Texas Heart Institute Journal (May 2024)

Incidence and Impact of Takotsubo Syndrome in Hospitalized Patients With COVID-19

  • Pengyang Li, MD, MSc,
  • Ao Shi, PhD,
  • Xiaojia Lu, MD,
  • Chenlin Li, MD,
  • Peng Cai, MSc,
  • Catherine Teng, MD,
  • Lingling Wu, MD,
  • Yuan Shu,
  • Su Pan, MD,
  • Richard A. F. Dixon, PhD,
  • Qi Liu, PhD,
  • Bin Wang, MD, PhD

DOI
https://doi.org/10.14503/THIJ-23-8309
Journal volume & issue
Vol. 51, no. 1
pp. 1 – 10

Abstract

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Background Takotsubo syndrome has been reported in patients with COVID-19, although minimal data are available. This investigation assessed the incidence and impact of takotsubo syndrome on patients hospitalized with COVID-19. Methods A retrospective cohort study was conducted using International Statistical Classification of Diseases, Tenth Revision, codes to identify patients with a primary diagnosis of COVID-19 with or without takotsubo syndrome in the National Inpatient Sample 2020 database. Outcomes between groups were compared after propensity score matching for patient and hospital demographics and comorbidities. Results A total of 211,448 patients with a primary diagnosis of COVID-19 were identified. Of these, 171 (0.08%) had a secondary diagnosis of takotsubo syndrome. Before matching, patients with COVID-19 and takotsubo syndrome, compared with patients without takotsubo syndrome, were older (68.95 vs 64.26 years; P < .001); more likely to be female (64.3% vs 47.2%; P < .001); and more likely to have anxiety (24.6% vs 12.8%; P < .001), depression (17.5% vs 11.4%; P = .02), and chronic obstructive pulmonary disease (24.6% vs 14.7%; P < .001). The takotsubo syndrome group had worse outcomes than the non–takotsubo syndrome group for death (30.4% vs 11.1%), cardiac arrest (7.6% vs 2.1%), cardiogenic shock (12.9% vs 0.4%), length of hospital stay (10.7 vs 7.5 days), and total charges ($152,685 vs $78,468) (all P < .001). After matching and compared with the non–takotsubo syndrome group (n = 508), the takotsubo syndrome group (n = 170) had a higher incidence of inpatient mortality (30% vs 14%; P < .001), cardiac arrest (7.6% vs 2.8%; P = .009), and cardiogenic shock (12.4% vs 0.4%; P < .001); a longer hospital stay (10.7 vs 7.6 days; P < .001); and higher total charges ($152,943 vs $79,523; P < .001). Conclusion Takotsubo syndrome is a rare but severe in-hospital complication in patients with COVID-19.

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