states. The study included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with cumulative 8989 HF hospitalizations 2341 hospitalizations during the COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator group. We used Poisson regression, Kaplan-Meier estimates, multivariable logistic, and Cox regression analysis to determine whether prespecified study outcomes varied by time frames.

RESULTS:

The adjusted 30-day readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19 period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89). Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period (relative risk increase, 16%; number of admissions needed for one additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite significant differences in rates of index hospitalization, readmission, and mortality across the study time frames, the disease severity, HF subtypes, and treatment patterns remained unchanged (P>0.05).

CONCLUSION:

The findings of this large tristate multicenter cohort study of HF hospitalizations suggest lower rates of index hospitalizations and 30-day readmissions but higher incidence of 30-day mortality with broadly similar use of HF medication, surgical interventions, and devices during the COVID-19 pandemic compared with the pre-COVID-19 time frame.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Heart Failure Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male Language: English Journal: Mayo Clin Proc Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Heart Failure Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male Language: English Journal: Mayo Clin Proc Year: 2023 Document Type: Article