The Impact of COVID-19 Pandemic on Hospitalization and Interventional Procedures for Cardiovascular Diseases during the First Wave in Italy

Russo, Vincenzo; Cante, Luigi Colucci; Imbalzano, Egidio; Micco, Pierpaolo Di; Bottino, Roberta; Carbone, Andreina; D’Andrea, Antonello

doi:10.3390/ijerph20010472

Cited by 4 publications

(2 citation statements)

References 42 publications

(73 reference statements)

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“…While most previous studies compared the COVID-19 period to a prior short period close to the outbreak [6], this study described the incidence of cardiovascular diagnoses and procedures as part of a trend throughout a whole decade. The previous studies that compared the COVID-19 period with a long pre-pandemic period have been mostly limited to a single outcome [34] or a small sample size [17,34] or were based on information that was documented during hospitalizations without considering community clinic records [8,16]. Looking at a whole decade, this study enables health professionals to estimate the consequences of the pandemic on cardiovascular outcomes more accurately and, to a large extent, to rule out the influence of secular trends or random changes.…”

Section: Discussionmentioning

confidence: 99%

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Trends in the Incidence of Cardiovascular Diagnoses and Procedures over the Years 2012–2021 in Israel: The Impact of the COVID-19 Pandemic

Reges,

Abu Ahmad,

Battat

et al. 2024

JCM

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Prior studies found reduced incidences of cardiovascular diagnoses and treatments in the initial phase of the COVID-19 pandemic. However, these studies included a limited number of outcomes and did not consider pre-pandemic trends. This study aimed to describe trends in the incidence of cardiovascular diagnoses and treatments over the years 2012–2021 in Israel and to compare the two years of the COVID-19 period with the preceding 8 years. In this retrospective, population-based study, carried out within Clalit Health Services, the incidence rates of cardiovascular outcomes were calculated for individuals aged ≥ 25 (~2.7 million adults per year) during the first (Y1, 3/2020–2/2021) and second (Y2, 3/2021–2/2022) years of COVID-19 and the 8 years prior (3/2012–2/2020). Declines were observed in Y1 compared to 2019 in all diagnoses and treatments: STEMI (−16.3%; 95% CI: −16.6, −16.1), non-STEMI (−16.4%; −16.6, −16.2), AF (−14.1%; −14.2, −14.0), CHF (−7.8%; −7.9, −7.7), CVA (−5.0%; −5.0, −4.9), catheterization (−64.7%; −65.2, −64.2), CABG (−77.7%; −79.2, −76.2), ablation (−21.2%; −22.0, −20.4), pacemaker implantation (−39.3%; −40.7, −37.9), and defibrillator insertion (−12.5%; −13.1, −12.0). Compared with expected rates based on pre-pandemic trends, observed rates were within expected ranges (CHF, CVA, and ablation), less than expected (STEMI, non-STEMI, AF, catheterization, CABG, and pacemaker insertion), or more than expected (defibrillator insertion). In Y2, STEMI, catheterization, and CABG returned to expected rates; non-STEMI and AF were lower than expected; and CHF, CVA, ablation, and pacemaker and defibrillator implantations were higher than expected. Several cardiovascular diagnoses and treatment trends were interrupted by COVID-19. The long-term consequences of these changes should be considered by health policymakers.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies on the cardiovascular sequelae of the COVID-19 pandemic mostly reported decreases in cardiovascular diagnoses and medical procedures in the initial phase of the pandemic [6][7][8][9][10]. Different trends were observed as the pandemic proceeded [11].…”

Section: Introductionmentioning

confidence: 99%

Trends in the Incidence of Cardiovascular Diagnoses and Procedures over the Years 2012–2021 in Israel: The Impact of the COVID-19 Pandemic

Reges,

Abu Ahmad,

Battat

et al. 2024

JCM

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Impact of the COVID-19 Pandemic on Healthcare Utilization among Medically Underserved Patients with Ambulatory Care Sensitive Conditions

Chumbler,

Ogunsanmi,

Surbhi

2024

Health Services Research and Managerial Epidemiology

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Introduction This study aims to examine (1) the impact of the pandemic phases on overall and preventable hospitalizations and emergency department (ED) visits, and (2) the effect of the pandemic on these outcomes within subgroup populations including gender, race, patients’ residence in health professional shortage areas (HPSA), and residence in a federal poverty level. Study Design We used electronic medical record (EMR) data for the year 2019 and 2020 from a large health system predominantly serving medically underserved patients in the South. We used a difference-in-differences approach to examine changes in weekly rates of overall and preventable hospitalizations and ED visits in the pandemic phase 1 (Mid-March to June of 2020) and phase 2 (July-September of 2020) compared to the same period in 2019 after adjusting for weekly outcome rates in the baseline period (January to Mid-March of 2020) compared to the same period in 2019. Results The study sample included 1.4 million hospitalizations and ED encounters. In phase 1 of the pandemic, there were significant reductions in overall (−108) and preventable (−75.3) hospitalizations, and overall (−408) and preventable (−306) ED visits when compared to the same period in 2019. In phase 2 of the pandemic, there were significant reductions in overall (−60) and preventable (−43) hospitalizations and in overall (−360) and preventable (−258) ED visits as compared to 2019. We found greater reductions in ED visits, both overall and preventable, during the early pandemic phases among Black patients than among White patients. Similar patterns in the reduction of ED visits were found in Black versus White patients within subgroups of women, men, and those residing in a HPSA and low-income areas. Discussion Substantial reductions in utilization were observed in Black patients in comparison to white patients and these differences persisted among men, women, and those living in underserved and low-income areas.

