Impact of COVID-19 pandemic on in-patient mortality of patients with implantable cardiac devices

Manorekang, R.; Nayar, V.

Background Patients with cardiovascular disease have a higher risk of death from COVID-19 infection. Most patients with implantable cardiac devices (pacemakers and defibrillators) have significant cardiovascular co-morbidities, which would suggest a higher mortality in device patients during the pandemic. AimTo review inpatient mortality of patients with cardiac devices in our hospital before and after the outbreak of the COVID-19 pandemic.MethodA retrospective analysis of all in-hospital deaths over 12 months, between 1st November 2019 and 31st October 2020, at a district general hospital in the UK. All patients with implantable cardiac devices were identified and their COVID-19 infection status determined from the death certificate. Results 131 in-patients (76% male) with implantable cardiac devices (64% pacemakers, 23% biventricular pacemakers, and 13% defibrillators) died during the study period. Mean age of death was 84 years (SD ± 8 years). Most deaths (91%) occurred on the medical ward (including level 2 respiratory care unit). There were more deaths from March 2020, peaking in April 2020, before gradually declining in May 2020, correlating with the first wave of the COVID-19 pandemic in the UK (figure 1). The majority of patients who died in April 2020 were COVID positive. From early September 2020 onwards, the number of COVID positive deaths started to increase again, correlating with the second wave. Following the declaration of the pandemic, deaths occurred mostly amongst COVID negative patients (figure 2). Conclusion Inpatient mortality of patients with cardiac device were highest in the elderly population which predominantly occurred during the first wave of COVID-19 pandemic.