• Mohammed Yousufuddin, Mohamad H Yamani, Kianoush B Kashani, Ye Zhu, Zhen Wang, Ashok Seshadri, Katherine R Blocker, Jessica L Peters, Jewell M Doss, Dhauna Karam, Kanika Khandelwal, Umesh M Sharma, Daniel V Dudenkov, Tahir Mehmood, Sandeep R Pagali, Sanjeev Nanda, Ahmed D Abdalrhim, Nichole Cummings, Sagar B Dugani, Michael Smerina, Larry J Prokop, Lawrence R Keenan, Sumit Bhagra, Arshad Jahangir, Philippe R Bauer, Gregg C Fonarow, and Mohammad Hassan Murad.
• Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN. Electronic address: Yousufuddin.mohammed@Mayo.edu.
• Mayo Clin. Proc. 2023 Jan 1; 98 (1): 314731-47.

ObjectiveTo compare clinical characteristics, treatment patterns, and 30-day all-cause readmission and mortality between patients hospitalized for heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic.Patients And MethodsThe study was conducted at 16 hospitals across 3 geographically dispersed US states. The study included 6769 adults (mean age, 74 years; 56% [5033 of 8989] men) with cumulative 8989 HF hospitalizations: 2341 hospitalizations during the COVID-19 pandemic (March 1 through October 30, 2020) and 6648 in the pre-COVID-19 (October 1, 2018, through February 28, 2020) comparator group. We used Poisson regression, Kaplan-Meier estimates, multivariable logistic, and Cox regression analysis to determine whether prespecified study outcomes varied by time frames.ResultsThe adjusted 30-day readmission rate decreased from 13.1% (872 of 6648) in the pre-COVID-19 period to 10.0% (234 of 2341) in the COVID-19 pandemic period (relative risk reduction, 23%; hazard ratio, 0.77; 95% CI, 0.66 to 0.89). Conversely, all-cause mortality increased from 9.7% (645 of 6648) in the pre-COVID-19 period to 11.3% (264 of 2341) in the COVID-19 pandemic period (relative risk increase, 16%; number of admissions needed for one additional death, 62.5; hazard ratio, 1.19; 95% CI, 1.02 to 1.39). Despite significant differences in rates of index hospitalization, readmission, and mortality across the study time frames, the disease severity, HF subtypes, and treatment patterns remained unchanged (P>0.05).ConclusionThe findings of this large tristate multicenter cohort study of HF hospitalizations suggest lower rates of index hospitalizations and 30-day readmissions but higher incidence of 30-day mortality with broadly similar use of HF medication, surgical interventions, and devices during the COVID-19 pandemic compared with the pre-COVID-19 time frame.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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