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Clinical particulars of acute coronary syndrome course in patients with COVID-19

Izmozherova,

Popov,

Tsvetkov

et al. 2023

Almanac of Clinical Medicine

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Background: Cardiovascular complications of COVID-19 result in challenges for differential diagnosis, patients referral and treatment, which negatively affect the outcomes. Aim: To identify clinical particulars of various types acute coronary syndrome course in patients with COVID-19. Materials and methods: This retrospective cross-sectional study included 202 patients with COVID-19 and acute coronary syndrome (ACS) admitted to a primary vascular medicine center from September to December 2020. Their medical records were used for the analysis of ACS and COVID-19 clinical course, including physical and history data, laboratory and instrumental work-up. For the analysis, the patient sampling was divided into three study groups: 50 patients with unstable angina (UA), 107 patients with acute myocardial infarction with ST segment elevation (STEMI), and 45 patients with acute myocardial infarction without ST segment elevation (non-STEMI). Results: There were no differences in clinical manifestations of ACS in the study groups. As far as clinical manifestations of coronavirus infections are concerned, the patients differed significantly as per prevalence of fever and dry cough. Fever was present in 22 (44%) UA patients, 18 (17%) of STEMI patients and in 10 (22%) of non-STEMI patients (p 0.001 for comparison of 3 groups, Kruskall-Wallis test), whereas dry cough was present in 18 (36%), 19 (18%), and 14 (31%) patients, respectively (p = 0.029). Paired comparison (Mann-Whitney test with Bonferroni adjustment) showed significant differences between US and STEMI groups for both symptoms. The number of involved vessels (median [25%; 75%]) in UA patients was 0 [0; 2], in STEMI and non-STEMI patients 2 [1; 3] (p 0.001). A left coronary artery stenosis was detected in 2 (6%) of the UA patients, 13 (14%) of the STEMI and 4 (13%) of the non-STEMI patients (p = 0.452); left anterior descending artery stenosis, in 12 (36%), 67 (72%) and 23 (72%) patients, respectively (p 0.001). In the pairwise comparison, there were differences between UA and STEMI groups and between UA and non-STEMI groups. A left circumflex artery stenosis was found in 7 (21%) of the UA patients, 45 (48%) of the STEMI and 18 (56%) of the non-STEMI patients (p = 0.008); the pairwise comparisons showed the difference between UA and non-STEMI study groups. A right coronary artery stenosis was identified in 9 (27%), 64 (69%) and 18 (56%) of the study patients, respectively (p 0.001); in the pairwise comparison the difference was found between the UA and STEMI group. There were significant differences in the percentage of the right descendent and right coronary artery stenosis: the right descending artery stenosis was 70% [45; 80] in the UA patients, 90% [70; 100] in the STEMI and 95% [70; 100] in the non-STEMI patients (p = 0.013), whereas the right coronary artery stenosis was 50% [45; 80], 90% [70; 100], 90% [60; 100], respectively (p = 0.018). In the pairwise comparison, the differences were found between the UA and STEMI patients in both arteries. The STEMI patients had higher TIMI thrombus grade scores than those with non-STEMI: 3 [0; 5] vs 0 [0; 4] (p = 0.023). The rates of successful percutaneous coronary intervention and achievement of TIMI flow grade 3 between them was not significantly different (p = 0.170). Conclusion: The ACS patients with ACS and COVID-19 have high thrombotic load according to coronary angiography and TIMI score in the case of STEMI and more frequent absence of hemodynamically significant stenosis in those with UA and non-STEMI. The absence of any difference in clinical manifestations of ACS and viral infection between the study groups (except fever and dry cough difference between the UA and STEMI patients) indicates that specific characteristics of the ACS course in COVID-19 patients can be identified only by coronaroangiography.

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The Impact of COVID-19 Pandemic on Hospitalization and Interventional Procedures for Cardiovascular Diseases during the First Wave in Italy

Cited by 4 publications

References 42 publications

Trends in the Incidence of Cardiovascular Diagnoses and Procedures over the Years 2012–2021 in Israel: The Impact of the COVID-19 Pandemic

Trends in the Incidence of Cardiovascular Diagnoses and Procedures over the Years 2012–2021 in Israel: The Impact of the COVID-19 Pandemic

Impact of the COVID-19 Pandemic on Healthcare Utilization among Medically Underserved Patients with Ambulatory Care Sensitive Conditions

Clinical particulars of acute coronary syndrome course in patients with COVID-19

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