Abstract 14303: COVID-19 and the Gender Impact on Sudden Cardiac Death

Background: Sudden Cardiac Death (SCD) is an unexpected death attributed to a cardiac cause that occurs within one hour of symptom onset. Males have a higher likelihood of experiencing sudden cardiac arrest compared to females, as evidenced by previous studies indicating a substantial disparity in mortality rates between the genders. The outbreak of the COVID-19 pandemic has had a profound impact on cardiovascular population health patterns. Therefore, our study aimed to assess the influence of the pandemic on the gender-related variation in SCD rates among males and females.

Methods: We used the National Inpatient Sample (NIS) to identify all patients admitted to hospitals in 2019 and 2020 with a primary diagnosis of sudden cardiac arrest. To analyze associations, we employed both logistic and linear regression methods, adjusting for potential confounding variables. We set the threshold for statistical significance at a 2-tailed p-value of 0.05.

Results: Between 2019 and 2020, a total of 27,430 individuals were admitted to hospitals with a primary diagnosis of sudden cardiac arrest, with 11,705 (42.7%) of these patients being female. When factors such as age, race, hospital bed size, location and teaching status, insurance, and income level, as well as Elixhauser comorbidities and COVID-19 status were considered through multivariate regression analysis, a distinct trend emerged. In the year 2020, which was marked by the COVID-19 pandemic, there was a significant increase in in-hospital mortality among female patients (adjusted Odds Ratio aOR 1.34, 95% Confidence Interval CI 1.04 - 1.79). This trend was not present in the previous year, 2019, prior to the pandemic (aOR 1.03, 95% CI 0.87 - 1.22).

Conclusion: Our study revealed a significant increase in mortality among female patients presenting with sudden cardiac arrest during the Covid-19 pandemic. We attribute this increase to the intricate interplay between Covid-19 and the healthcare system. While a direct association between SCD and Covid-19 is possible, it is crucial to acknowledge the indirect ramifications such as the impact of lockdown measures, alterations in behavior, and challenges faced by the healthcare system, all of which may be contributing factors.