HOSPITAL MORBIDITY AND OUTCOMES OF INPATIENT TREATMENT IN CARDIAC PATIENTS WITH NEW CORONAVIRUS INFECTION

Highlights

The article presents the results of analysis of hospital morbidity and mortality in patients with cardiovascular diseases receiving specialized medical care at the Department of Infectious Diseases of the Kuzbass Clinical Cardiology Dispensary named after Academician L.S. Barbarash.

Aim. To analyze hospital morbidity and mortality in patients with new coronavirus infection (NCI) who received specialized medical care at the Department of Infectious Diseases of the Kuzbass Clinical Cardiology Dispensary named after Academician Barbarash.

Methods. The object of the study were the reports of the head of the Department of Infectious Diseases regarding patients with circulatory system diseases (CSD) and NCI receiving care at the Kuzbass Cardiology Center for the period from 10.21.2020 to 30.06.2022. The subject of the retrospective study were the types of CSD and mortality (ICD-10 code) in treated patients. The unit of analysis – treated patients with CSD (18 years and older) and NCI (U07.1 and U07.2).

Results. Data of 1 248 patients with CSD and NCI were analyzed. The highest number of such cases occurred in 2021, accounting for more than half of all patients treated at the Department. More than half of the patients were hospitalized with acute coronary artery disease (CAD), less than a quarter of the patients were hospitalized with chronic CAD and heart failure. Acute coronary syndrome (ACS) was verified in 38.9% of patients, stroke in 22.4% of patients, and pulmonary embolism in 1.8% of patients (n = 22). Patients were more often admitted with acute (primary) myocardial infarction (MI) and unstable CAD (17.6% and 15%, respectively), and half as often with recurrent MI (6.3%). Less than 40% of patients were hospitalized due to chronic CSD, among which prevailed chronic CAD and decompensated chronic heart failure (CHF) (19.7%). Mortality was 16%, mortality within 24 hours was 2.5%. The mean age of the deceased patients was 72.69 ± 12.22 years. The proportion of patients of working age who died was 10.8 times lower than that of patients older than working age. On average, women were 1.1 times more likely to die during the analyzed period. Acute CSD (32.3%), chronic CSD (33.5%) and stroke (34.2%) caused death at an equal rate.

Conclusion. Patients with ACS and stroke were the majority of treated patients. Patients were more often admitted with primary MI and unstable CAD, and half as often with recurrent MI. The most predominant chronic CSD were chronic CAD and decompensated CHF. One sixth of all treated patients died. Acute and chronic CSD and stroke caused death at an equal rate.

1. Bazdyrev E.D., Gofman L.S., Tsygankova D.P., Kashtalap V.V., Gruzdeva O.V., Trushkina T.A., Sadovnikov A.V., Artamonova G.V. Characteristics of adult patients who suffered from COVID-19 in the Kemerovo region – Kuzbass (according to the federal registry of COVID-19 patients). Complex Issues of Cardiovascular Diseases. 2024;13(4):62-76. doi: 10.17802/2306-1278-2024-13-4-62-76. (In Russian)

2. Kashtalap V.V., Sadovnikov A.V., Sadovnikova N.V., Tupikova T.E., Zgurskaya T.D., Zvereva T.N., Gofman L.S., Bazdyrev E.D. Features of the course of myocardial infarction in patients with novel coronavirus infection. Complex Issues of Cardiovascular Diseases. 2023;12(4S):13-24. doi: 10.17802/2306-1278-2023-12-4S-13-24. (In Russian)

3. Pellicori P., Doolub G., Wong C.M., Lee K.S., Mangion K., Ahmad M., Berry C., Squire I., Lambiase P.D., Lyon A., McConnachie A., Taylor R.S., Cleland J.G. COVID-19 and its cardiovascular effects: a systematic review of prevalence studies. Cochrane Database Syst Rev. 2021;3(3):CD013879. doi: 10.1002/14651858.CD013879.

4. Nishiga M., Wang D.W., Han Y., Lewis D.B., Wu J.C. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020;17(9):543-558. doi: 10.1038/s41569-020-0413-9.

