Introduction
Congestive heart failure (CHF) is the most common cardiac admission diagnosis worldwide with high risk of morbidity and mortality. The data on the clinical impact of CHF on COVID-19 hospitalizations is limited. Here we present a study of the cardiovascular outcomes of baseline CHF on COVID-19 admissions at a national level.
Methods
The National Inpatient Sample database from 2020 was queried to identify patients with a primary diagnosis of COVID-19 and stratified based on the presence of congestive heart failure. Multivariate regressions analysis was done to compare inpatient outcomes among COVID patients with and without CHF. The primary outcome measure was in-hospital mortality. Secondary outcomes were in hospital cardiovascular outcomes. The adjusted odds ratios (aOR) of in-hospital outcomes were calculated using chi-square statistics in software STATA v.17.
Results
1,060,885 weighted COVID-19 hospitalizations were identified, of which 115,685(10.9%) were associated with CHF. On adjusted analysis, patients with COVID-CHF had significantly higher odds of MACCE (aOR 1.23, 95% CI 1.182-1.28, P<0.001), MCS ( aOR 3.22, 95% CI 2.26-3.26, P<0.001), cardiogenic shock ( aOR 2.72, 95% CI 2.26-3.26, P<0.001), AMI (aOR 2.72, 95% C. On the contrary, patients with COVID and baseline CHF had a lower incidence of inpatient AKI (aOR 0.64, 95% CI 0.49-0.84, P<0.001). The odds of in-hospital mortality, major bleeding and cardiac arrest between the two cohorts were similar. Additionally, presence of CHF in COVID hospitalization was associated with higher length of stay (8.81± 8.91 vs 7.28 ±7.9) and adjusted total charge ($96,640 ± 177,439 vs $76,214 ±145,830) compared to COVID without CHF
Conclusions
COVID 19 patients with CHF have increased odds of MACCE, MCS, cardiogenic shock, AMI, PCA and PCI. Out of hospital outcomes need further studies.
