Mortality Correlates in Takotsubo Syndrome Patients during the COVID-19 Pandemic

Chang, Amanda; Wang, Yi Grace; Jayanna, Manju B.; Wu, Xiaodong; Cadaret, Linda M.; Liu, Kan

We completed a systematic review of published Takotsubo syndrome (TTS) cases during COVID-19 pandemic and performed clustering and feature importance analysis, and statistical testing for independence on the demographic, clinical and imaging parameters. Compared with the data before the COVID-19 pandemic, TTS was increasingly diagnosed in physical stress (mostly COVID-19 pneumonia)-triggered male patients without psychiatric/neurologic disorders, warranting further investigation to establish new reference criteria to improve diagnostic specificity. In clustering analysis, the gender and in-patient mortality primarily contributed to the automated classification of the TTS. Both the gender and in-patient mortality showed significant correlations with COVID-19 infection/pneumonia. There is effect modification of gender on outcomes in patients with COVID-19 infection and TTS, with male patients having significantly worse inpatient mortality. Meanwhile, significantly more male TTS patients were classified as “high-risk” following InterTAK prognostic scores, suggestive of male COVID-19/TTS survivors will likely have worse long-term outcome.