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- Title
COVID-19 and NSTEMI Outcomes among Hospitalized Patients in the United States and Racial Disparities in Mortality: Insight from National Inpatient Sample Database.
- Authors
Majeed, Harris; Gangu, Karthik; Sagheer, Shazib; Garg, Ishan; Khan, Umair; Shuja, Hina; Bobba, Aniesh; Chourasia, Prabal; Shekhar, Rahul; Avula, Sindhu Reddy; Sheikh, Abu Baker
- Abstract
The COVID-19 pandemic has impacted healthcare delivery to patients with non-ST-segment elevation myocardial infraction (NSTEMI). The aim of our retrospective study is to determine the effect of COVID-19 on inpatient NSTEMI outcomes and to investigate whether changes in cardiac care contributed to the observed outcomes. After multivariate adjustment, we found that NSTEMI patients with COVID-19 had a higher rate of inpatient mortality (37.3% vs. 7.3%, adjusted odds ratio: 4.96, 95% CI: 4.6–5.4, p < 0.001), increased length of stay (9.9 days vs. 5.4 days, adjusted LOS: 3.6 days longer, p < 0.001), and a higher cost of hospitalization (150,000 USD vs. 110,000 USD, inflation-adjusted cost of hospitalization: 36,000 USD higher, p < 0.001) in comparison to NSTEMI patients without COVID-19, despite a lower burden of pre-existing cardiac comorbidity. NSTEMI patients with COVID-19 also received less invasive cardiac procedures (coronary angiography: 8.7% vs. 50.3%, p < 0.001; PCI: 4.8% vs. 29%, p < 0.001; and CABG: 0.7% vs. 6.2%, p < 0.001). In our study, we observed increased mortality and in-hospital complications to be a combined effect of COVID-19 infection and myocardial inflammation as a result of cytokine storm, prothrombic state, oxygen supply/demand imbalance and alterations in healthcare delivery from January to December 2020.
- Subjects
UNITED States; NON-ST elevated myocardial infarction; COVID-19; RACIAL inequality; HOSPITAL patients; CORONARY angiography
- Publication
Vaccines, 2022, Vol 10, Issue 12, p2024
- ISSN
2076-393X
- Publication type
Article
- DOI
10.3390/vaccines10122024