History of COVID-19 and Overall Survival Among Medicare Beneficiaries Hospitalized with Acute Ischemic Stroke, Medicare Cohort 2020-2021

Details

• Alternative Title:
  Austin J Cardiovasc Dis Atheroscler
• Personal Author:
  Tong, X ; Yang, Q ; Gillespie, C ; Merritt, RK
• Description:
  Background:
  
  COVID-19 is associated with increased risk of Acute Ischemic Stroke (AIS). The present study examined the impact of prior COVID-19 diagnoses on overall survival among older AIS patients.
  
  Methods:
  
  We included 250,079 Medicare Fee-For-Service (FFS) beneficiaries aged ≥65 years with AIS hospitalizations from 04/01/2020 through 12/31/2021. Overall survival was defined as the time from date of AIS hospitalization to date of death, or through end of follow-up on 03/31/2023. We used a Cox proportional hazard model to examine the association between history of COVID-19 and overall survival among AIS beneficiaries, and we obtained age, sex, race/ethnicity, Social Vulnerability Index (SVI), National Institutes of Health Stroke Scale score, and comorbidity-adjusted survival estimates.
  
  Results:
  
  Among 250,079 Medicare FFS beneficiaries with AIS, 98,327 (39.3%) died during a median of 590 days (IQR, 169–819 days) of follow-up with a total of 365,606 person-years. The 1-year adjusted overall survival was 62.0%, 67.4%, and 68.8% in beneficiaries with hospitalized COVID-19, with non-hospitalized COVID-19 and no COVID-19 respectively (p<0.001). Compared to AIS without history of COVID-19, the adjusted mortality hazard ratios were 1.30 (95% CI, 1.26–1.34) and 1.06 (95% CI, 1.03–1.10) for those with a history of hospitalized and non-hospitalized COVID-19, respectively. The patterns of overall survival by COVID-19 history were largely consistent across age groups, sex, race/ethnicity, and SVI groups.
  
  Conclusions:
  
  A history of COVID-19 diagnoses, especially with a history of severe COVID-19, was associated with a significantly higher risk of all-cause mortality among Medicare FFS beneficiaries hospitalized with AIS.
  
  
• Keywords:
  Acute Ischemic Stroke COVID-19 Hospitalizations Survival
• Source:
  Austin J Cardiovasc Dis Atheroscler. 11(1):1-6
• Pubmed ID:
  39664321
• Pubmed Central ID:
  PMC11633309
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  11
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:522793e486f7093d138dc84a6502e06169a6e09a9ffa3ac93e80e1fda0df5b1116f155eef8087efc4620e1116962eee65a83bd49d6e119e5577bf48de5035d80
• Download URL:
  https://stacks.cdc.gov/view/cdc/174800/cdc_174800_DS1.pdf
• File Type:
  [PDF - 215.53 KB ]