Abstract 14906: Incidence and Impact of Takotsubo Syndrome in Hospitalized COVID-19 Patients

Abstract

Background: Takotsubo syndrome (TTS) has been reported in coronavirus disease-2019 (COVID-19) patients, although minimal data are available. Objectives: We assessed the incidence and impact of TTS on hospitalized COVID-19 patients. Methods: We conducted a retrospective cohort study using ICD-10 to identify patients with a primary diagnosis of COVID-19 with or without TTS in the National Inpatient Sample 2020 database. We compared outcomes between both groups after propensity score matching for patient and hospital demographics and comorbidities. Results: A total of 211,448 patients with a primary diagnosis of COVID-19 were identified. Of these, 171 (0.08%) had a secondary diagnosis of TTS. Before matching, COVID-19 patients with TTS, compared with those without TTS, were older (68.95 vs 64.26 years) and more likely to be female (64.3% vs 47.2%) and to have anxiety (24.6% vs 12.8), depression (17.5% vs 11.4%), and COPD (24.6% vs 14.7%) (all p<0.05). The TTS group had worse outcomes in death (30.4% vs 11.1%), cardiac arrest (7.6% vs 2.1%), cardiogenic shock (12.9% vs 0.4%), length of stay (LOS, 10.7 vs 7.5 days), and total charges ($152,685 vs $78,468), respectively (all p< 0.001). After matching, the TTS group (n=170), compared with the non-TTS group (n=508), had a higher incidence of inpatient mortality (30% vs 14%, p<0.001), cardiac arrest (7.6% vs 2.8%, p=0.009), and cardiogenic shock (12.4% vs 0.4%, p<0.001), a longer LOS (10.7 vs 7.6 days, p<0.001), and higher total charges ($152,943 vs $79,523, p<0.001). Conclusions: TTS is a rare but severe in-hospital complication in COVID-19 patients.