Impact of COVID‐19 infection among patients hospitalized for conventional pacemaker implantation: Analysis of the Nationwide Inpatient Sample (NIS) 2020

Abstract

AbstractIntroductionThe cardiac pacemaker is indicated for treating various types of bradyarrhythmia, providing lifelong cardiovascular benefits. Recent data showed that COVID‐19 has impacted procedure numbers and led to adverse long‐term outcomes in patients with cardiac pacemakers. However, the impact of COVID‐19 infection on the in‐hospital outcome of patients undergoing conventional pacemaker implantation remains unclear.MethodPatients aged above 18 years who were hospitalized for conventional pacemaker implantation in the Nationwide In‐patient Sample (NIS) 2020 were identified using relevant ICD‐10 CM and PCS codes. Multivariable logistic and linear regression models were used to analyze pre‐specified outcomes, with the primary outcome being in‐patient mortality and secondary outcomes including system‐based and procedure‐related complications.ResultsOf 108 020 patients hospitalized for conventional pacemaker implantation, 0.71% (765 out of 108 020) had a concurrent diagnosis of COVID‐19 infection. Individuals with COVID‐19 infection exhibited a lower mean age (73.7 years vs. 75.9 years, p = .027) and a lower female proportion (39.87% vs. 47.60%, p = .062) than those without COVID‐19. In the multivariable logistic and linear regression models, adjusted for patient and hospital factors, COVID‐19 infection was associated with higher in‐hospital mortality (aOR 4.67; 95% CI 2.02 to 10.27, p < .001), extended length of stay (5.23 days vs. 1.04 days, p < .001), and linked with various in‐hospital complications, including sepsis, acute respiratory failure, post‐procedural pneumothorax, and venous thromboembolism.ConclusionOur study suggests that COVID‐19 infection is attributed to higher in‐hospital mortality, extended hospital stays, and increased adverse in‐hospital outcomes in patients undergoing conventional pacemaker implantation.