30-Day Cardiovascular Readmissions Following Discharge With COVID-19: A US Nationwide Readmission Database Analysis From the Pandemic Year 2020

Abstract

BackgroundCOVID-19 is known to be associated with a myriad of cardiovascular (CV) complications during acute illness, but the rates of readmissions for CV complications after COVID-19 infection are less well established. MethodsThe US Nationwide Readmission Database was utilized to identify COVID-19 admissions that occurred in the period from April 1st to November 30th, 2020, using International Classification of Diseases, 10th edition, Clinical Modification administrative claims. ResultsA total of 521,351 admissions for COVID-19 were identified. The all-cause 30-day readmission rate was 11.6% (n = 60,262). The incidence of CV-related readmissions was 5.1% (n = 26,725), accounting for 44.3% of all-cause 30-day readmissions. Both CV-related and non-CV-related readmissions occurred at a median of 7 days. Patients readmitted with CV causes had a higher comorbidity burden, with a median Charlson comorbidity score of 6. The most common CV cause of readmission was acute heart failure (8.5%), followed by acute myocardial infarction (5.2%). Venous thromboembolism and stroke during 30-day readmission occurred at rates of 4.6% and 3.6%, respectively. Stress cardiomyopathy and acute myocarditis were less frequent, with incidences of 0.1% and 0.2%, respectively. CV-related readmissions were associated with higher mortality, compared with non-CV-related readmissions (16.5% vs 7.5%, P < 0.01). Each 30-day CV-related readmission was associated with greater cost of care than each non-CV-related readmission ($13,803 vs $10,310, P < 0.01). ConclusionsAmong survivors of index COVID-19 admission, 44.7% of all 30-day readmissions were attributed to CV causes. Acute heart failure remains the most common cause of readmission after COVID-19, followed closely by acute myocardial infarction. CV causes of readmissions remain a significant source of mortality, morbidity, and resource utilization.