Reduction in heart failure hospitalization rate during coronavirus disease 19 pandemic outbreak

Severino, Paolo; D’Amato, Andrea; Saglietto, Andrea; D’Ascenzo, Fabrizio; Marini, Claudia; Schiavone, Marco; Ghionzoli, Nicolò; Pirrotta, Filippo; Troiano, Francesca; Cannillo, Margherita; Mennuni, Marco; Rognoni, Andrea; Rametta, Francesco; Galluzzo, Alessandro; Agnes, Gianluca; Infusino, Fabio; Pucci, Mariateresa; Lavalle, Carlo; Cacciotti, Luca; Mather, Paul; Marra, Walter Grosso; Ugo, Fabrizio; Forleo, Giovanni B.; Viecca, Maurizio; Morici, Nuccia; Patti, Giuseppe; Ferrari, Gaetano Maria De; Palazzuoli, Alberto; Mancone, Massimo; Fedele, Francesco

doi:10.1002/ehf2.13043

Cited by 34 publications

(47 citation statements)

References 22 publications

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“…In this study we extended the time frame of observation reporting the data of the first trimester 2020 from a different region of Italy, i.e., the Tuscany, and we demonstrated that a low rate of contacts to EMS during this pandemic was observed also in regions of Italy less affected by the pandemic. We found that the reduction in admission was observed also for patients with heart failure, with a delta of −56% for the last period of observation in comparison with 2018 and 2019 (p < 0.0001), in agreement with data reported by Severino et al and demonstrating a reduction of admission during the lockdown (13). These findings suggest that the ubiquitous presence of COVID-19 news on the mass media and social media and the lack of verified information have contributed to the perception of unsafe hospitals, even if hospital were not overwhelmed by the COVID-19 emergency, as in Tuscany, and an underestimation of mortality and morbidity risks due to cardiac conditions.…”

Section: Discussionsupporting

confidence: 92%

Reduction of Emergency Calls and Hospitalizations for Cardiac Causes: Effects of Covid-19 Pandemic and Lockdown in Tuscany Region

D’Ascenzi

Cameli

Forni

et al. 2021

Front. Cardiovasc. Med.

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Introduction: Containment measures were established to flatten the curve of COVID-19 contagion in order to avoid a crash of the healthcare system. However, these measures influenced the rate of hospitalization of cardiac patients. In this study, we aimed to analyse the impact of COVID-19 and the effects of lockdown measures on hospital admissions and alerts of emergency medical system (EMS) for cardiac causes in the Tuscany region.Methods: An observational, retrospective analysis from Italian Tuscany region was conducted. We evaluated consecutive patients contacting EMS or admitted to the 39 Emergency Departments (EDs) in Tuscany for cardiac causes in the first trimester of 2020. Data were compared with the same period in 2018/19.Results: The alerts of EMS for cardiac causes significantly decrease in 2020 and the highest difference between 2018/19 and 2020 was found immediately after national lockdown (Δ = −47.4%, p < 0.001). The number of admissions for chest pain in the EDs also decreased, with a maximum difference of −67.6% (p < 0.001) vs. 2018/19. The number of hospital accesses for acute coronary syndromes, atrial fibrillation, and heart failure in the EDs significantly decreased in 2020 as compared to 2018/19 (maximum Δ = −58.9%, p < 0.001; maximum Δ = −63.0%, p < 0.001; maximum Δ = −72.7%, p < 0.001, respectively).Conclusions: A significant decrease in the contacts to EMS for cardiac causes and in cardiac diagnoses was observed during the first trimester of 2020. Fear of contagion has likely played a relevant role. The lesson learnt from first wave of COVID-19 pandemic suggests that appropriate public information strategies and re-education of people are essential.

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Section: Discussionsupporting

confidence: 92%

Reduction of Emergency Calls and Hospitalizations for Cardiac Causes: Effects of Covid-19 Pandemic and Lockdown in Tuscany Region

D’Ascenzi

Cameli

Forni

et al. 2021

Front. Cardiovasc. Med.

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“…Perhaps more interesting is the current data suggesting a trend towards reduced hospital admissions for diagnoses other than COVID-19, including other cardiac conditions such as ACS and new-onset atrial fibrillation [3,5]. Early studies from Europe and the UK have described reductions in HF admission and readmissions during the COVID-19 pandemic [3,8,[12][13][14][15]. Currently, robust prospective and retrospective data regarding the impact of the COVID-19 pandemic on HF admission in the USA remain limited.…”

Section: Discussionmentioning

confidence: 99%

“…During the pandemic, the primary focus of many hospitals shifted, out of necessity, from a wide breadth of medical care to treating the morbidity and mortality of COVID-19 patients, with multiple studies demonstrating this phenomenon with decreased inpatient admissions for non-COVID-19-related problems, including asthma, atrial fibrillation, acute Coronary Syndrome (ACS), and influenza [3][4][5][6][7]. The COVID-19 pandemic has been shown to similarly impact hospital admissions for heart failure (HF), with the most robust data originating from major tertiary centers in Europe and the UK [7,8]. Data on the COVID-19 pandemic's impact on US HF admissions remains Savalan Babapoor-Farrokhran and Jafar Alzubi contributed equally to this work.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on Heart Failure Hospitalizations

Babapoor-Farrokhran

Alzubi

Port

et al. 2021

SN Compr. Clin. Med.

