{"doi":"10.1002/clc.23590","title":"Acute cardiovascular hospitalizations and illness severity before and during the <scp>COVID</scp>‐19 pandemic","abstract":"BACKGROUND: Cardiovascular disease (CVD) hospitalizations declined worldwide during the COVID-19 pandemic. It is unclear how shelter-in-place orders affected acute CVD hospitalizations, illness severity, and outcomes. HYPOTHESIS: COVID-19 pandemic was associated with reduced acute CVD hospitalizations (heart failure [HF], acute coronary syndrome [ACS], and stroke [CVA]), and worse HF illness severity. METHODS: We compared acute CVD hospitalizations at Duke University Health System before and after North Carolina's shelter-in-place order (January 1-March 29 vs. March 30-August 31), and used parallel comparison cohorts from 2019. We explored illness severity among admitted HF patients using ADHERE (\"high risk\": >2 points) and GWTG-HF (\">10%\": >57 points) in-hospital mortality risk scores, as well as echocardiography-derived parameters. RESULTS: Comparing hospitalizations during January 1-March 29 (N = 1618) vs. March 30-August 31 (N = 2501) in 2020, mean daily CVD hospitalizations decreased (18.2 vs. 16.1 per day, p = .0036), with decreased length of stay (8.4 vs. 7.5 days, p = .0081) and no change in in-hospital mortality (4.7 vs. 5.3%, p = .41). HF hospitalizations decreased (9.0 vs. 7.7 per day, p = .0019), with higher ADHERE (\"high risk\": 2.5 vs. 4.5%; p = .030), but unchanged GWTG-HF (\">10%\": 5.3 vs. 4.6%; p = .45), risk groups. Mean LVEF was lower (39.0 vs. 37.2%, p = .034), with higher mean LV mass (262.4 vs. 276.6 g, p = .014). CONCLUSIONS: CVD hospitalizations, HF illness severity, and echocardiography measures did not change between admission periods in 2019. Evaluating short-term data, the COVID-19 shelter-in-place order was associated with reductions in acute CVD hospitalizations, particularly HF, with no significant increase in in-hospital mortality and only minor differences in HF illness severity.","journal":"Clinical Cardiology","year":2021,"id":198933,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9658,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":706689,"name":"Michelle D. Kelsey","orcid":"0000-0002-2169-043X","position":1,"is_corresponding":false},{"id":505262,"name":"Anita M. Kelsey","orcid":"0000-0002-2351-4990","position":2,"is_corresponding":false},{"id":235995,"name":"Stuart D. Russell","orcid":"0000-0003-1115-0349","position":3,"is_corresponding":false},{"id":274218,"name":"Robert J. Mentz","orcid":"0000-0002-3222-1719","position":4,"is_corresponding":false},{"id":302877,"name":"Manesh R. Patel","orcid":"0000-0002-2393-0855","position":5,"is_corresponding":false},{"id":274214,"name":"Marat Fudim","orcid":"0000-0002-8671-7007","position":6,"is_corresponding":false},{"id":548588,"name":"Vishal N. Rao","orcid":"0000-0003-3545-4267","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-18T23:50:36.595945Z","pmid":"33682157","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}