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Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic

JAMA Network Open, 2020-07, Vol.3 (7), p.e2014780-e2014780 [Peer Reviewed Journal]

2020. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Copyright 2020 Jabri A et al. . ;ISSN: 2574-3805 ;EISSN: 2574-3805 ;DOI: 10.1001/jamanetworkopen.2020.14780 ;PMID: 32644140

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  • Title:
    Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic
  • Author: Jabri, Ahmad ; Kalra, Ankur ; Kumar, Ashish ; Alameh, Anas ; Adroja, Shubham ; Bashir, Hanad ; Nowacki, Amy S ; Shah, Rohan ; Khubber, Shameer ; Kanaa’N, Anmar ; Hedrick, David P ; Sleik, Khaled M ; Mehta, Neil ; Chung, Mina K ; Khot, Umesh N ; Kapadia, Samir R ; Puri, Rishi ; Reed, Grant W
  • Subjects: Acute Coronary Syndrome - epidemiology ; Acute coronary syndromes ; Aged ; Betacoronavirus ; Cardiology ; Cardiomyopathy ; Cohort Studies ; Comorbidity ; Coronavirus Infections - epidemiology ; Coronaviruses ; COVID-19 ; Female ; Humans ; Incidence ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Ohio - epidemiology ; Online Only ; Original Investigation ; Pandemics ; Patients ; Pneumonia, Viral - epidemiology ; Retrospective Studies ; SARS-CoV-2 ; Takotsubo Cardiomyopathy - epidemiology
  • Is Part Of: JAMA Network Open, 2020-07, Vol.3 (7), p.e2014780-e2014780
  • Description: IMPORTANCE: The coronavirus disease 2019 (COVID-19) pandemic has resulted in severe psychological, social, and economic stress in people’s lives. It is not known whether the stress of the pandemic is associated with an increase in the incidence of stress cardiomyopathy. OBJECTIVE: To determine the incidence and outcomes of stress cardiomyopathy during the COVID-19 pandemic compared with before the pandemic. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study at cardiac catheterization laboratories with primary percutaneous coronary intervention capability at 2 hospitals in the Cleveland Clinic health system in Northeast Ohio examined the incidence of stress cardiomyopathy (also known as Takotsubo syndrome) in patients presenting with acute coronary syndrome who underwent coronary arteriography. Patients presenting during the COVID-19 pandemic, between March 1 and April 30, 2020, were compared with 4 control groups of patients with acute coronary syndrome presenting prior to the pandemic across 4 distinct timelines: March to April 2018, January to February 2019, March to April 2019, and January to February 2020. Data were analyzed in May 2020. EXPOSURES: Patients were divided into 5 groups based on the date of their clinical presentation in relation to the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES: Incidence of stress cardiomyopathy. RESULTS: Among 1914 patient presenting with acute coronary syndrome, 1656 patients (median [interquartile range] age, 67 [59-74]; 1094 [66.1%] men) presented during the pre–COVID-19 period (390 patients in March-April 2018, 309 patients in January-February 2019, 679 patients in March-April 2019, and 278 patients in January-February 2020), and 258 patients (median [interquartile range] age, 67 [57-75]; 175 [67.8%] men) presented during the COVID-19 pandemic period (ie, March-April 2020). There was a significant increase in the incidence of stress cardiomyopathy during the COVID-19 period, with a total of 20 patients with stress cardiomyopathy (incidence proportion, 7.8%), compared with prepandemic timelines, which ranged from 5 to 12 patients with stress cardiomyopathy (incidence proportion range, 1.5%-1.8%). The rate ratio comparing the COVID-19 pandemic period to the combined prepandemic period was 4.58 (95% CI, 4.11-5.11; P < .001). All patients during the COVID-19 pandemic had negative reverse transcription–polymerase chain reaction test results for COVID-19. Patients with stress cardiomyopathy during the COVID-19 pandemic had a longer median (interquartile range) hospital length of stay compared with those hospitalized in the prepandemic period (COVID-19 period: 8 [6-9] days; March-April 2018: 4 [3-4] days; January-February 2019: 5 [3-6] days; March-April 2019: 4 [4-8] days; January-February: 5 [4-5] days; P = .006). There were no significant differences between the COVID-19 period and the overall pre–COVID-19 period in mortality (1 patient [5.0%] vs 1 patient [3.6%], respectively; P = .81) or 30-day rehospitalization (4 patients [22.2%] vs 6 patients [21.4%], respectively; P = .90). CONCLUSIONS AND RELEVANCE: This study found that there was a significant increase in the incidence of stress cardiomyopathy during the COVID-19 pandemic when compared with prepandemic periods.
  • Publisher: United States: American Medical Association
  • Language: English
  • Identifier: ISSN: 2574-3805
    EISSN: 2574-3805
    DOI: 10.1001/jamanetworkopen.2020.14780
    PMID: 32644140
  • Source: Journals@Ovid Open Access Journal Collection Rolling
    MEDLINE
    ProQuest Databases
    Alma/SFX Local Collection
    Coronavirus Research Database
    DOAJ Directory of Open Access Journals
    JAMA Network (Open Access)
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