Impact of hard lockdown on interventional cardiology procedures in congenital heart disease: a survey on behalf of the Italian Society of Congenital Heart Disease

Abstract

The Coronavirus disease 2019 (COVID-19) pandemic has thoroughly and deeply affected the provision of healthcare services worldwide. In order to limit the in-hospital infections and to redistribute the healthcare professionals, cardiac percutaneous intervention in Pediatric and Adult Congenital Heart Disease (ACHD) patients were limited to urgent or emergency ones. The aim of this article is to describe the impact of the COVID-19 pandemic on Pediatric and ACHD cath laboratory activity during the so-called ‘hard lockdown’ in Italy. Eleven out of 12 Italian institutions with a dedicated Invasive Cardiology Unit in Congenital Heart Disease actively participated in the survey. The interventional cardiology activity was reduced by more than 50% in 6 out of 11 centers. Adolescent and ACHD patients suffered the highest rate of reduction. There was an evident discrepancy in the management of the hard lockdown, irrespective of the number of COVID-19 positive cases registered, with a higher reduction in Southern Italy compared with the most affected regions (Lombardy, Piedmont, Veneto and Emilia Romagna). Although the pandemic was brilliantly addressed in most cases, we recognize the necessity for planning new, and hopefully homogeneous, strategies in order to be prepared for an upcoming new outbreak.

A global analysis of implants and replacements of pacemakers and cardioverter-defibrillators before, during, and after the COVID-19 pandemic in Italy

“…For ICDs, a slow but statistically significant (p < 0.01) increase in procedure rates was observed from 2012 (20,774, 350/million) to 2019 (24,153, 403/million); afterward, there was a small reduction in 2020 (22,355, 375/ million, − 7% towards 2019). In 2021, the rate of ICD procedures (25,384, 429/million) increased to values higher than those observed before the pandemic (+ 14% compared to 2020) (Fig. 1).…”

Coronavirus disease 2019 and cardiovascular disease: what we have learnt during the last 2 years

“…A ‘Hubs and Spokes’ system was adopted, with only Hub hospitals that performed urgent and nondeferrable interventional procedures with COVID-free pathways, and Spokes that were turned into COVID-19 centers and referred all emergent cases to Hubs. Elective procedures were postponed with a significant decrease in cardiac surgeries 2,7–9 . Transthoracic or transesophageal echocardiography and stress echocardiography were also avoided if not necessary 1 …”

“…Elective procedures were postponed with a significant decrease in cardiac surgeries. 2,[7][8][9] Transthoracic or transesophageal echocardiography and stress echocardiography were also avoided if not necessary. 1 Several reports showed a significant impact of the COVID-19 pandemic on the prevalence, clinical presentation and outcomes of patients hospitalized for an acute CV disease, namely acute coronary syndrome.…”

Echocardiographic screening in pediatric asymptomatic or paucisymptomatic coronavirus disease 2019 outpatients: is it a useful test or an excess of zeal?

“…Coronavirus disease 2019 (COVID- 19) is an infectious disease caused by SARS-CoV-2, and it quickly became a pandemic, 1 challenging healthcare systems [2][3][4] and affecting the lives of billions of people worldwide. From 31 December 2019, when a cluster of pneumonia with unknown cause was first reported in Wuhan City (https://www.…”

“…Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2, and it quickly became a pandemic, 1 challenging healthcare systems 2 – 4 and affecting the lives of billions of people worldwide. From 31 December 2019, when a cluster of pneumonia with unknown cause was first reported in Wuhan City ( https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/ ), 5 to 31 December 2022, in Italy, almost 25 million cases had been confirmed and ∼180 000 patients have died ( https://coronavirus.jhu.edu/region/italy ).…”