Outcomes in patients with COVID-19 and new onset heart blocks: Insight from the National Inpatient Sample database

Table 1 Baseline demographics and comorbid condition rate of patients admitted for coronavirus disease 2019 pneumonia with and without high degree atrioventricular block without a pacemaker, n (%)

	Study group	Control group	P value
	High degree atrioventricular block (n = 3210/0.4%)	No high degree atrioventricular block (n = 1058815/99.6%)
Age (year), mean	72	64	< 0.001
Gender			< 0.001
Female	1075 (33.5)	498545 (47.2)
Male	(66.5)	(52.7)
Ethnicity			0.0359
White	1862 (58)	550584 (52)
Black	578 (18)	201175 (19)
Hispanic	482 (15)	211763 (21)
Other	225 (7)	84705 (8)
Chronic kidney disease	1084 (33)	205000 (19)	< 0.001
Hypertension	1030 (32)	437190 (41)	< 0.001
Congestive heart failure	1095 (34)	162930 (15)	< 0.001
Government insured	2555 (82)	673794 (67)	< 0.001
Private insured	480 (15)	292190 (29)	< 0.001
Self-pay	80 (2.6)	35875 (3.6)	0.1828
Poor socioeconomic status	550 (17)	168015 (16)
Hospital region			0.0144
Northeast	550 (17)	186650 (17.6)
Midwest	925 (29)	245190 (23.2)
South	1225 (38)	441800 (42)
West	510 (16)	181964 (17.2)
Hospital bed size			0.0286
Small	770 (24)	270620 (25.6)
Medium	810 (25.2)	304920 (29)
Large	1630 (50.8)	480065 (45.4)
Charlson index			< 0.001
0	385 (12)	296468 (28)
1	642 (20)	296468 (28)
2	578 (18)	169410 (16)
3	1605 (50)	296468 (28)
Median household income			0.0418
First quartile	931 (29)	359997 (34)
Second quartile	995 (31)	296468 (28)
Third quartile	738 (23)	232939 (22)
Fourth quartile	546 (17)	169410 (16)
Myocardial infarction	570 (17)	77240 (7)	< 0.001
Peripheral vascular disease	320 (10)	47355 (4.5)	< 0.001
Cerebrovascular disease	185 (5)	42075 (4)	0.0223
Dementia	570 (17)	116035 (11)	< 0.001
Chronic obstructive lung disease	875 (27)	247225 (23.4)	0.0244
Rheumatoid arthritis	65 (2)	30120 (3)	0.2037
Peptic ulcer disease	20 (0.6)	4625 (0.4)	0.4797
Mild liver disease	95 (3)	36275 (3.4)	0.5039
Diabetes mellitus	680 (21)	262850 (25)	0.0311
Diabetic complications	1790 (55)	327870 (30)	< 0.001
Hemiplegia or paraplegia	50 (1.5)	16690 (1.5)	0.9732
Renal disease	2220 (70)	421060 (40)	< 0.001
Cancer	260 (8)	57440 (5.4)	0.0371
Moderate/severe liver disease	45 (1.4)	15855 (1.5)	0.9051
Metastatic cancer	210 (6.5)	49170 (4.6)	0.3633
AIDS	60 (1.9)	13980 (1.3)	0.6272

Student’s t-test and Chi-square test were used to compare the baseline characteristics accordingly, and the resulting P values are shown. AIDS: Acquired immunodeficiency syndrome.

Table 2 Baseline demographics and comorbid condition rate of patients admitted for coronavirus disease 2019 pneumonia with and without bundle branch block without a pacemaker, n (%)

