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

• Published in: Texas Heart Institute journal 2024-05, Vol.51 (1), p.1-10
• Main Authors: Li, Pengyang, Shi, Ao, Lu, Xiaojia, Li, Chenlin, Cai, Peng, Teng, Catherine, Wu, Lingling, Shu, Yuan, Pan, Su, Dixon, Richard A F, Liu, Qi, Wang, Bin
• Format: Article
• Language: English
• Subjects: Aged; Clinical Investigation; Comorbidity; covid-19; COVID-19 - complications; COVID-19 - epidemiology; Female; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Incidence; Male; Middle Aged; mortality; Retrospective Studies; Risk Factors; SARS-CoV-2; takotsubo cardiomyopathy; Takotsubo Cardiomyopathy - diagnosis; Takotsubo Cardiomyopathy - epidemiology; United States - epidemiology
• ISSN: 0730-2347; 1526-6702
• DOI: 10.14503/THIJ-23-8309

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. 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. 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). Takotsubo syndrome is a rare but severe in-hospital complication in patients with COVID-19.