5. Shao H.H., Yin R.X. Pathogenic mechanisms of cardiovascular damage in COVID-19. Mol Med. 2024;30(1):92. doi: 10.1186/s10020-024-00855-2.

6. Tian W., Jiang W., Yao J., Nicholson C.J., Li R.H., Sigurslid H.H., Wooster L., Rotter J.I., Guo X., Malhotra R. Predictors of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis. J Med Virol. 2020;92(10):1875-1883. doi: 10.1002/jmv.26050.

7. Shu H., Wen Z., Li N., Zhang Z., Ceesay B.M., Peng Y., Zhou N., Wang D.W. COVID-19 and cardiovascular diseases: from cellular mechanisms to clinical manifestations. Aging Dis. 2023;14(6):2071-2088. doi: 10.14336/AD.2023.0314.

8. Tsampasian V., Bäck M., Bernardi M., Cavarretta E., Dębski M., Gati S., Hansen D., Kränkel N., Koskinas K., Niebauer J., Spadafora L., Frias Vargas M., Biondi-Zoccai G., Vassiliou V.S. Cardiovascular disease as part of Long COVID: A systematic review. Eur J Prev Cardiol. 2024:zwae070. doi: 10.1093/eurjpc/zwae070.

9. Adu-Amankwaah J., Mprah R., Adekunle A.O., Ndzie Noah M.L., Adzika G.K., Machuki J.O., Sun H. The cardiovascular aspect of COVID-19. Ann Med. 2021;53(1):227-236. doi: 10.1080/07853890.2020.1861644.

10. Zhao Y., Han X., Li C., Liu Y., Cheng J., Adhikari B.K., Wang Y. COVID-19 and the cardiovascular system: a study of pathophysiology and interpopulation variability. Front Microbiol. 2023;14:1213111. doi: 10.3389/fmicb.2023.1213111.

11. Sedykh D.Yu., Barbarash O.L., Indukaeva E.V., Artamonova G.V. Selected public health indicators in the Siberian Federal District, the impact of COVID-19. Social'nye aspekty zdorov'a naselenia [serial online]. 2023;69(5):3. doi: 10.21045/2071-5021-2023-69-5-3. (In Russian)

12. Tsygankova D.P., Agienko A.S., Sedykh D.Yu., Makarov S.A., Artamonova G.V. Analysis of the mortality rate dynamics due to circulatory system diseases in the Kemerovo region for the period 2017-2021. Complex Issues of Cardiovascular Diseases. 2023;12(3):57-65. doi: 10.17802/2306-1278-2023-12-3-57-65. (In Russian)

13. Healthcare in Russia. 2023: Statistical Digest / Federal State Statistics Service (Rosstat). – Moscow, 2023. – 179 p. (In Russian)

14. Nanavaty D., Sinha R., Kaul D., Sanghvi A., Kumar V., Vachhani B., Singh S., Devarakonda P., Reddy S., Verghese D. Impact of COVID-19 on acute myocardial infarction: a national inpatient sample analysis. Curr Probl Cardiol. 2024;49(1 Pt A):102030. doi: 10.1016/j.cpcardiol.2023.102030.

15. Katsoularis I., Fonseca-Rodríguez O., Farrington P., Lindmark K., Fors Connolly A.M. Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. Lancet. 2021;398(10300):599-607. doi: 10.1016/S0140-6736(21)00896-5.

16. Gharibzadeh A., Shahsanaei F., Rahimi Petrudi N. Clinical and cardiovascular characteristics of patients suffering ST-segment elevation myocardial infarction after Covid-19: a systematic review and meta-analysis. Curr Probl Cardiol. 2023;48(1):101045. doi: 10.1016/j.cpcardiol.2021.101045.

17. Baytuğan N.Z., Kandemir H.Ç., Bezgin T. In-hospital outcomes of ST-segment elevation myocardial infarction in COVID-19 positive patients undergoing primary percutaneous intervention. Arq Bras Cardiol. 2024;121(1):e20230258. doi: 10.36660/abc.20230258.

