Background COVID-19 frequently affects the cardiovascular system. Advanced age and pre-existing heart failure HF are considered risk factors for a poor prognosis. However, the cardiovascular consequences of COVID-19 in older adults with a history of HF have not been clearly depicted. Methods A retrospective review was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD codes, patients aged 65–75 and Elixhauser Comorbidity Score(ECI)>4 with a history of HF admitted for COVID-19 were identified. This cohort was propensity score matched with a group of patients without HF by age, gender, other cardiovascular diseases, and ECI. Records from both groups were reviewed for new onset of cardiovascular-related conditions, including myocardial infarction(MI), arrhythmias, and hypertension, within one year following the admission. Pearson’s chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results 4,014 members in each group were identified. A history of HF was associated with an increased risk of MI(RR=1.18, CI95% =1.005–1.37, p=0.04), and arrhythmias (RR=1.17, CI95% =1.08–1.26, p < 0.00001). No differences present in risk of myocarditis(RR=0.05, CI95%=0.12–1.99, p=50) across groups. Conclusion Older adults with a history of HF are more likely to experience MI and arrhythmias over a year after hospitalization for COVID-19.
Background According to the CDC, approximately 30% of hospitalizations for COVID-19 infection between the onset of the pandemic and November 2020 were attributed to obesity. However, there is limited data on how obesity affects the overall outcome of COVID-19 in hospitalized older adults. Methods A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD-10 codes, a cohort of patients aged 65–75 and Elixhauser Comorbidity Index (ECI) >4 with a history of obesity admitted for COVID-19 was identified. This cohort was matched with a group of patients with no history of obesity, considering age, gender, and ECI. Records from both groups were reviewed for multiple outcomes over 30 days following admission. Pearson’s chi-squared was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results There were 151,429 members in each group. Obese individuals had a higher risk of 30-day all-cause readmission (RR=1.10, CI95% 1.07–1.11, p < 0.0001), ICU admission (RR=1.11, CI95% 1.08–1.15, p < 0.0001), acute thromboembolic events (RR=1.14, CI95% 1.07–1.2, p < 0.001), and deep venous thrombosis (RR=1.21, CI95% 1.12–1.32, p < 0.00001). There was no difference in length of hospitalization. Conclusion Obesity is a modifiable risk factor that negatively affects COVID-19 outcomes in the older population. Given the prevalence of obesity in our population, primary and secondary obesity prevention is more important than ever.
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