Background: The COVID-19 pandemic has presented unprecedented challenges to global healthcare systems. As the pandemic unfolded, it became evident that certain groups of individuals were at an elevated risk of experiencing severe disease outcomes. Among these high-risk groups, individuals with pre-existing cardiac conditions emerged as particularly vulnerable. Objective: This study aimed to investigate the relationship between the length of stay, mortality, and costs of COVID-19 patients with and without a history of cardiac disease. Design: This retrospective study was conducted in Jam Hospital in Tehran, Iran, from March 21, 2021, to March 21, 2022. All patients with laboratory-confirmed COVID-19 who were hospitalized during this period were included. Results: A total of 500 COVID-19 patients were hospitalized, with 31.6% having a history of cardiac disease and 68.4% without any cardiac disease. Patients with cardiac disease were significantly older (median [range] age, 69.35 [37 - 94] years) compared to non-cardiac patients (54.95 [13 - 97] years) (p < 0.001). Hypertension (39.2%) and diabetes (28.6%) were the most prevalent comorbid conditions. According to the Cox regression model, patients with cardiac disease did not have a statistically higher risk of death than those without cardiac disease. However, age and underlying disease were significant risk factors for mortality with COVID-19, with high hazard ratios (HRs) of 1.041 (95% CI, 1.041 - 1.070) and 2.297 (95% CI, 1.152 - 4.581), respectively. The median length of stay (LOS) in cardiac patients was seven days, with an average total cost of $1865.77 per patient, significantly higher than in patients with no cardiac history (p-value: 0.004, <0.001). Conclusion: Patients with cardiac disease who are hospitalized with COVID-19 have a higher mortality rate, longer hospital stays, greater disease severity, ICU admission, and higher costs. Therefore, improved prevention and management strategies are crucial for these patients.
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