Table 1.
Baseline characteristics of patients hospitalized for heart failure before and during the COVID‐19 pandemic
| Overall (n = 79 031) | Before COVID‐19 pandemic (n = 42 004) | During COVID‐19 pandemic (n = 37 027) | Standardized difference a | p‐value | |
|---|---|---|---|---|---|
| Demographics | |||||
| Age (years), median (IQR) | 68 (57–79) | 68 (58–79) | 67 (57–78) | 5.6 | <0.001 |
| Female sex (%) | 33.2 | 33.2 | 33.1 | 0.2 | 0.761 |
| Race (%) | |||||
| White | 58.3 | 58.6 | 58.0 | 1.2 | <0.0001 |
| Black | 28.2 | 28.1 | 28.3 | 0.5 | |
| Hispanic | 8.1 | 8.1 | 8.1 | 0.1 | |
| Asian | 1.9 | 2.0 | 1.8 | 1.6 | |
| Other | 3.5 | 3.2 | 3.8 | 3.1 | |
| Insurance (%) | |||||
| None documented | 6.2 | 6.2 | 6.1 | 1.7 | <0.0001 |
| Medicare | 44.8 | 44.7 | 45.0 | 4.3 | |
| Medicaid | 21.2 | 20.3 | 22.2 | 1.7 | |
| Other | 27.8 | 28.8 | 26.7 | 7.8 | |
| Medical history | |||||
| HF admissions in past 6 months (%) | 0.5 | <0.0001 | |||
| >2 | 8.3 | 8.7 | 7.8 | ||
| 2 | 7.8 | 8.4 | 7.1 | ||
| 1 | 24.3 | 24.9 | 23.5 | ||
| 0 | 42.6 | 41.7 | 43.7 | ||
| Atrial fibrillation/flutter (%) | 36.5 | 36.8 | 36.1 | 1.5 | 0.040 |
| Coronary disease (%) | 52.8 | 52.7 | 52.9 | 0.3 | 0.649 |
| Valvular heart disease (%) | 18.7 | 18.7 | 18.7 | 0.1 | 0.879 |
| Anaemia (%) | 22.8 | 21.9 | 23.7 | 4.4 | <0.0001 |
| COPD or asthma (%) | 32.2 | 31.9 | 32.6 | 1.4 | 0.051 |
| CVA/TIA (%) | 16.1 | 16.0 | 16.2 | 0.6 | 0.383 |
| Peripheral vascular disease (%) | 11.5 | 11.2 | 11.9 | 2.2 | 0.002 |
| Hyperlipidaemia (%) | 58.4 | 56.6 | 60.6 | 8.1 | <0.0001 |
| Hypertension (%) | 83.5 | 82.0 | 85.1 | 8.4 | <0.0001 |
| Diabetes (%) | 45.7 | 44.7 | 46.8 | 4.1 | <0.0001 |
| Renal insufficiency (%) | 26.5 | 26.8 | 26.2 | 1.2 | 0.098 |
| Dialysis (%) | 4.2 | 4.1 | 4.3 | 1.2 | 0.097 |
| ICD (%) | 17.3 | 17.9 | 16.5 | 3.6 | <0.0001 |
| Smoking (%) | 24.4 | 23.9 | 25.0 | 2.7 | 0.0002 |
| DVT or PE (%) | 1.9 | 1.7 | 2.0 | 2.5 | 0.004 |
| Ischaemia/ACS | 10.0 | 8.4 | 11.8 | 11.3 | <0.0001 |
| Admission laboratory and vital signs | |||||
| Heart rate (bpm), median (IQR) | 78 (69–89) | 78 (69–88) | 79 (70–90) | 5.8 | <0.0001 |
| Lower extremity oedema (%) | 64.9 | 64.3 | 65.6 | 2.7 | 0.046 |
| Systolic BP (mmHg), median (IQR) | 132 (114–151) | 131 (114–151) | 132 (115–152) | 4.2 | <0.0001 |
| Diastolic BP (mmHg), median (IQR) | 70 (61–78) | 69 (61–78) | 70 (62–79) | 5.9 | <0.0001 |
| BMI (kg/m2), mean (SD) | 28.7 (24.5–34.3) | 28.4 (24.4–34.1) | 28.7 (24.6–34.4) | 3.8 | <0.0001 |
| Obese (BMI >30 kg/m2) (%) | 42.7 | 41.8 | 43.4 | 3.4 | 0.0002 |
