Table 2.
Changes in Presentation, In‐Hospital Treatments, and Outcomes
| Pre‐COVID‐19 (January 1, 2018–March 20, 2020) | COVID‐19 (March 21, 2020–September 21, 2020) | P value | ||||||
|---|---|---|---|---|---|---|---|---|
| Winter | Spring | Summer | Fall | Spring | Summer | |||
| Heart failure cohort | ||||||||
| Presentation severity | ||||||||
| Cardiogenic shock | 215 (3.6) | 165 (4.0) | 135 (3.5) | 174 (4.3) | 61 (3.9) | 62 (3.7) | 215 (3.6) | |
| ED admission | 4998 (84.0) | 3490 (83.8) | 3265 (84.9) | 3380 (84.2) | 1341 (85.7) | 1462 (86.8) | 0.041 | |
| Direct admission | 933 (15.7) | 659 (15.8) | 566 (14.7) | 627 (15.6) | 221 (14.1) | 218 (12.9) | 0.053 | |
| In‐hospital procedures/outcomes | ||||||||
| Right‐heart catheterization | 474 (8.0) | 349 (8.4) | 319 (8.3) | 339 (8.4) | 139 (8.9) | 180 (10.7) | 0.431 | |
| LOS, mean (SD) | 4.85 (6.16) | 4.78 (6.26) | 4.83 (6.31) | 4.96 (7.28) | 4.90 (5.96) | 4.76 (5.33) | 0.973 | |
| Death | 145 (2.4) | 93 (2.2) | 69 (1.8) | 94 (2.3) | 42 (2.7) | 27 (1.6) | 0.944 | |
| Discharge status | ||||||||
| Against medical advice | 110 (1.8) | 87 (2.1) | 92 (2.4) | 68 (1.7) | 38 (2.4) | 55 (3.3) | <0.001 | |
| Home | 3716 (62.5) | 2594 (62.3) | 2404 (62.5) | 2511 (62.5) | 1003 (64.1) | 1070 (63.5) | ||
| Home with services | 933 (15.7) | 694 (16.7) | 603 (15.7) | 643 (16.0) | 293 (18.7) | 314 (18.6) | ||
| Other | 63 (1.1) | 45 (1.1) | 32 (0.8) | 35 (0.9) | 15 (1.0) | 17 (1.0) | ||
| Postacute care | 981 (16.5) | 650 (15.6) | 644 (16.8) | 665 (16.6) | 174 (11.1) | 202 (12.0) | ||
| AMI cohort | ||||||||
| Presentation severity | ||||||||
| Cardiogenic shock | 184 (11.2) | 140 (11.3) | 117 (10.4) | 120 (10.1) | 60 (13.3) | 58 (11.5) | 184 (11.2) | |
| ED admission | 1275 (77.5) | 949 (76.9) | 840 (74.5) | 949 (80.0) | 362 (80.4) | 418 (82.8) | 0.001 | |
| Direct admission | 368 (22.4) | 280 (22.7) | 286 (25.4) | 237 (20.0) | 88 (19.6) | 87 (17.2) | 0.002 | |
| NSTEMI | 1147 (69.7) | 873 (70.7) | 801 (71.0) | 861 (72.6) | 281 (62.4) | 341 (67.5) | 0.005 | |
| STEMI | 498 (30.3) | 361 (29.3) | 327 (29.0) | 325 (27.4) | 169 (37.6) | 164 (32.5) | ||
| Procedures and LOS | ||||||||
| Left heart catheterization | 1130 (68.7) | 879 (71.2) | 801 (71.0) | 843 (71.1) | 315 (70.0) | 362 (71.7) | 0.991 | |
| LOS, mean (SD) | 5.22 (5.92) | 5.17 (6.71) | 5.09 (6.21) | 5.05 (6.94) | 4.98 (6.73) | 4.42 (5.19) | 0.184 | |
| Death | 145 (2.4) | 93 (2.2) | 69 (1.8) | 94 (2.3) | 42 (2.7) | 27 (1.6) | <0.001 | |
| Discharge status | ||||||||
| Against medical advice | 110 (1.8) | 87 (2.1) | 92 (2.4) | 68 (1.7) | 38 (2.4) | 55 (3.3) | <0.001 | |
| Home | 3716 (62.5) | 2594 (62.3) | 2404 (62.5) | 2511 (62.5) | 1003 (64.1) | 1070 (63.5) | ||
| Home with services | 933 (15.7) | 694 (16.7) | 603 (15.7) | 643 (16.0) | 293 (18.7) | 314 (18.6) | ||
| Other | 63 (1.1) | 45 (1.1) | 32 (0.8) | 35 (0.9) | 15 (1.0) | 17 (1.0) | ||
| Post‐acute care | 981 (16.5) | 650 (15.6) | 644 (16.8) | 665 (16.6) | 174 (11.1) | 202 (12.0) | ||
Categorical variables were reported as numbers and percentages, and continuous variables were reported as means and standard deviations. P value compares spring/summer pre‐COVID‐19 to spring/summer during COVID‐19.
AMI indicates acute myocardial infarction; ED, emergency department; LOS, length of stay; NSTEMI, non–ST‐segment–elevation myocardial infarction; and STEMI, ST‐segment–elevation myocardial infarction.