Sex-Based Differences in Cardiovascular Diagnoses, Mortality, and Resource Utilization in Long COVID Hospitalizations: A National Inpatient Sample Analysis.

Long COVID refers to persistent sequelae following SARS-CoV-2 infection, and sex-specific cardiovascular outcomes among hospitalized patients remain incompletely characterized. We queried the 2022 National Inpatient Sample (NIS) to identify adult hospitalizations with a diagnosis of long COVID (ICD-10 U09.9), excluding patients younger than 18 years or with missing outcome data. Analyses incorporated NIS discharge weights to generate national estimates. Multivariable (survey-weighted) logistic regression was used to estimate adjusted odds ratios (aORs) for cardiovascular diagnoses and in-hospital mortality. Among 87,415 weighted hospitalizations for long COVID, 49.4% were male, and 50.6% were female. Males had more complicated hypertension, coagulopathy, and alcohol use disorder, whereas females had higher rates of obesity, depression, and hypothyroidism (all p <0.05). Males had a higher in-hospital mortality rate (5.9% vs 4.7%, p <0.001). In adjusted analyses, females had lower odds of in-hospital mortality (aOR: 0.874 [95% CI 0.819-0.932]), cardiac arrhythmias (aOR: 0.652 [0.629-0.677]), venous thromboembolism (aOR: 0.846 [0.807-0.887]), and myocardial infarction (aOR: 0.767 [0.720-0.817]). Adjusted odds of ischemic cerebrovascular accident were not significantly different (aOR: 0.955 [0.795-1.146]). Females had higher odds of transient ischemic attack (aOR: 1.441 [1.067-1.945]). Median length of stay (5 vs 4 days) and total hospital charges ($50,447 vs $43,839) were lower in females (all p <0.001). In conclusion, in this nationally representative analysis of long COVID hospitalizations, sex-based differences were observed in cardiovascular diagnoses, mortality, and healthcare utilization, and these findings support sex-sensitive risk stratification and hypothesis generation for post-COVID care.