Key result
COVID-19 admissions are linked to ~5% 30-day CV readmission incidence carrying disproportionately high mortality.
Why the study?
COVID-19 is associated with acute cardiovascular complications, but the rates of readmissions for cardiovascular complications after COVID-19 infection are less well established.
Observational (n=521,351)
Yes
Cardiovascular complications, particularly acute heart failure, are a major driver of 30-day readmissions following COVID-19 hospitalization and are associated with increased mortality and healthcare costs.
Supports closer post-discharge cardiovascular surveillance after COVID-19; hypothesis-generating for targeted interventions pending higher-level evidence.
BACKGROUND: COVID-19 is known to be associated with a myriad of cardiovascular (CV) complications during acute illness, but the rates of readmissions for CV complications after COVID-19 infection are less well established. METHODS: The U.S Nationwide Readmission Database was utilized to identify COVID-19 admissions from April 1st to November 30th, 2020 using ICD-10-CM administrative claims. RESULTS: A total of 521,351 admissions for COVID-19 were identified. The all-cause 30-day readmission rate was 11.6% (n=60,262). The incidence of CV readmissions was 5.1% (n=26,725), accounting for 44.3% of all-cause 30-day readmissions. Both CV and non-CV readmissions occurred at a median of 7 days. Patients readmitted with CV causes had a higher comorbidity burden with Charlson comorbidity median score of 6. The most common CV cause of readmission was acute heart failure (HF) (8.5%) followed by acute myocardial infarction (MI) (5.2%). Venous thromboembolism and stroke during 30-day readmission occurred at a rate of 4.6% and 3.6%, respectively. Stress cardiomyopathy and acute myocarditis were less frequent with an incidence of 0.1% and 0.2%, respectively. CV readmissions were associated with higher mortality compared with non-CV readmissions (16.5% vs. 7.5%, p<0.01). Each 30-day CV readmission was associated with greater cost of care than each non-CV readmission ($13,803 vs. $10,310, p=<0.01). CONCLUSIONS: Among survivors of index COVID-19 admission, 44.7% of all 30-day readmissions were attributed to CV causes. Acute HF remains the most common cause of readmission after COVID-19, followed closely by acute MI. CV causes of readmissions remain a significant source of mortality, morbidity, and resource utilization.
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Zahid et al. (2023) conducted an observational in COVID-19 (n=521,351). COVID-19 was evaluated on 30-day cardiovascular readmission. COVID-19 index admission was followed by a 5.1% incidence of 30-day cardiovascular readmission, which carried a higher mortality than non-cardiovascular readmissions (16.5% vs. 7.5%, p<0.01).
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