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Cardiovascular Disease in Hospitalizations with a Diagnosis of Coronavirus from Pre-COVID-19 Era in United States: National Analysis from 2016-2017

Agarwal MA, Ziaeian B, Lavie CJ, Fonarow GC. Cardiovascular Disease in Hospitalizations with a Diagnosis of Coronavirus from Pre-COVID-19 Era in United States: National Analysis from 2016-2017. Mayo Clinic proceedings. 2020 Sep 22; doi: 10.1016/j.mayocp.2020.09.022.

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Abstract:

Objective To analyze the cardiovascular disease (CVD) burden in hospitalized patients with a diagnosis of coronavirus from pre-COVID-19 era in United States (US). Patients and Methods We identified adult hospitalizations with a diagnosis of coronavirus in a large US administrative database, National (Nationwide) Inpatient Sample (January 1, 2016 to December 3, 2017) to study patient demographics, clinical comorbidities and outcomes (in-hospital mortality and healthcare resource utilization) based upon presence or absence of CVD. Results A total of 21,300 adult hospitalizations with a diagnosis of coronavirus from 2016 to 2017 all across US were included in the final analysis; the mean age was 63.6 years, 51.8% were female and 74.7% public insurers. Among these, 11,930 hospitalizations (56.0%) had a diagnosis of CVD. Compared with those without CVD, hospitalizations with CVD were older (age, 70.1 vs. 55.4 years), had higher Charlson comorbidity score (2.5 vs. 1.6) and Elixhauser comorbidity index (4.3 vs. 2.4) (all p < .001). After multivariable risk adjustment, hospitalizations with CVD had higher mortality than those without CVD (5.3% vs. 1.5%; adjusted odds ratio = 2.0, 95% CI 1.2 to 3.4, p = .008). The mean length of stay (6.9 vs. 6.1 days, p = .003), hospital charges (78,377 vs. 66,538 US dollars, p = .002) and discharge disposition to nursing home was higher in those with CVD (24.6% vs. 12.9%, p < .001) when compared to no-CVD group. Conclusion: CVD was present in a significant proportion of hospitalizations with coronavirus in pre-COVID-19 era in US and was associated with higher risk of in-hospital mortality and healthcare resource utilization





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