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Cosmos Study

Patterns of Heart Failure in COVID-19 Admitted Patients

Abstract: 7.1% of patients admitted for COVID-19 were diagnosed with new heart failure within 3 months of their COVID positivity.
April 1, 2021
Dual-Team Study
Team A:Sam Butler, MDLily Rubin-Miller, MPHTyler Heist, PhD
Team B:Chris Alban, MDAlejandro Munoz del Rio, PhDDavid Berry, PhD

Recent studies have suggested COVID-19 may result in new cardiovascular disease.1,2 To better understand this, we examined patterns of heart failure diagnoses for patients admitted with COVID-19.

Our study population consists of 55,285 patients who were diagnosed with COVID-19 or tested positive for SARS-CoV-2 and had a COVID-19-related admission by October 1, 2020. These data come from 70 healthcare organizations covering 352 hospitals. We found 23.6% of the 55,285 COVID-19 admitted patients had heart failure documented within 3 months after their COVID positivity. 7.1% of the 55,285 patients had new heart failure with no prior history within 3 months after their COVID positivity.

Figure 1
Heart Failure Documentation in COVID-19 Admitted Patients
Heart Failure Documentation in COVID-19 Admitted Patients
Figure 1. Breakdown of when COVID-19 admitted patients had heart failure documented, including whether heart failure was documented only before, before and after, or only after their COVID-19 positivity.

We found that a large majority of patients had heart failure documented within 14 days of COVID-19 positivity, regardless of whether the patient had a prior history of heart failure. This finding may suggest that new heart failure happens within two weeks of COVID-19 positivity or could be documentation of a pre-existing condition due to increased interaction with healthcare providers during their admission. To further evaluate the impact of increased surveillance during hospital admissions and its impact on new diagnosis of conditions, we will pursue a follow-up study on the timing of documentation for other chronic conditions in relation to admissions to see how this finding of increased heart failure compares.


This study was completed by two teams, each comprised of a clinician and two data scientists, that independently acquired and analyzed data. Both teams were involved in the interpretation of results and drafting of this brief. Overall, the two teams came to similar conclusions. Data are pooled from 70 healthcare organizations representing 352 hospitals that span 48 states and cover 54 million patients.

References

  1. Topol EJ. COVID-19 can affect the heart. Science. 2020;370(6515):408-409. doi:10.1126/science.abe2813
  2. Lindner D, Fitzek A, Bräuninger H, et al. Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases. JAMA Cardiol. 2020;5(11):1281. doi:10.1001/jamacardio.2020.3551