Cardiac operations and interventions during the COVID-19 pandemic: a nationwide perspective

Abstract

Aims The COVID-19 pandemic has led to a decline in hospitalizations for non-COVID-19-related conditions. We explored the impact of the COVID-19 pandemic on cardiac operations and interventions undertaken in England. Methods and results An administrative database covering hospital activity for England, the Health Episodes Statistics, was used to assess a total of 286 697 hospitalizations for cardiac operations and interventions, as well as 227 257 hospitalizations for myocardial infarction (MI) and 453 799 for heart failure (HF) from 7 January 2019 to 26 July 2020. Over the 3 months of ‘lockdown’, total numbers and mean reductions in weekly rates [n (−%)], compared with the same time period in 2019, were: coronary artery bypass grafting [−2507 (−64%)]; percutaneous coronary intervention [−5245 (−28%)]; surgical [−1324 (−41%)] and transcatheter [−284 (−21%)] aortic valve replacement; mitral valve replacement; implantation of pacemakers [−6450 (−44%)], cardiac resynchronization therapy with [−356 (−42%)] or without [−491 (−46%)] defibrillation devices, and implantable cardioverter-defibrillators [−501 (−45%)]; atrial fibrillation ablation [−1902 (−83%)], and other ablations [−1712 (−64%)] (all P < 0.001). Over this period, there were 21 038 fewer procedures than in the reference period in 2019 (P < 0.001). These changes paralleled reductions in hospitalizations for MI [−10 794 (−27%)] and HF [−63 058 (−28%)] (both P < 0.001). Conclusions The COVID-19 pandemic has led to substantial reductions in the number of cardiac operations and interventions undertaken. An alternative strategy for healthcare delivery to patients with cardiac conditions during the COVID-19 pandemic is urgently needed.

Heart failure quality of care and in‐hospital outcomes during the COVID‐19 pandemic: findings from the Get With The Guidelines‐Heart Failure registry

“…First, blood pressure control at discharge was worse during the pandemic period. Second, the present study also observed significant declines in prescription or placement of ICD at discharge, which is consistent with reports from Italy 19 and the UK 20 in patients with HF during the pandemic. This also mimics the overall decrease in elective procedures noted during the early phase of the pandemic due to concern for care team exposure to patients during lengthy procedures, lack of pre‐procedural COVID‐19 testing capabilities, and state‐wide or institution‐wide mandates to limit elective or semi‐elective procedures to preserve hospital resources.…”

One year of the COVID-19 pandemic in Poland–the incidence of osteoporotic forearm, arm, and hip fractures

“…The COVID-19 pandemic has had a marked impact on societies around the world. Patients did not arrive at hospitals or call ambulance services even for cardiological or surgical reasons [8,9]. That situation affects both adults and children [8][9][10][11].…”

“…Patients did not arrive at hospitals or call ambulance services even for cardiological or surgical reasons [8,9]. That situation affects both adults and children [8][9][10][11]. These circumstances refer also to patients after a fall from a standing position [10].…”

A case series of myocardial infarction in SARS‐CoV‐2‐infected patients: Same complication, different outcomes

“…However, according to the evidences, the impact of COVID-19 on acute MI care seems to be the core reason. There are also other studies from other countries indicating the same dropped admission rate, 19,32,33 which emphasizes on the fact that this issue must be taken seriously as a global concern. We are also facing an increasing number of case reports of late presentations of MI such as ventricular septal defects, myocardial ruptures, and ventricular pseudo-aneurisms pointing out to unfortunate sequalae of such delays.…”