Abstract 4145229: Outcomes among hospitalized patients with stress-induced cardiomyopathy and concomitant Coronavirus Disease 2019 (COVID-19) infection: Insight from the US National Inpatient Sample

Background: Stress-induced cardiomyopathy (CM) is a form of acute transient left ventricular dysfunction triggered by underlying physiological stress which often leads to increased morbidity and mortality. Coronavirus disease 2019 (COVID-19) is thought to cause stress-induced CM due to overwhelming systemic inflammation. There is paucity of data regarding the impact of COVID-19 on in-hospital outcomes of patients with stress-induced CM. The purpose of this study is to investigate in-hospital outcomes, including mortality and cardiogenic shock, of patients with concomitant COVID-19 and stress-induced CM. Methods: We queried the 2020 USA National Inpatient Sample (NIS) Database in conducting this retrospective cohort study. We identified hospitalized adult patients ≥ 18 years old with stress-induced CM and concomitant COVID-19 using ICD-10 CM codes. We used a survey multivariable logistic and linear regression analysis to calculate adjusted odds ratios (aORs) for outcomes of interest. A p value of <0.05 was considered statistically significant. Results: A total of 30,705 hospitalized patients with stress-induced CM were identified in 2020, of which 2.41% had concomitant COVID-19. The overall in-hospital mortality rate among patients with stress-induced CM was 10.15%. Among those with concomitant COVID-19, the mortality rate was significantly higher to 39.86% (P=0.00). Using a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, concomitant COVID-19 among patients with stress-induced CM was associated with increased risk for in-hospital mortality (aOR 5.50; p=0.00), development of CS (aOR 2.40; p=0.00) and AKI (aOR 1.84; p=0.00), use of MV (aOR 3.88; p=0.00), and longer LOS (aOR 4.93; p=0.00). (See table 1) Conclusion: Our analysis showed that concomitant COVID-19 among hospitalized patients with stress-induced CM increased the risk for in-hospital mortality, risk for the development of CS and AKI, utilization of MV, and longer LOS, but was not significantly associated with the utilization of RRT. This highlights the potential for COVID-19 as a predictor for worse outcomes among hospitalized patients with stress-induced CM.