Increased cardiovascular death rates in a COVID‐19 low prevalence area

Pinto, Rita Del; Ferri, Claudio; Mammarella, L; Abballe, Stefano; Dell'Anna, S.; Cicogna, Sabrina; Grassi, Davide; Sacco, Simona; Desideri, Giovambattista

doi:10.1111/jch.14013

Cited by 16 publications

(20 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9,19 More recent evidences, consistent with our results, showed a significant decrease in mean number of endovascular therapies per hospital performed before and after COVID-19 confinement along with a significant increase in mean stroke onset-to groin puncture time 260 .A delayed presentation of STEMI patients that may led to worsened prognosis and unnecessary deaths has also been observed 261 . Moreover, an additional study confirmed that more in-hospital cardiovascular deaths occurred in March 2020 compared with March 2019, a finding possibly due to late hospital presentations and consequent greater disease severity that affected eligibility and outcome of cardiovascular procedures 262 .…”

Section: Discussionmentioning

confidence: 78%

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

Lugli

Ottaviani

Botta

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Italy has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties during the pandemic in Italy. Methods: A PRISMA guideline-based systematic review of the available literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19. Findings: Of the 4643 potentially eligible studies identified by the search, 247 studies were included in the systematic review. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine during the pandemic. Interpretation: Our work highlights the changes taking place in the Italian public healthcare system in order to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.

show abstract

Section: Discussionmentioning

confidence: 78%

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

Lugli

Ottaviani

Botta

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Interestingly, from March 10th to April 20th, 2020, the proportion of children and adolescents presenting to ophthalmological ED halved from 10 to 5.3% in comparison with 2019 [22]. Similarly, Del Pinto and colleagues reported a significant reduction in less all-cause and cardiovascular hospitalizations occurred from January 1st to March 31st, 2020, than in the similar period of 2019 in 5 Italian hospitals located in the province of L'Aquila (Southern Italy) [24]. These authors also reported a significant increase in intra-hospital deaths attributable to major cardiovascular diseases in March 2020 compared with the same month in 2019 (+ 6.8%), possibly due to barriers to seeking emergency care during COVID-19 pandemic [25].…”

Section: Discussionmentioning

confidence: 93%

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Vierucci¹,

Bacci

Mucaria

et al. 2020

SN Compr. Clin. Med.

View full text Add to dashboard Cite

Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), p < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March − 74.6%, April − 71.6%, May − 58.6%). Nasopharyngeal What is Known: Italy was the first European country hit by SARS-CoV-2 infection. Published preliminary Italian data confirmed a general favorable clinical course of COVID-19 in childhood. What is New: Even if COVID-19 pandemic more seriously affected Northern Italy, the admission of children and adolescents to pediatric emergency services significantly changed also in Central Italy with reduced demand and increased appropriateness.

show abstract

“…6 Second, direct deaths from unfamiliar complications of Covid-19 such as coagulopathy, myocarditis, inflammatory processes, and arrhythmias may have caused confusion and led to attributions of death to other causes, especially early in the pandemic. [7][8][9] Third, Covid-19 death counts do not take into account the indirect consequences of the Covid-19 pandemic on mortality levels. [10][11][12] Indirect effects may include increases in mortality resulting from reductions in access to and use of health care services and psychosocial consequences of stay-at-home orders.…”

Section: Introductionmentioning

confidence: 99%

“…First, some direct deaths attributable to Covid-19 may be assigned to other causes of death due to an absence of widespread testing and low rates of diagnoses at the time of death [6]. Additionally, direct deaths from unfamiliar complications of Covid-19 such as coagulopathy, myocarditis, inflammatory processes, and arrhythmias may have caused confusion and led to attributions of death to other causes, especially early in the pandemic and among persons with comorbid conditions [7–9]. Second, Covid-19 death counts do not take into account the indirect consequences of the Covid-19 pandemic on mortality levels [10,11].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Impact of the Covid-19 Pandemic on US Mortality: A County-Level Analysis

Stokes

Lundberg

Hempstead

et al. 2020

Preprint

View full text Add to dashboard Cite

Covid-19 excess deaths refer to increases in mortality over what would normally have been expected in the absence of the Covid-19 pandemic. In this study, we take advantage of spatial variation in Covid-19 mortality across US counties to construct an Ordinary Least Squares regression model estimating its relationship with all-cause mortality. We then examine how the extent of excess mortality not assigned to Covid-19 varies across subsets of counties defined by demographic, structural, and policy characteristics. We estimate that 20.4% [95% CI (13.7%, 27.2%)] of excess deaths between February 1 and August 26, 2020 were ascribed to causes of death other than Covid-19 itself. Excess deaths not assigned to Covid-19 were even higher than predicted by our model in counties with high income inequality, low median income, low homeownership, and high percentages of Black residents, showing a pattern related to socioeconomic disadvantage and structural racism. Our work suggests that inequities in excess deaths attributable to Covid-19 may be even greater than revealed by data reporting deaths assigned to Covid-19 alone.

show abstract

Increased cardiovascular death rates in a COVID‐19 low prevalence area

Cited by 16 publications

References 11 publications

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Assessing the Impact of the Covid-19 Pandemic on US Mortality: A County-Level Analysis

Contact Info

Product

Resources

About