Recurrent stroke admissions with vs without COVID-19 and associated in-hospital mortality: A United States nationwide analysis, 2020

Table 1 Baseline characteristics, comorbidities and outcomes of recurrent/subsequent stroke admissions with vs without coronavirus disease 2019, 2020

Variables		Total recurrent stroke (AIS with prior stroke/TIA) (n = 97255)		P value
		No COVID-19 (n = 95115), %	COVID-19 (n = 2140), %
Age in years at admission	Median (IQR)	72 (62-82)	73 (63-82)	0.001
	18-44	3.6	3.7
	45-64	27.0	23.4
	≥ 65	69.4	72.9
Sex	Male	51.0	53.5	0.023
	Female	49.0	46.5
Race	White	68.9	53.2	< 0.001
	Black	19.3	25.1
	Hispanic	8.6	17.2
	Asian/Pacific Islander	2.8	4.2
	Native American	0.4
Median household income national quartile for patient ZIP code	0-25th	31.3	36.5	< 0.001
	26-50th	27.1	30.1
	51-75th	23.1	18.0
	76-100th	18.4	15.4
Payer type	Medicare	72.8	74.6	0.118
	Medicaid	10.2	9.0
	Private	17.0	16.4
Hospital location & teaching status	Rural	6.7	8.4	0.001
	Urban Nonteaching	18.6	16.6
	Urban Teaching	74.7	75.0
Hospital region	Northeast	14.5	16.8	< 0.001
	Midwest	21.1	19.2
	South	45.2	47.9
	West	19.2	16.1
Comorbidities
Hypertension		89.5	85.7	< 0.001
Diabetes		43.2	53.0	< 0.001
Hyperlipidemia		66.8	61.4	< 0.001
Obesity		14.9	16.1	0.124
Peripheral vascular disease		11.7	8.6	< 0.001
Tobacco use disorder		28.9	28.3	0.535
Prior MI		10.3	5.8	< 0.001
Prior VTE		5.6	6.3	0.162
Cancer		5.0	3.7	0.009
Chronic kidney disease		22.7	30.8	< 0.001
Alcohol abuse		4.3	2.8	0.001
Drug abuse		3.1	2.1	0.007
Depression		11.8	9.6	0.001
Chronic pulmonary disease		17.3	15.0	0.004
Hypothyroidism		15.2	14.0	0.133
Other thyroid disorders		2.3	2.1	0.502
Valvular disease		2.7	1.6	0.002
Autoimmune conditions		3.2	2.8	0.283
Outcomes
All-cause in-hospital mortality		4.0	22.9	< 0.001
Disposition of patient	Routine	36.6	25.2	< 0.001
	Transfer to short-term hospital	2.8	3.4
	Transfer other: SNF, ICF, etc.	38.6	49.7
	Home health care	21.9	21.8
Length of stay (days)	Median (IQR)	3 (2-6)	7 (3-13)	< 0.001
Hospital charges (USD)	Median	$52662	$80888	< 0.001

P < 0.05 is noted to be statistically significant. MI: Myocardial infarction; VTE: Venous thromboembolism; SNF: Skilled nursing facility; ICF: Intermediate care facility; IQR: Inter-quartile range; TIA: Transient ischemic attack; COVID-19: Coronavirus disease 2019.

Table 2 Multivariable logistic regression assessing impact of coronavirus disease 2019 on mortality following recurrent stroke admissions

In-hospital mortality	COVID-19	Adjusted OR	95%CI		P value
			Lower Limit	Upper limit
Overall mortality	Yes vs No	7.01	5.36	9.18	< 0.001
In-hospital mortality by individual subgroup
Ages 45-64	Yes vs No	8.4	4.18	16.91	< 0.001
Ages 65 and above	Yes vs No	7.04	5.24	9.44	< 0.001
Male	Yes vs No	7.82	5.38	11.35	< 0.001
Female	Yes vs No	6.15	4.12	9.18	< 0.001
Whites	Yes vs No	5.54	3.79	8.09	< 0.001
Blacks	Yes vs No	5.73	3.08	10.68	< 0.001
Hispanics	Yes vs No	15.47	7.61	31.44	< 0.001
Asian/Pacific Islanders	Yes vs No	14.93	7.22	30.87	< 0.001

P < 0.05 indicates statistical significance. Multivariable regression models were adjusted for baseline demographics, hospital level characteristics and relevant comorbidities. COVID-19: Coronavirus disease 2019; OR: Odds ratio.