How Does SARS-CoV-2 Infection Affect Survival of Emergency Cardiovascular Patients? A Cohort Study From a German Insurance Claims Database
Autor: | Helmut L'Hoest, Götz Thomalla, Laura Acar, Christian Gerloff, Moritz Seiffert, Christian-Alexander Behrendt |
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Rok vydání: | 2021 |
Předmět: |
Male
Acute limb ischaemia medicine.medical_specialty Myocardial Infarction 030204 cardiovascular system & hematology 030230 surgery Article Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Germany Internal medicine medicine Humans Hospital Mortality cardiovascular diseases Myocardial infarction Aortic rupture Pandemics Stroke Aged Retrospective Studies Insurance Health SARS-CoV-2 business.industry Mortality rate ST elevation COVID-19 Extremities Retrospective cohort study medicine.disease Ischemic Attack Transient Female Surgery Health Services Research Emergencies Cardiology and Cardiovascular Medicine business Administrative Claims Healthcare Cohort study |
Zdroj: | European Journal of Vascular and Endovascular Surgery Journal of Vascular Surgery Europe PubMed Central |
ISSN: | 1078-5884 |
Popis: | Objective A previous study revealed a preliminary trend towards higher in hospital mortality in patients admitted as an emergency with acute stroke during the COVID-19 pandemic in Germany. The current study aimed to further examine the possible impact of a confirmed SARS-CoV-2 infection on in hospital mortality. Methods This was a retrospective analysis of health insurance claims data from the second largest insurance fund in Germany, BARMER. Patients hospitalised for ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction, acute limb ischaemia (ALI), aortic rupture, acute stroke, or transient ischaemic attack (TIA) between 1 January 2017, and 31 October 2020, were included. Admission rates per 10 000 insured and mortality were compared between March − June 2017 – 2019 (pre-COVID) and March − June 2020 (COVID). Mortality rates were determined by the occurrence of a confirmed SARS-CoV-2 infection. Results A total of 316 718 hospitalisations were included (48.7% female, mean 72.5 years), and 21 191 (6.7%, 95% CI 6.6% – 6.8%) deaths occurred. In hospital mortality increased during the COVID-19 pandemic when compared with the three previous years for patients with acute stroke from 8.3% (95% CI 8.0 – 8.5) to 9.6% (95% CI 9.1 – 10.2), while no statistically significant changes were observed for STEMI, NSTEMI, ALI, aortic rupture, and TIA. When comparing patients with confirmed SARS-CoV-2 infection (2.4%, 95% CI 2.3 – 2.5) vs. non-infected patients, a higher in hospital mortality was observed for acute stroke (12.4% vs. 9.0%), ALI (14.3% vs. 5.0%), and TIA (2.7% vs. 0.3%), while no statistically significant differences were observed for STEMI, NSTEMI, and aortic rupture. Conclusion This retrospective analysis of claims data has provided hints of an association between the COVID-19 pandemic and increased in hospital mortality in patients with acute stroke. Furthermore, confirmed SARS-CoV-2 infection was associated with increased mortality in patients with stroke, TIA, and ALI. Future studies are urgently needed to better understand the underlying mechanism and relationship between the new coronavirus and acute stroke. |
Databáze: | OpenAIRE |
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