Abstract

Introduction: Patients with COVID-19 had experienced adverse cardiovascular outcomes, such as myocarditis, MI, and Heart Failure (HF). Among them, HF has emerged as the most common critical complication during COVID-19 exacerbations, potentially leading to increased mortality rates and poorer clinical outcomes. However, there is a lack of available data to thoroughly investigate the consequences of acute HF in patients admitted with COVID-19. Methods: We analyzed the Nationwide Inpatient Sample (NIS) dataset to select COVID-19 patients over 18 years old who were hospitalized during 2020, in the United States (US) using ICD-10. Based on the presence of acute HF, patients were divided into two cohorts. Propensity score was used to match patients across various factors including age, race, sex, and comorbidities. Results: A total of 1,666,960 COVID-19 patients were hospitalized in 2020, of which 156,755 (9.4%) had associated HF. COVID-19 patients with HF had a mean age of (72.38±13.50) years compared to (62.3 ± 17.67) years for patients without HF. HF patients had a higher prevalence of HTN, hyperlipidemia, type 2 diabetes, smoking, and preexisting cardiovascular disease. After propensity matching, HF patients had higher rates of in-hospital mortality (23.86% vs 17.63%, p<0.001), acute MI (18.83% vs 10.91%, p<0.001), acute stroke (0.78% vs 0.58%, p=0.004), cardiogenic shock (2.56% vs 0.69%, p<0.001), and sudden cardiac arrest (5.54% vs 3.41%, p<0.001) compared to those without HF. Conclusions: COVID-19 patients admitted with acute HF had worse clinical outcomes and higher mortality rates. In addition to a higher length of stay and healthcare compared with patients without HF.

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