Search

Introduction:Approximately 531 million cases of coronavirus disease 2019 (COVID-19) has been reported globally, leading to 6.3 million deaths. Many studies have previous studies have reported that PE is a significantly dangerous complication of COVID-19. Therefore, we explored the prevalence of PE among COVID-19 hospitalizations. We also looked for the adverse effects of the coexistence of these two conditions using a large administrative database.Hypothesis:PE among COVID-19 hospitalizations could significantly increased the risk for adverse in-hospital outcomes.Methods:Using a retrospective analysis of the 2020 California State Inpatient Database we identified all COVID-19 hospitalizations and PE using ICD-10-CM codes among patients aged 18 years and above. Several outcomes such as in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission were explored for differences between those with and without PE. Prolonged length of stay was defined as hospital length of stay ≥75th percentile. We used multivariate logistic regression analyses to understand the relationship between PE and adverse hospital outcomes after accounting for cofactors.Results:A total of 94,114 COVID-19 hospitalizations were included for the analysis, of which 1798 (1.9%) had PE. COVID-19 hospitalizations with PE had significantly greater rates of adverse hospital outcomes such as mortality (19.5% versus 11.2%, P<0.001), prolonged length of stay (40.0% versus 28.2%, P<0.001), vasopressor use (4.6% versus 2.1%, P<0.001), mechanical ventilation (20.4% versus 9.9%, P<0.001), and ICU admission (19.6% versus 9.6%, P<0.001). PE significantly increased the odds of for mortality (aOR, 2.34, 95% CI: 2.07-2.65), prolonged length of stay (aOR, 3.51, 95% CI: 3.16-3.91), vasopressor use (aOR, 4.23, 95% CI: 3.78-4.74), mechanical ventilation (aOR, 2.90, 95% CI: 2.38-3.53), and ICU admission (aOR, 4.32, 95% CI: 3.85-4.84).Conclusions:Though very few COVID-19 hospitalizations in our cohort had PE, they had greater risk for adverse hospital outcomes and death. Given these adverse associations, PE among COVID-19 patients should be aggressively treated in order to decrease the disease burden of COVID-19.

Introduction:Current estimates show that, globally, there are 531 million cases and 6.3 million deaths due to COVID-19. Studies have shown that COVID-19 could lead to deep vein thrombosis (DVT) resulting in increased morbidity and mortality. In this study we sought to estimate the prevalence of DVT among COVID-19 hospitalizations as well as its effects on hospital outcomes using a large administrative database.Hypothesis:The adverse in-hospital outcomes of COVID-19 will be significantly higher among DVT hospitalizations.Methods:We conducted a retrospective analysis of the 2020 California State Inpatient Database. All hospitalizations with age 18 and above and primary diagnosis of COVID-19 were included for the study. They were classified into those with and without DVT. The main outcomes of the study were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Length of stay ≥75th percentile was grouped as prolonged length of stay. Multivariate logistic regressions with covariate adjustments were conducted to compare COVID-19 related outcomes between those with and without DVT.Results:We included a total of 94,114 primary COVID-19 hospitalizations for the analysis. Among them 1575 (1.7%) had DVT. The prevalence of mortality (27.5% versus 11.1%, P<0.001), prolonged length of stay (62.2% versus 27.8%, P<0.001), vasopressor use (7.9% versus 2.1%, P<0.001), mechanical ventilation (36.2% versus 9.7%, P<0.001), and ICU admission (35.7% versus 9.3%, P<0.001) were significantly higher among those with DVT.After adjusting for covariates, regression analysis showed that those with DVT had significantly greater odds for mortality (aOR, 2.34, 95% CI: 2.07-2.65), prolonged length of stay (aOR, 3.51, 95% CI: 3.16-3.91), vasopressor use (aOR, 4.23, 95% CI: 3.78-4.74), mechanical ventilation (aOR, 2.90, 95% CI: 2.38-3.53), and ICU admission (aOR, 4.32, 95% CI: 3.85-4.84).Conclusions:In our cohort, only few COVID-19 hospitalizations had a diagnosis of DVT. However, among those with DVT, the risk for adverse outcomes were significantly higher. Since DVT among COVID-19 is uncommon but associated with adverse hospital outcomes, healthcare providers should promptly monitor for DVT and manage it.