| Respiration (breath/min), median (IQR) | 20 (18–22) | 20 (18–22) | 20 (18–22) | 9.4 | <0.0001 |
| BNP (pg/ml), mean (SD) | 1442 (2046) | 1458 (1983) | 2116 (4250) | 4.1 | 0.201 |
| NT‐proBNP (pg/ml), mean (SD) | 12 669 (15334) | 12 395 (15072) | 13 031 (15667) | 4.1 | 0.0007 |
| eGFR (ml/min/1.73 m2), median (IQR) b | 52.2 (34.5–71.4) | 51.9 (34.4–71.1) | 52.6 (34.6–71.7) | 6.7 | 0.016 |
| Troponin (ng/dl), mean (SD) | 3.0 (15.1) | 1.7 (8.5) | 4.5 (20.3) | 17.7 | <0.0001 |
| Troponin (%) | 0.001 | ||||
| Troponin I | 80.4 | 79.6 | 81.4 | 4.5 | |
| Troponin T | 19.6 | 20.4 | 18.6 | 6.1 | |
| Troponin abnormal (%) | 56.4 | 55.1 | 58.1 | 6.1 | <0.0001 |
| In‐hospital care | |||||
| Ejection fraction (%), median (IQR) | 25 (20–32) | 25 (20–32) | 25 (20–32) | 2.5 | 0.0002 |
| Ejection fraction <30% (%) | 66.0 | 65.4 | 66.7 | 2.8 | <0.0001 |
| Coronary angiography (%) | 16.2 | 15.7 | 16.5 | 2.3 | 0.014 |
| Intra‐aortic balloon pump (%) | 0.5 | 0.5 | 0.6 | 1.9 | 0.048 |
| Mechanical ventilation (%) | 2.9 | 3.0 | 2.8 | 1.0 | 0.264 |
| Dialysis (%) | 3.6 | 3.3 | 3.7 | 2.1 | 0.026 |
| Left ventricular assist device (%) | 0.6 | 0.4 | 0.4 | 3.4 | 0.0003 |
| Heart transplant (%) | 0.1 | 0.1 | 0.1 | 0.3 | 0.520 |
| Hospital characteristics | |||||
| No. of beds, median (IQR) | 385 (248–583) | 385 (248–581) | 387 (248–595) | 2.5 | 0.0003 |
| No. of HF admissions per year, median (IQR) | 103 (62–170) | 118 (71–190) | 86 (54–140) | 27 | <0.0001 |
| Geographic region (%) | 0.065 | ||||
| West | 15.8 | 15.8 | 15.7 | 1.3 | |
| South | 34.0 | 34.4 | 33.6 | 1.7 | |
| Midwest | 24.2 | 24.3 | 24.6 | 0.7 | |
| Northeast | 25.8 | 25.6 | 26.2 | 0.2 | |
| Rural location (%) | 2.5 | 2.7 | 2.3 | 2.6 | 0.0002 |
| Teaching hospital (%) | 79.2 | 79.5 | 79.0 | 1.4 | 0.058 |
ACS, acute coronary syndrome; BMI, body mass index; BNP, B‐type natriuretic peptide; BP, blood pressure; COPD, chronic obstructive pulmonary disease; CVA, cerebrovascular accident; DVT, deep vein thrombosis; eGFR, estimated glomerular filtration rate; HF, heart failure; ICD, implantable cardioverter‐defibrillator; IQR, interquartile range; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide; PE, pulmonary embolism; SD, standard deviation; TIA, transient ischaemic attack.
Standardized difference represents the absolute difference in rank‐based means or proportions divided by the standard deviation and multiplied by 100.
eGFR calculated using the abbreviated Modification of Diet in Renal Disease (MDRD) equation.