Indirect impact of the COVID-19 pandemic on hospitalisations for cardiometabolic conditions and their management: A systematic review

Seidu, Samuel; Kunutsor, Setor K; Cos, Xavier; Khunti, Kamlesh

doi:10.1016/j.pcd.2021.05.011

Cited by 31 publications

(36 citation statements)

References 25 publications

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“…In addition, being afraid of infection could have limited patients´ attendance at medical appointments during the pandemic, which in turn may have delayed diagnoses or even not detecting them. The results of our study are in line with recent reviews showing a decrease in the number of hospitalizations due to ischemic heart disease during the COVID-19 pandemic ( Seidu et al., 2021 ).…”

Section: Discussionsupporting

confidence: 92%

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey

Cervera-Martínez

Atienza-Carbonell

Mota

et al. 2021

Journal of Affective Disorders

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Background This study aimed to compare self-reported changes on lifestyle behaviors during two phases of the COVID-19 pandemic in Spain, and to evaluate clinical and sociodemographic factors associated with lifestyles. Methods Two cross-sectional web surveys were conducted during lockdown (April 15-May 15, 2020) and seven months later (November 16-December 16, 2020). Lifestyle behaviors were self-reported by a multidimensional scale (SMILE-C). Two separate samples of respondents were analyzed. A multivariate regression model was performed to evaluate the association of SMILE-C scores with demographic and clinical variables. Results The sample comprised, 3412 participants from the first survey (S1) and in the S1 and 3635 from the second (S2). SMILE-C score decreased across surveys ( p < 0.001). The rates of positive screenings for depression and anxiety were similar between the surveys, whereas those for alcohol abuse decreased ( p < 0.001). Most participants in S2 reported that their lifestyle had not changed compared to those before the pandemic. Variables independently associated with an unhealthier lifestyle were working as an essential worker, lower educational level, previous mental disease, worse self-rated health, totally/moderate changes on diet, sleep or social support, as well as positive screenings for alcohol abuse, anxiety and depression. Limitations The cross-sectional design and recruitment by non-probabilistic methods limit inferring causality and the external validity of the results. Conclusions Overall lifestyle worsened seven months after the lockdown in Spain. Several demographic and clinical factors were associated with lifestyle scores. The contribution of common mental disorders to unhealthier lifestyles should be considered in order to prevent the negative impact of the pandemic.

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Section: Discussionsupporting

confidence: 92%

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey

Cervera-Martínez

Atienza-Carbonell

Mota

et al. 2021

Journal of Affective Disorders

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“…Several studies have assessed and reported the extent to which consultation rates of patients and healthcare services have been impacted during the COVID-19 pandemic compared to pre-pandemic times. These have included patient delays in seeking medical care, declines in hospitalisations for acute medical conditions such as strokes and myocardial infarctions (with reductions ranging from 20.2 to 73.0%), impact on routine cancer care, less utilisation of in-hospital procedures such as coronary angiographies, postponing or cancellation of surgical procedures, and shorter length of hospital stays [ 9 , 10 , [18] , [19] , [20] ]. Several studies have also reported on the impact of the COVID-19 pandemic on primary care services.…”

Section: Discussionmentioning

confidence: 99%

“…Consultation rates of patients for medical conditions, their management and outcomes have all been adversely impacted by the COVID-19 pandemic [ 8 ]. Compared to the pre-pandemic period, there has been a substantial decrease in admissions for acute medical conditions, longer delays between the onset of the symptoms and hospital treatment, less utilisation of inhospital procedures, and reduction in access to care for chronic diseases [ [9] , [10] , [11] ]. Even primary care services (the first point of contact in the healthcare system) have had to restructure their services to minimise the burden of COVID-19, whilst trying to deliver necessary care.…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care

