Readmissions for Myocardial Infarction Among Survivors of COVID-19 Hospitalization: Nationwide Analysis From Pandemic Year 2020

Abstract

BackgroundCOVID-19 is known to be associated with acute myocardial infarction (MI). ObjectivesThe purpose of this study was to evaluate the outcomes of 30-day readmissions for MI among survivors of COVID-19 hospitalization. Methods and ResultsWe used the U.S. Nationwide Readmission Database to identify COVID-19 admissions from April 1, 2020, to November 30, 2020, using International Classification of Diseases-10th Revision-Clinical Modification (ICD-10-CM) claims. The primary outcome was 30-day readmission incidence for MI. A total of 521,251 cases of COVID-19 were included, of which 11.6% were readmitted within 30 days of discharge. The 30-day readmission incidence for MI was 0.6%. The 30-day all-cause readmission mortality incidence was 1.3%. Patients readmitted for MI were more frequently males (61.6% vs 38.4%) and had a higher Charlson comorbidity burden score (7 vs 4). The most common diagnosis among 30-day MI readmission was type 2 MI (51.1%), followed by a diagnosis of a type 1 non-ST-segment elevation MI (41.7%). ST-segment elevation MI cases constituted 7.6% of all MI-readmission whereas 0.6% of patients had unstable angina. 30-day MI readmissions with a recurrent diagnosis of COVID-19 had higher readmission mortality and incidence of complications. Conversely, the odds of performing revascularization procedures were lower for MI with recurrent COVID-19. Furthermore, MI readmissions with recurrent COVID-19 had a higher length of stay (7 vs 5 days) and cost of hospitalization ($18,398 vs $16,191) when compared with non-COVID-19 MI readmissions. ConclusionsAmong survivors of COVID-19 hospitalization, 5.2% of all-cause 30-day readmissions and 12% of all-cause readmission mortality were attributed to MI. MI-related readmissions were a significant source of mortality, morbidity, and resource utilization.