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Cardiovascular Disease in Hospitalized Patients With a Diagnosis of Coronavirus From the Pre–COVID-19 Era in United States: National Analysis From 2016-2017

  • Manyoo A. Agarwal
    Correspondence
    Manyoo Agarwal, MD, Division of Cardiology, UCLA, 650 Charles E. Young, A2-237 CHS, Los Angeles, CA 90025
    Affiliations
    Division of Cardiovascular Medicine, University of California, Los Angeles, CA
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  • Boback Ziaeian
    Affiliations
    Division of Cardiovascular Medicine, University of California, Los Angeles, CA

    Division of Cardiology, VA Greater Los Angeles, Los Angeles, CA
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  • Carl J. Lavie
    Affiliations
    John Ochsner Heart and Vascular Institute, Ochsner Clinical School–the University of Queensland School of Medicine, New Orleans, LA
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  • Gregg C. Fonarow
    Correspondence
    Correspondence: Address to Gregg C. Fonarow, MD, Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, 10833 LeConte Ave, Rm 47-123 CHS, Los Angeles, CA 90095-1679
    Affiliations
    Division of Cardiovascular Medicine, University of California, Los Angeles, CA

    Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, CA
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Published:September 22, 2020DOI:https://doi.org/10.1016/j.mayocp.2020.09.022

      Abstract

      Objective

      To analyze the cardiovascular disease (CVD) burden in hospitalized patients with a diagnosis of coronavirus from the pre–coronavirus disease 2019 era in the United States.

      Patients and Methods

      We identified hospitalized adults with a diagnosis of coronavirus in a large US administrative database, the National (Nationwide) Inpatient Sample, from January 1, 2016, to December 3, 2017, to study patient demographic characteristics, clinical comorbidities, and outcomes (in-hospital mortality and health care resource utilization) based on the presence or absence of CVD.

      Results

      A total of 21,300 hospitalized adults with a diagnosis of coronavirus in 2016 and 2017 from all across the United States were included in the final analysis; the mean age was 63.6 years, 11,033 (51.8%) were female, and 15,911 (74.7%) had public insurers. Among these hospitalized patients, 11,930 (56.0%) had a diagnosis of CVD. Compared with those without CVD, the patients with CVD were older (70.1 vs 55.4 years) and had higher Charlson comorbidity index scores (2.5 vs 1.6) and Elixhauser comorbidity index scores (4.3 vs 2.4) (all P<.001). After multivariable risk adjustment, patients with CVD had higher mortality than those without CVD (5.3% [632 of 11,930] vs 1.5% [140 of 9370]; adjusted odds ratio, 2.0 [95% CI, 1.2 to 3.4]; P=.008). The mean length of hospital stay (6.9 vs 6.1 days; P=.003), hospital charges ($78,377 vs $66,538; P=.002), and discharge to nursing home (24.6% [2945 of 11,930] vs 12.9% [1208 of 9370]; P<.001) were higher in those with CVD compared with the patients without CVD.

      Conclusion

      Cardiovascular disease was present in a notable proportion of hospitalized patients with coronavirus in the pre–coronavirus disease 2019 era in United States and was associated with higher risk of in-hospital mortality and health care resource utilization.

      Abbreviations and Acronyms:

      AOR (adjusted odds ratio), COVID-19 (coronavirus disease 2019), CV (cardiovascular), CVD (CV disease), HCoV (human coronavirus), HF (heart failure), IL (interleukin), LOS (length of stay), MI (myocardial infarction), NIS (National (Nationwide) Inpatient Sample), SARS (severe acute respiratory syndrome)
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