Abstract Body (Do not enter title and authors here): Background. Peripartum cardiomyopathy (PPCM) is defined as a dilated form of cardiomyopathy that occurs within the last month of pregnancy and up to 5 months postpartum. The etiology is likely multifactorial and viral infections may account for up to a third of PPCM cases. We aimed to examine the impact of concurrent COVID-19 infection on in-hospital outcomes of women with PPCM.
Methods. National Inpatient Sample was queried to identify women admitted with PPCM with COVID-19 (group A) between the years 2020-2021 and without (group B) concurrent COVID-19 infection between the years 2016-2019.
Results. A total of 19135 women were admitted with PPCM between the years 2016-2021, of whom 420 (2%) had concurrent COVID-19 infection. Group A PPCM followed a seasonal pattern with peak incidence in fall (43%) followed by winter (31%), spring (13%) and summer (13%) [p=0.002]. Group A was more often Hispanic (20.3% -vs- 10.8%, p<0.001) and more often admitted to urban teaching hospitals (88.1% -vs- 79.7%, p<0.001), had longer length of stay (9.7 -vs- 5.8 days), and overall greater cost of hospitalization ($162181 -vs- $92155). Group A also had greater rates of acute myocardial infarction (11.9% -vs- 5.6%, p<0.001), bleeding requiring transfusion (8.3% -vs- 5.4%, p=0.030), pulmonary embolism (4.8% -vs- 2.4%, p=0.057), shock (14.3% -vs- 3.1%, p<0.001), ICU admission (29.8% -vs- 10.2%, p<0.001), vasopressor requirement (10.7% -vs- 2.1%, p<0.001), ventilator requirement (27.4% -vs- 9.1%, p<0.001), and cardiopulmonary resuscitation (7.1% -vs- 1.1%, p=0.005). Overall in-hospital mortality was also higher in group A (8.3% -vs- 1.5%, p<0.001).
Conclusion. PPCM appeared to follow a seasonal trend in incidence similar to COVID-19. COVID-19 infection may have accounted for some cases of PPCM and was associated with adverse in-hospital outcomes and higher mortality.