¿Qué hemos dejado de atender por la COVID-19? Diagnósticos perdidos y seguimientos demorados. Informe SESPAS 2022

Cura-González, Isabel del; Polentinos-Castro, Elena; Fontán-Vela, Mario; López-Rodríguez, Juan A.; Fernández, Jesús Martín

doi:10.1016/j.gaceta.2022.03.003

Cited by 20 publications

(19 citation statements)

References 35 publications

(36 reference statements)

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“…However, few studies have analysed such prolonged periods as the one presented in this study. For instance, an observational study conducted in Madrid (Spain) found that some of the chronic diseases analysed had returned to expected incidence rates, but without compensation [18]. However, the study period only comprised data spanning as far as mid-2021, while some diagnosis compensation found in our study started at the end of 2021.…”

Section: Discussionmentioning

confidence: 67%

“…3 Percentage of difference between observed and expected chronic diagnoses during the pandemic period in Catalonia. Total and by age groups, sex and socioeconomic status increase respiratory transmission, such as spirometry [3,18]. Further research should be performed to confirm these findings and to identify possible explanations; and appropriate actions should be taken to revert this situation.…”

Section: Discussionmentioning

confidence: 94%

“…Although reductions of chronic disease diagnoses have been well described [7,9], the majority of the studies are focussed on trends from 2020 and early 2021, which raises doubts about the long-term impact of the pandemic in chronic disease diagnoses and its evolution thereafter. For instance, a study performed in Madrid (Spain) observed that, after huge declines of several longterm conditions diagnosed in primary care in 2020, a recovery on the number of diagnoses was observed during 2021 for some diseases, while others remained missing [18]. In this way, a previous study of our research group showed that the number of cancer diagnoses performed in primary care had returned to pre-pandemic levels by the end of 2021, although this did not compensate for the drops in 2020 and, therefore, missing diagnoses during the two previous years were not fully recovered [19].…”

Section: Introductionmentioning

confidence: 99%

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“Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years: an observational retrospective population-based study using primary care electronic health records”

et al. 2023

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Background The incidence of chronic diseases during the COVID-19 pandemic has drastically been reduced worldwide due to disruptions in healthcare systems. The aim of our study is to analyse the trends in the incidence of 7 commonly managed primary care chronic diseases during the last 2 years of the COVID-19 pandemic in Catalonia. Methods We performed an observational retrospective population-based study using data from primary care electronic health records from January 2018 to August 2022 (5.1 million people older than 14 years). We divided the study period into two: a pre-pandemic period (before 14 March 2020) and a pandemic period. We performed a segmented regression analysis of daily incidence rates per 100,000 inhabitants of 7 chronic diseases: type 2 diabetes mellitus (T2DM), asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD), heart failure (HF), hypertension and hypercholesterolemia. In addition, we compared annual incidence between pandemic years (2020, 2021 and 2022) and 2019. Associated incidence rate ratios (IRR) were also calculated. Finally, we estimated the number of expected diagnoses during the pandemic period using data from 2019 and we compared it with the observed data. Results We analysed 740,820 new chronic diseases’ diagnoses. Daily incidence rates of all 7 chronic diseases were drastically interrupted on 14 March 2020, and a general upward trend was observed during the following months. Reductions in 2020 were around 30% for all conditions except COPD which had greater reductions (IRR: 0.58 [95% CI: 0.57 to 0.6]) and HF with lesser drops (IRR: 0.86 [95% CI: 0.84 to 0.88]). Some of the chronic conditions have returned to pre-pandemic diagnosis levels, except asthma, COPD and IHD. The return to pre-pandemic diagnosis levels compensated for the drops in 2020 for T2DM and HF, but not for hypertension which presented an incomplete recovery. We also observed an excess of hypercholesterolemia diagnoses of 8.5% (95%CI: 1.81% to 16.15%). Conclusions Although primary care has recovered the pre-pandemic diagnosis levels for some chronic diseases, there are still missing diagnoses of asthma, COPD and IHD that should be addressed.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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“Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years: an observational retrospective population-based study using primary care electronic health records”

et al. 2023

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“…Thus, there was not an exacerbated decrease in new urgent diagnoses such as strokes and heart attacks, etc. [15,39].…”

Section: Discussionmentioning

confidence: 99%

“…In diseases such as hypertension and COPD, the diagnosis rate decreased by 50% compared to the previous year. In the case of diabetes mellitus, heart failure, cancer and strokes, it decreased by approximately 10-15% [15].…”