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The Novel Coronavirus Disease 2019 (COVID-19) pandemic has transformed individual lives and societal framework on a global scale, and in no other sector is this more evident than healthcare. Herein, we aim to describe the impact of the current COVID-19 pandemic and its associated restrictions on heart failure (HF) admissions. In this retrospective cohort study, we obtained administrative data for patients with a primary discharge diagnosis of HF (identified by ICD-10 code) with discharge dates ranging from January 2019 to November 2020. The study is comprised of 2 distinct sub-cohorts: HF admissions during the COVID-19 pandemic (case) period from March 2020 to October 2020 and corresponding control period during the previous year (March 2019 to December 2019). Primary outcome analysis involved comparison of total and daily HF admissions and secondary outcomes included hospital Length of Stay (LOS) and 30-day readmissions. The number of total HF admissions and average daily admissions were significantly lower in 2020 compared to 2019 (774 vs. 864; p < 0.001 and 3.17 vs. 3.53 days; p < 0.001), respectively. Average length of stay was significantly higher between March and October 2020 relative to the same months in 2019 (6.05 vs. 5.25 days; p < 0.001). Thirty-day readmission rates were also significantly higher in March-October 2020 compared to the same months in 2019 (20.6% vs. 19.1%; p < 0.001). During the pandemic, both readmission rates and length of stay for HF-related admissions were significantly impacted. The COVID-19 pandemic significantly impacted HF-related admissions as well as associated LOS and 30-day readmissions. High-risk patients should be identified carefully, and timely and appropriate treatment should be provided.

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“…Meanwhile, epidemiological findings from countries with low COVID-19 incidence during the first wave of the pandemic, including Greece, were comparable [ 4 ]. During this same period, in Norway, a 29% reduction in the weekly number of admissions for stroke and 41% for transient ischemic attack during the 1st 7 weeks of the pandemic lockdown were observed [ 5 ], while admissions for heart failure in Italy were reduced by 70% [ 6 ]. In the USA alone, there was an overall 42.8% reduction in admissions, varying from 23.7% for pancreatitis to 68.6% for chronic obstructive pulmonary disease (COPD)/asthma [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Reduction in Hospitalizations for Respiratory Diseases during the First COVID-19 Wave in Greece

et al. 2021

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Introduction: During the first COVID-19 wave, a considerable decline in hospital admissions was observed worldwide. Aim: This retrospective cohort study aimed to assess if there were any changes in the number of patients hospitalized for respiratory diseases in Greece during the first COVID-19 wave. Methods: In the present study, we evaluated respiratory disease hospitalization rates across 9 tertiary hospitals in Greece during the study period (March–April 2020) and the corresponding period of the 2 previous years (2018–2019) that served as the control periods. Demographic data and discharge diagnosis were documented for every patient. Results: Of the 1,307 patients who were hospitalized during the study period, 444 (35.5%) were males with a mean (±SD) age of 66.1 ± 16.6 years. There was a 47 and 46% reduction in all-cause respiratory morbidity compared to the corresponding periods of 2018 and 2019, respectively. The mean incidence rate for respiratory diseases during the study period was 21.4 admissions per day, and this rate was significantly lower than the rate during the same period in 2018 (40.8 admissions per day; incidence rate ratio [IRR], 0.525; 95% confidence interval [CI], 0.491–0.562; p < 0.001) or the rate during 2019 (39.9 admissions per day; IRR, 0.537; 95% CI, 0.502–0.574; p < 0.001). The greatest reductions (%) in the number of daily admissions in 2020 were observed for sleep apnoea (87% vs. 2018 and 84% vs. 2019) followed by admissions for asthma (76% vs. 2018 and 79% vs. 2019) and chronic obstructive pulmonary disease (60% vs. 2018 and 51% vs. 2019), while the lowest reductions were detected in hospitalizations for pulmonary embolism (6% vs. 2018 and 23% vs. 2019) followed by tuberculosis (25% vs. both 2018 and 2019). Discussion/Conclusion: The significant reduction in respiratory admissions in 2020 raises the reasonable question of whether some patients may have avoided seeking medical attention during the COVID-19 pandemic and suggests an urgent need for transformation of healthcare systems during the pandemic to offer appropriate management of respiratory diseases other than COVID-19.

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Reduction in heart failure hospitalization rate during coronavirus disease 19 pandemic outbreak

Cited by 34 publications

References 22 publications

Reduction of Emergency Calls and Hospitalizations for Cardiac Causes: Effects of Covid-19 Pandemic and Lockdown in Tuscany Region

Reduction of Emergency Calls and Hospitalizations for Cardiac Causes: Effects of Covid-19 Pandemic and Lockdown in Tuscany Region

Impact of COVID-19 on Heart Failure Hospitalizations

Reduction in Hospitalizations for Respiratory Diseases during the First COVID-19 Wave in Greece

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