A-38 | A Nationwide Analysis of the Impact of the COVID-19 Pandemic on Acute Myocardial Infarction Hospitalizations

Abstract

There is a paucity of data on the COVID-19 pandemic's impact on acute myocardial infarction (AMI) hospitalizations nationally. We conducted this study to define trends from the COVID-19 pandemic’s influence on AMI hospitalizations and assess the impact of a concurrent infection. The National Inpatient Sample (NIS) was queried for all hospitalizations with a primary AMI diagnosis from 2017 – 2020. Among all AMI hospitalizations between April 1, 2020, to December 31, 2020 (AMI-2020), concurrent COVID-19 infections were identified, and hospitalizations were divided based on concomitant COVID-19 disease, i.e., AMI-COVID+ve and AMI-COVID-ve, respectively. AMI-2020 was also compared with pre-pandemic AMI hospitalizations between April 2019 and December 2019 (AMI-2019). AMI admissions were reduced by 35.5 % in April 2020 compared to January 2020, following by incomplete return to the prepandemic baseline (Figure 1). AMI-2020 admissions had an increased complication burden compared to AMI-2019, including cardiogenic shock (7.3% vs. 6.9%, p<0.05) and pulmonary embolism (70 vs. 59 per 10,000, p<0.005). AMI-COVID +ve hospitalizations had 2.48 times higher odds of inpatient mortality and an increased adjusted length of stay by 1.43 days (p<0.005). There was a significant drop in AMI admissions during the COVID-19 pandemic, which did not return to pre-pandemic levels after the initial decline. AMI-2020 constituted patients with higher severity of illness. Concomitant diagnosis of COVID-19 was associated with worse outcomes.