Introduction:According to recent global estimates there are nearly 530 million cases and 6.3 million deaths due to novel coronavirus disease 2019 (COVID-19) pandemic. Studies have shown that COVID-19 disproportionately affects males than females. In this study we looked at differences in in-hospital outcomes of COVID-19 based on sex using a larger administrative database.Hypothesis:The adverse in-hospital outcomes of COVID-19 will be significantly higher among males.Methods:This was a retrospective analysis of the California State Inpatient Database 2020. All COVID-19 hospitalizations with age 18 years and above were included for the analysis. These hospitalizations were classified into males and females. The main outcomes of the study were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Any length of stay ≥75th percentile value for the entire cohort was considered as prolonged length of stay. Logistic regression analyses after adjusting for covariates were used to compare COVID-19 related outcomes between males and females.Results:A total of 95,180 primary COVID-19 hospitalizations were included for the analysis. Of these 52465 (55.1%) were males and 42715 (44.9%) were females. Among these hospitalizations, mortality (12.4% versus 10.1%, P<0.001), prolonged length of stay (30.6% versus 25.8%, P<0.001), vasopressor use (2.6% versus 1.6%, P<0.001), mechanical ventilation (11.8% versus 8.0%, P<0.001), and ICU admission (11.4% versus 7.8%, P<0.001) were significantly higher among males. Logistics regression analysis showed that males had significantly greater odds for mortality (aOR, 1.38, 95% CI: 1.32-1.44), prolonged length of stay (aOR, 1.35, 95% CI: 1.31-1.39), vasopressor use (aOR, 1.59, 95% CI: 1.51-1.66), mechanical ventilation (aOR, 1.62, 95% CI: 1.47-1.78), and ICU admission (aOR, 1.58, 95% CI: 1.51-1.66).Conclusions:Adverse outcomes such as mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission were independently associated with male sex. These findings could be due differences to both biological and social factors between the sexes. Future studies should explore these factors to efficiently control COVID-19.

Introduction:In the US, there are approximately 84 million cases of COVID-19 accounting for 1 million deaths. Though there are not many studies, acute myocardial infarction (AMI) is one of the most lethal complications of COVID-19. In this study, we looked for occurrence of AMI and its effects on hospital outcomes among COVID-19 patients.Hypothesis:AMI among COVID-19 hospitalizations could worsen the levels of adverse in-hospital outcomes.Methods:Data from the 2020 California State Inpatient Database was used retrospectively. All COVID-19 hospitalizations with age ≥18 years were included in the analyses. Adverse hospital outcomes included in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and ICU admission. Prolonged length of stay included any hospital length of stay ≥75th percentile. We explored for differences in adverse hospital outcomes between those with and without AMI. Multivariate logistic regression analyses were used to understand the strength of these associations after adjusting for cofactors.Results:Our analysis had a total of 94,114 COVID-19 hospitalizations and 1548 (1.6%) had AMI. Adverse hospital outcomes such as mortality (43.2% versus 10.8%, P<0.001), prolonged length of stay (39.9% versus 28.2%, P<0.001), vasopressor use (7.8% versus 2.1%, P<0.001), mechanical ventilation (35.0% versus 9.7%, P<0.001), and ICU admission (33.0% versus 9.4%, P<0.001) were significantly higher among COVID-19 hospitalizations with AMI. The odds of adverse outcomes such as mortality (aOR, 3.90, 95% CI: 3.48-4.36), prolonged length of stay (aOR, 1.23, 95% CI: 1.10-1.37), vasopressor use (aOR, 3.71, 95% CI: 3.30-4.17), mechanical ventilation (aOR, 2.71, 95% CI: 2.21-3.32), and ICU admission (aOR, 3.51, 95% CI: 3.12-3.96) were significantly more prevalent among COVID-19 hospitalizations with AMI.Conclusions:In spite of very low prevalence of AMI among COVID-19 hospitalizations, we observed a substantially greater risk of adverse hospital outcomes and mortality. The hyperinflammatory response of COVID-19 could additionally worsen the factors precipitating mortality among AMI. COVID-19 patients with AMI should be aggressively treated to improve hospital outcomes.