Impact of the COVID-19 Pandemic on In-Patient Treatment of Peripheral Artery Disease in Germany during the First Pandemic Wave

Abstract

Patients with peripheral artery disease (PAD) belong to a vulnerable population with relevant comorbidity. Appropriate care and timely treatment are imperative, but not readily assured in the current pandemic. What impact did the first wave have on in-hospital treatment in Germany? Nationwide healthcare remuneration data for inpatient care of the years 2019 and 2020 were used to compare demographic baseline data including the assessment of comorbidity (van Walraven score), as well as the encoded treatments. A direct comparison was made between the first wave of infections in 2020 and the reference period in 2019. The number of inpatient admissions decreased by 10.9%, with a relative increase in hospitalizations due to PAD Fontaine IV (+13.6%). Baseline demographics and comorbidity showed no relevant differences. The proportion of emergency admissions increased from 23.4% to 28.3% during the first wave to the reference period in 2019, and in-hospital mortality increased by 21.9% from 2.5% to 3.1%. Minor and major amputations increased by 24.5% and 18.5%. Endovascular and combined surgical/endovascular treatment strategies increased for all stages. Already in the first, comparatively mild wave of the pandemic, significantly fewer patients with predominantly higher-grade PAD stages were treated as inpatients. Consecutively, in-hospital mortality and amputation rates increased.

Nationwide Trends and the Influence of Age and Gender in the In-Patient Care of Patients with Hepatocellular Carcinoma in Germany between 2010 and 2020

“…This finding might be explained by the above-mentioned reallocation of in-hospital capacities with corresponding reduction in surgical capacities and thus an increase in transarterial treatments. Additionally, the number of admissions without liver-directed treatments decreased, potentially reflecting a more focused admission of patients that required treatment as was also observed in other diseases such as peripheral artery disease [53].…”

Inpatient treatment of acute diverticulitis between 2010 and 2021 – A German nationwide study about long‐term trends and effects of the SARS‐CoV‐2 pandemic

“…To flatten the curve of infections, the German Ministry of Health introduced lockdown measures and social distancing in March 2020. In previous studies, a decline was reported in hospitalization of patients with acute medical conditions (e.g., ischaemic stroke or vascular diseases) during the periods of lockdown and socual distancing in 2020 and 2021 [7–11].…”