Aims The coronavirus disease‐2019 (COVID‐19) pandemic has changed the landscape of medical care delivery worldwide. We aimed to assess the influence of COVID‐19 pandemic on hospital admissions and in‐hospital mortality rate in patients with acute heart failure (AHF) in a retrospective, multicentre study. Methods and results From 1 January 2019 to 31 December 2020, a total of 101 433 patients were hospitalized in 24 Cardiology Departments in Poland. The number of patients admitted due to AHF decreased by 23.4% from 9853 in 2019 to 7546 in 2020 ( P < 0.001). We noted a significant reduction of self‐referrals in the times of COVID‐19 pandemic accounting 27.8% ( P < 0.001), with increased number of AHF patients brought by an ambulance by 15.9% ( P < 0.001). The length of hospital stay was overall similar (7.7 ± 2.8 vs. 8.2 ± 3.7 days; P = not significant). The in‐hospital all‐cause mortality in AHF patients was 444 (5.2%) in 2019 vs. 406 (6.5%) in 2020 ( P < 0.001). A total number of AHF patients with concomitant COVID‐19 was 239 (3.2% of AHF patients hospitalized in 2020). The rate of in‐hospital deaths in AHF patients with COVID‐19 was extremely high accounting 31.4%, reaching up to 44.1% in the peak of the pandemic in November 2020. Conclusions Our study indicates that the COVID‐19 pandemic led to (i) reduced hospital admissions for AHF; (ii) decreased number of self‐referred AHF patients and increased number of AHF patients brought by an ambulance; and (iii) increased in‐hospital mortality for AHF with very high mortality rate for concomitant AHF and COVID‐19.

Hypocalcemia is an independent predictive factor for LV diastolic dysfunction in patients with CKD.

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Background: The COVID-19 pandemic affected the functioning of healthcare systems (HSs) in a way that was difficult to foresee earlier. It quickened the introduction of e-medicine, and changed the manner and number of services provided in the open medical setting. Aim: To assess variations in the consultation rate of patients in primary healthcare centers (PHCs) in consecutive months of the pandemic. Method: Data collected from two PHCs located in Olsztyn (Poland) were analyzed retrospectively. Collectively, these two centers provide care for approximately 20,000 inhabitants and perform approximately 100,000 medical services annually. The analysis was based on data covering the period April–July of the years 2010–2020, consisting in total of 337,510 medical services records. Results: A large, statistically significant decrease in the consultation rate (consultation rate understood as the number of individuals seeking consultation in relation to the number of people under care in a given time period) was revealed in each age group in the initial phase of the pandemic. In consecutive months, the approximated consultation rate achieved mean long-term values. Conclusions. The largest reduction in the consultation rate was revealed in the youngest age group, with the smallest occurring in the oldest. In the group of patients older than 65 years of age, the consultation rate after 3 months of the pandemic was the same as before the outbreak. Variations in the consultation rate were independent of the epidemiological situation. During the study, we observed an increased level of the administrative and paperwork activities carried out by PHC physicians.

Background. It has been reported that elevated serum uric acid (UA) levels is an independent factor of poor prognosis in patients with chronic heart failure and chronic kidney disease (CKD). Objectives. In our study, we assessed the potential impact of hyperuricemia on left ventricular (LV) diastolic dysfunction (DD) in patient with CKD. Material and Methods. The study group consisted of 50 patients with CKD, stages 2-5. Standard echocardiography and tissue Doppler imaging (TDI) were performed. The levels of UA and N-terminal prohormone brain natriuretic peptide (NT-proBNP) were determined. Patients were divided into two groups according to the results of peak mitral annular early diastolic velocity (EmLV): group with LV diastolic dysfunction (EmLV < 8 cm/s) DD (+) and group with normal LV diastolic function DD (-), when EmLV ≥ 8 cm/s. Results. Patients DD (+) group, as compared to DD (-) patients were characterized by significantly higher serum UA levels [6.7 (4.4-14.3) mg/dL vs 5.8 (1.9-8.9) mg/dL, p = 0.004] respectively. The area under the receiver operating characteristic (ROC) curve was of serum UA levels for the detection of LV diastolic dysfunction was 0.734, 95% confidence interval (CI) 0.590-0.849, p = 0.001, whereas ROC derived UA value of > 6.0 mg/dL was characterized by a sensitivity of 76.9% and specificity of 62.5% for diagnosing LV diastolic dysfunction. The independent variable predicting LV diastolic dysfunction as measured by a multivariate logistic regression analysis was UA level > 6.0 mg/dL with odds ratio (OR) = 14.3 (95% CI 2.0-103.2), p = 0.006. Conclusions. Hyperuricemia is an independent predictive factor for LV diastolic dysfunction in patients with CKD (Adv Clin Exp Med 2015, 24, 1, 47-54).