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Multicenter Study
. 2023 Jan;98(1):31-47.
doi: 10.1016/j.mayocp.2022.09.005. Epub 2022 Sep 21.

Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020

Mohammed Yousufuddin  1 , Mohamad H Yamani  2 , Kianoush B Kashani  3 , Ye Zhu  4 , Zhen Wang  4 , Ashok Seshadri  5 , Katherine R Blocker  6 , Jessica L Peters  6 , Jewell M Doss  6 , Dhauna Karam  6 , Kanika Khandelwal  6 , Umesh M Sharma  7 , Daniel V Dudenkov  8 , Tahir Mehmood  9 , Sandeep R Pagali  9 , Sanjeev Nanda  10 , Ahmed D Abdalrhim  10 , Nichole Cummings  11 , Sagar B Dugani  9 , Michael Smerina  8 , Larry J Prokop  12 , Lawrence R Keenan  13 , Sumit Bhagra  14 , Arshad Jahangir  15 , Philippe R Bauer  16 , Gregg C Fonarow  17 , Mohammad Hassan Murad  18
Affiliations
Multicenter Study

Characteristics, Treatment Patterns, and Clinical Outcomes After Heart Failure Hospitalizations During the COVID-19 Pandemic, March to October 2020

Mohammed Yousufuddin et al. Mayo Clin Proc. 2023 Jan.

Abstract

Objective: To compare clinical characteristics, treatment patterns, and 30-day all-cause readmission and mortality between patients hospitalized for heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic.

Patients and methods: The study was conducted at 16 hospitals across 3 geographically dispersed US states. The study included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with cumulative 8989 HF hospitalizations: 2341 hospitalizations during the COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator group. We used Poisson regression, Kaplan-Meier estimates, multivariable logistic, and Cox regression analysis to determine whether prespecified study outcomes varied by time frames.

Results: The adjusted 30-day readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19 period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89). Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period (relative risk increase, 16%; number of admissions needed for one additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite significant differences in rates of index hospitalization, readmission, and mortality across the study time frames, the disease severity, HF subtypes, and treatment patterns remained unchanged (P>0.05).

Conclusion: The findings of this large tristate multicenter cohort study of HF hospitalizations suggest lower rates of index hospitalizations and 30-day readmissions but higher incidence of 30-day mortality with broadly similar use of HF medication, surgical interventions, and devices during the COVID-19 pandemic compared with the pre-COVID-19 time frame.

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