Abstract 12670: Trends in Patients With COVID-19 and Device Related Infections: A National Inpatient Sample Trend From 2020

Abstract

Background: Cardiac implantable electronic devices (CIED) are essential for managing arrhythmias, improving hemodynamics, and preventing sudden cardiac death. However, device-related infections (DRI) remain a significant complication of CIED and are associated with primary adverse outcomes. However, limited data exists on concomitant Covid-19 infection and its effects on outcomes of DRI. Methods: National Inpatient Sample 2020 was used to identify patients hospitalized for DRI based on ICD-10 codes. DRIs were further stratified into concomitant Covid-19 infected patients and non-Covid-19 infected groups. Logistic regression was used to compare in-hospital outcomes. Results: In 2020, there were 59,270 admissions for DRIs. 1,890 (3.2%) DRI cases were observed to have concomitant Covid-19 infection. Racial disparities observed included higher rates of DRI and concurrent Covid-19 infection in the African American (30.6% -vs- 20.2, p=0.002) and Hispanic (18.2% -vs- 9.4%, p=0.002) population. Lead extraction rates were lower in the Covid-19 infection with DRI group (5.33% -vs- 11.17%, p<0.001). Cases with DRI and concurrent Covid-19 infection also had a significantly longer length of stay (LOS, 21.6 -vs- 11.5 days, p<0.001), higher total hospital cost (305,644 -vs- 172,711, p<0.001), and higher mortality (23.1% -vs- 6.6%, p<0.001). This group was also observed to have increased needs for ICU level of care including higher proportion of ARDS, shock, mechanical ventilation and vasopressor use as listed in Table 1. Conclusion: DRIs with concurrent Covid-19 infection had higher all-cause mortality, complication rates, LOS and total hospital costs. Further research needs to be performed to delineate long-term outcomes in this patient population.