Section: Introductionmentioning

confidence: 99%

Evolution of patients with chronic diseases who did not contract COVID-19 during the first year of the pandemic; new comorbidities, mortality, drug use and use of health and social services: retrospective study and comparison by sex

Oliván-Blázquez¹,

Lear-Claveras

Méndez-López

et al. 2022

Preprint

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Background: The restrictions introduced to stop the spread of the COVID-19 virus have also had a direct impact on people with chronic diseases and especially on diseases to which lifestyles are relevant in their control and management, such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD), etc. The lockdown measures implemented hindered patients’ ability to lead a healthy lifestyle (balanced diet, physical activity, etc.), which plays a crucial role in the proper management and control of chronic diseases. Method: An observational real world data pre-post study of 668,974 people was undertaken. The patients studied were over 16 years of age, had been receiving care from the Aragon Health Service (Northeastern Spain), been diagnosed with one or more chronic diseases and had not contracted COVID-19. Sociodemographic, comorbidity, pharmacological and health resource use variables were collected during the six months prior to the onset of the lockdown and during the six and 12 months following the end of the lockdown. The comparisons by sex were carried out using a Student T-test or chi squared test to analyse differences. Results: Dyslipidaemia (42.1%) followed by hypertension (35.1%) and anxiety and depression (34.6%) were the most prevalent chronic diseases among the study popualtion. 79.2% patients had between zero and four illness comorbidities. There was a decrease in new diagnoses of other chronic comorbidities in this population as well as a decrease in drugs prescribed and the use of health services. Although women received a higher number of diagnoses of chronic diseases, the number of drugs dispensed was lower, but the use of health services was higher. These figures were maintained throughout the pandemic. Conclusion: Our results suggest that there was a decrease in new diagnoses of comorbidities and in the mortality rate from causes unrelated to COVID-19 due to the closure of health centres during the pandemic. This trend was exacerbated in women.

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Outpatient atorvastatin use and severe COVID‐19 outcomes: A population‐based study

Visos‐Varela,

Zapata‐Cachafeiro,

Pintos‐Rodríguez

et al. 2023

Journal of Medical Virology

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Evidence of the effect of statins on patients with coronavirus disease (2019) COVID-19 is inconsistent. The aim of this study was to evaluate the association between chronic use of statins-both overall and by active ingredient-and severe outcomes of COVID-19 (risk of hospitalization and mortality), progression to severe outcomes, and susceptibility to the virus. We conducted a populationbased case-control study with data from electronic records to assess the risk of (1) hospitalization: cases were patients admitted due to COVID-19 and controls were subjects without COVID-19; (2) mortality: cases were hospitalized patients who died due to COVID-19 and controls were subjects without COVID-19; (3) progression: cases were hospitalized COVID-19 subjects and controls were nonhospitalized COVID-19 patients; and (4) susceptibility: cases were patients with COVID-19 (both hospitalized and nonhospitalized) and controls were subjects without COVID-19.We collected data on 2821 hospitalized cases, 26 996 nonhospitalized cases, and 52 318 controls. Chronic use of atorvastatin was associated with a decreased risk of hospitalization (adjusted odds ratios [aOR] = 0.83; 95% confidence interval [CI]: 0.74-0.92) and mortality (aOR = 0.70; 95% CI: 0.53-0.93), attributable in part to a lower risk of susceptibility to the virus (aOR = 0.91; 95% CI: 0.86-0.96). Simvastatin was associated with a reduced risk of mortality (aOR = 0.59; 95% CI: 0.40-0.87). The wide degree of heterogeneity observed in the estimated odds ratios (ORs) of the different statins suggests that there is no class effect. The results of this real-world study suggest that chronic use of atorvastatin (and to a lesser degree, of simvastatin) is associated with a decrease in risk of severe COVID-19 outcomes.

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¿Qué hemos dejado de atender por la COVID-19? Diagnósticos perdidos y seguimientos demorados. Informe SESPAS 2022

Cited by 20 publications

References 35 publications

“Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years: an observational retrospective population-based study using primary care electronic health records”

“Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years: an observational retrospective population-based study using primary care electronic health records”

Evolution of patients with chronic diseases who did not contract COVID-19 during the first year of the pandemic; new comorbidities, mortality, drug use and use of health and social services: retrospective study and comparison by sex

Outpatient atorvastatin use and severe COVID‐19 outcomes: A population‐based study

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