18. Dogan Z., Erden I., Bektasoglu G., Karabulut A. Association between history of polymerase chain reaction-verified COVID-19 infection and outcomes of subsequent ST-Elevation myocardial infarction. Angiology. 2024;75(2):131-138. doi: 10.1177/00033197221139918.

19. Changal K., Veria S., Mack S., Paternite D., Sheikh S.A., Patel M., Mir T., Sheikh M., Ramanathan P.K. Myocardial injury in hospitalized COVID-19 patients: a retrospective study, systematic review, and meta-analysis. BMC Cardiovasc Disord. 2021;21(1):626. doi: 10.1186/s12872-021-02450-3.

20. Skorodumova E.G., Kostenko V.A., Skorodumova E.A., Siverina A.V. Myocardial infarction and COVID‑19 in a “non‑COVID” hospital: epidemiology, annual analysis. Emergency medical care. 2021;22(4):34-38. doi: 10.24884/2072-6716-2021-22-4-34-38. (In Russian)

21. Chashchin M.G., Strelkova A.V., Gorshkov A.Yu., Drapkina O.M. In-hospital outcomes of ST elevation myocardial infarction in post-COVID-19 patients. Russian Journal of Cardiology. 2023;28(2):5278. doi: 10.15829/1560-4071-2023-5278. (In Russian)

22. Akhmentaeva D.A., Kapsultanova D.A., Lisovenko O.I., Rahmankul D.J., Dursunov S.D., Sovetkanova P.E., Mayufi A.M., Aliakbarov E.A. Influence of COVID 19 coronavirus infection on the severity of coronary heart disease course and the risk of acute myocardial infarction. Vestnik KAZNMU. 2022;1:121-127. doi: 10.53065/kaznmu.2022.47.81.019. (In Russian)

23. Shahjouei S., Naderi S., Li J., Khan A., Chaudhary D., Farahmand G., Male S., Griessenauer C., Sabra M., Mondello S., Cernigliaro A., Khodadadi F., Dev A., Goyal N., Ranji-Burachaloo S., Olulana O., Avula V., Ebrahimzadeh S.A., Alizada O., Hancı M.M., Ghorbani A., Vaghefi Far A., Ranta A., Punter M., Ramezani M., Ostadrahimi N., Tsivgoulis G., Fragkou P.C., Nowrouzi-Sohrabi P., Karofylakis E., Tsiodras S., Neshin Aghayari Sheikh S., Saberi A., Niemelä M., Rezai Jahromi B., Mowla A., Mashayekhi M., Bavarsad Shahripour R., Sajedi S.A., Ghorbani M., Kia A., Rahimian N., Abedi V., Zand R. Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study. EBioMedicine. 2020;59:102939. doi: 10.1016/j.ebiom.2020.102939.

24. Zuin M., Mazzitelli M., Rigatelli G., Bilato C., Cattelan A.M. Risk of ischemic stroke in patients recovered from COVID-19 infection: A systematic review and meta-analysis. Eur Stroke J. 2023;8(4):915-922. doi: 10.1177/23969873231190432.

25. Shamalov N.A., Klimov L.V., Soldatov M.A., Kiseleva T.V., Shamalova V.N., Marskaya N.A., Lyang O.V. Acute cerebrovascular accidents in patients with new coronavirus infection COVID-19. Neurology, Neuropsychiatry, Psychosomatics. 2024;16(1):82-86. doi: 10.14412/2074-2711-2024-1-82-86. (In Russian)

26. Luo W., Liu X., Bao K., Huang C. Ischemic stroke associated with COVID-19: a systematic review and meta-analysis. J Neurol. 2022;269(4):1731-1740. doi: 10.1007/s00415-021-10837-7.

27. Tangos M., Jarkas M., Akin I., El-Battrawy I., Hamdani N. Cardiac damage and tropism of severe acute respiratory syndrome coronavirus 2. Curr Opin Microbiol. 2024;78:102437. doi: 10.1016/j.mib.2024.102437.