Seidu

Hambling²,

Holmes³

et al. 2022

Primary Care Diabetes

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Background Healthcare systems worldwide have been adversely affected by the Coronavirus disease 2019 (COVID-19) pandemic. There has been a substantial decrease in admissions for acute medical conditions with longer delays between the onset of the symptoms and hospital treatment compared to the pre-pandemic period. The impact of the COVID pandemic on primary care services is uncertain. Aim Using an online survey, we examined the impact of the COVID pandemic on primary care diabetes services in the UK. Methods An online survey was developed by the Primary Care Diabetes Society research group and administered to healthcare and allied health professionals delivering diabetes care in the UK from January to May 2021. Descriptive statistics and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results Of the 1070 professionals surveyed, 975 (91.1%) completed the questionnaire. Most respondents were nurses or nurse practitioners (59.7%) and doctors (32.9%). The mean age of respondents was 52 years and 79% were female. The majority of respondents felt overloaded with work (71.2%) or emotionally drained at the end of a working day (79.1%) compared with the pre-pandemic period. Being a doctor and worried about infecting a family member with the Coronavirus were each associated with an increased odds of being substantially overworked or emotionally drained: (OR = 2.52; 95% CI, 1.25−5.07) and (OR = 2.05; 95% CI, 1.24–3.39), respectively. The most common consultation method used to provide diabetes care during the pandemic was telephone consultation (92.0%). Overall 79.1% of respondents felt the COVID-19 pandemic had had moderate to significant impact on their practice's ability to provide routine diabetes care; 70.6% of respondents felt the COVID-19 pandemic had had moderate to significant impact on their practice's ability to provide routine health checks or screening for type 2 diabetes and approximately half of respondents (48.3%) reported encountering mental health concerns in people with diabetes. Conclusions COVID-19 pandemic has had significant impact on the ability of healthcare professionals and their practices to deliver routine diabetes care. Failure to restore primary care provision urgently and safely to at least pre-pandemic levels in a sustainable manner may lead to emotionally drained and overworked workforce in primary care, place additional burden on the already overburdened healthcare system and worse outcomes for patients.

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“…The most immediate indirect effects were likely seen in both purposeful and inadvertent redirection of health services (45)(46)(47). A population-based study of the primary care practices in England observed a 70% decrease in the rate of diabetes diagnoses and a 30% decrease in HbA 1c testing during April 2020; both of these rates gradually returned to usual levels over the subsequent 6 months (47).…”

Section: Health System and Service Effectsmentioning

confidence: 99%

Diabetes and COVID-19: Population Impact 18 Months Into the Pandemic

2021

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Eighteen months into the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 ) pandemic, epidemiologic studies indicate that diabetes is a central contributor to severe COVID-19 morbidity, and, conversely, COVID-19 has had a devastating effect on the population with diabetes. In this literature synthesis, we summarize the relationship of diabetes to COVID-19-related morbidity and mortality, discuss the predictors of severe adverse outcomes and implications of the overall pandemic, and critique the current status of and identify needs for epidemiologic studies for the next phase of the pandemic. Case series show that 30-40% of people with COVID-19-related hospitalization, severe morbidity requiring intensive care, and/or death have type 2 or type 1 diabetes. Among hospitalized individuals with diabetes, 21-43% required intensive care and case fatality is 25%. Risk of severe morbidity and mortality is 100-250% higher among people with diabetes than those without, even after adjustment for sociodemographic factors and comorbid conditions. Impact on the general population with diabetes has been similarly dire, as overall mortality rates were 50% higher than historical trends, a net increase more than twice that of the general population. Of the excess deaths, 75-80% are not officially attributed to COVID-19, which raises unanswered questions about missed attribution or collateral impact. Many predictors of poor outcomes have been identified, particularly comorbid conditions (chronic kidney disease, coronary heart disease, and heart failure), concurrent obesity, and acute and chronic poor HbA 1c control, that point to the potential to reduce severe morbidity and mortality in its next stages. However, response to the continuing pandemic will benefit from population-wide studies with broader examination of the risks of exposure, infection, and hospitalization, for which few data currently exist. The indirect impact of the pandemic's effects on health services, health behaviors, disease management, care, control, and complications has not been well quantified; determining this impact will be essential to lessen the future impact. Expanding epidemiologic studies of the relationship of diabetes to COVID-19 beyond few high-income countries will also be essential to limit the burden in low-and middle-income countries where 80% of individuals with diabetes reside and where the COVID-19 pandemic has been so damaging.Barely 1 month following the first reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 ) clusters, diabetes was already identified as an associated factor and key predictor of poor outcomes (1,2). As case series expanded beyond China and were gradually complemented by larger cohorts, the evidence for a central role of diabetes in the COVID-19 epidemic only strengthened, and numerous etiologic links were identified. The potential pathways, including disruption of glucose metabolism, immune

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Indirect impact of the COVID-19 pandemic on hospitalisations for cardiometabolic conditions and their management: A systematic review

Cited by 31 publications

References 25 publications

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey

The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care

Diabetes and COVID-19: Population Impact 18 Months Into the Pandemic

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