	Study group	Control group	P value
	All bundle branch blocks without pacemaker (n = 17365/1.6%)	No bundle branch blocks (n = 1044660/98.4%)
Age (year), mean	72.5	64	< 0.001
Gender			< 0.001
Female	6845 (39.4)	492775 (47.3)
Male	(60.6)	(52.7)
Ethnicity			0.0359
White	10766 (62)	543223 (52)
Black	2431 (14)	198485 (19)
Hispanic	2952 (17)	219378 (21)
Other	1216 (7)	83573 (8)
Chronic kidney disease	5005 (29)	201080 (19)	< 0.001
Hypertension	6390 (37)	431830 (41)	< 0.001
Congestive heart failure	5470 (32)	158555 (15)	< 0.001
Government insured	13360 (79.5)	662990 (67)	< 0.001
Private insured	3065 (18.2)	289605 (29.3)	< 0.001
Self-pay	385 (2.3)	35570 (3.6)	< 0.001
Poor socioeconomic status	3290	165275
Hospital region			< 0.001
Northeast	3885 (22.4)	183315 (17.6)
Midwest	4725 (27.2)	241390 (23.2)
South	6160 (35.4)	436866 (42)
West	2595 (15)	179880 (17.2)
Hospital bed size			0.0025
Small	3900 (22.4)	267490 (25.6)
Medium	5345 (30.8)	300385 (29)
Large	8120 (46.8)	473575 (45.4)
Charlson index			< 0.001
0	2952 (17)	292505 (28)
1	3646 (21)	292505 (28)
2	3299 (19)	147145 (16)
3	7466 (43)	292505 (28)
Median household income			< 0.001
First quartile	5088 (29.3)	355184 (34)
Second quartile	4705 (27.1)	292505 (28)
Third quartile	4202 (24.4)	229825 (22)
Fourth quartile	3334 (19.2)	147145 (16)
Myocardial infarction	3035 (17.5)	74775 (7)	< 0.001
Peripheral vascular disease	1530 (9)	46145 (4.4)	< 0.001
Cerebrovascular disease	1045 (6)	41215 (4)	< 0.001
Dementia	2835 (16)	113770 (11)	< 0.001
Chronic obstructive lung disease	4300 (25)	243800 (23.4)	0.0592
Rheumatoid arthritis	495 (3)	29690 (3)	0.9993
Peptic ulcer disease	60 (0.4)	4585 (0.4)	0.4011
Mild liver disease	670 (3.8)	35700 (3.4)	0.1675
Diabetes mellitus	4005 (23)	259525 (25)	0.0137
Diabetic complications	7420 (43)	322240 (30.8)	< 0.001
Hemiplegia or paraplegia	320 (1.8)	16420 (1.6)	0.3728
Renal disease	10370 (60)	412910 (39.5)	< 0.001
Cancer	970 (5.6)	56730 (5.4)	0.7950
Moderate/Severe liver disease	240 (1.4)	15660 (1.5)	0.7335
Metastatic cancer	840 (4.8)	48540 (4.6)	0.8478
AIDS	210 (1.2)	13830 (1.3)	0.8074

Student’s t-test and Chi-square test were used to compare the baseline characteristics accordingly, and the resulting P values are shown. AIDS: Acquired immunodeficiency syndrome.

Table 3 A Univariate regression analysis of encounters with coronavirus disease 2019 and with high grade atrioventricular block without pacemakers

High degree atrioventricular block without pacemakers	Adjusted OR	95%CI	P value
Mortality	2.18	1.80-2.64	< 0.001
Cardiac arrest	2.78	2.00-3.86	< 0.001
Atrial fibrillation	2.46	2.10-2.90	< 0.001
Atrial flutter	5.45	4.00-7.42	< 0.001
Ventricular fibrillation	6.33	3.27-12.27	< 0.001
Supraventricular tachycardia	3.39	2.31-4.96	< 0.001
Ventricular tachycardia	4.75	3.05-6.46	< 0.001
Acute kidney injury	1.73	1.47-2.03	< 0.001
Sepsis	1.85	1.44-2.39	< 0.001
Mechanical ventilation	1.72	1.33-2.22	< 0.001
Cardiogenic shock	8.75	5.61-13.63	< 0.001

Table 4 Univariate regression analysis of encounters with coronavirus disease 2019 and with bundle branch block without pacemakers

Right or left bundle branch blocks without pacemaker	Adjusted OR	95%CI	P value
Mortality	1.63	1.42-1.89	< 0.001
Cardiac arrest	1.43	1.04-1.97	0.026
Atrial fibrillation	2.12	1.88-2.40	< 0.001
Atrial flutter	2.32	1.70-3.17	< 0.001
Ventricular fibrillation	2.31	1.11-4.82	0.024
Supraventricular tachycardia	2.22	1.64-2.99	< 0.001
Ventricular tachycardia	4.09	3.24-5.14	< 0.001
Acute kidney injury	1.71	1.53-1.90	< 0.001
Sepsis	1.81	1.52-2.26	< 0.001
Mechanical ventilation	1.67	1.38-2.23	< 0.001
Cardiogenic shock	3.29	2.04-5.31	< 0.001

Table 5 Univariate regression analysis demonstrating absolute value of outcomes of interest in encounters with coronavirus disease 2019 and with high grade atrioventricular block or bundle branch blocks without pacemakers, n (%)

In-hospital outcomes Rates	High degree atrioventricular block (n = 3210)	All bundle branch blocks without pacemaker (n = 17365)
Mortality	665 (21.3)	2952 (17.0)
Cardiac arrest	175 (5.6)	504 (2.9)
Atrial fibrillation	172 (5.5)	799 (4.6)
Atrial flutter	209 (6.7)	538 (3.1)
Ventricular fibrillation	44 (1.4)	87 (0.5)
Supraventricular tachycardia	150 (4.8)	555 (3.2)
Ventricular Tachycardia	222 (7.1)	799 (4.6)
Sepsis	365 (11.6)	1233 (7.1)
Mechanical ventilation	324 (10.4)	1528 (8.8)
Cardiogenic shock	103 (3.3)	174 (1.0)
Pulmonary embolism	106 (3.4)	521 (3.0)
Acute kidney injury	1298 (41.6)	5956 (34.3)
Cerebrovascular accidents	50 (1.6)	191 (1.1)