The impact of the COVID-19 pandemic on delayed care of cardiovascular diseases in Europe: a systematic review

Abstract

Aims Cardiovascular diseases (CVD) are the leading cause of death worldwide. The COVID-19 pandemic has disrupted healthcare systems, causing delays in essential medical services, and potentially impacting CVD treatment. This study aims to estimate the impact of the pandemic on delayed CVD care in Europe by providing a systematic overview of the available evidence. Methods and results PubMed, Embase and Web of Science were searched until mid-September 2022 for studies focused on the impact of delayed CVD care due to the pandemic in Europe among adult patients. Outcomes were changes in hospital admissions, mortality rates, delays in seeking medical help after symptom onset, delays in treatment initiation, and change in the number of treatment procedures. We included 132 studies, of which all were observational retrospective. Results were presented in five disease groups: ischemic heart diseases (IHD), cerebrovascular accidents (CVA), cardiac arrests (CA), heart failures (HF), and others, including broader CVD groups. There were significant decreases in hospital admissions for IHD, CVA, HF and urgent and elective cardiac procedures, and significant increases for CA. Mortality rates were higher for IHD and CVA. Conclusion The pandemic led to reduced acute CVD hospital admissions and increased mortality rates. Delays in seeking medical help were observed, while urgent and elective cardiac procedures decreased. Adequate resource allocation, clear guidelines on how to handle care during health crises, reduced delays, and healthy lifestyle promotion should be implemented. The long-term impact of pandemics on delayed CVD care, and the health-economic impact of COVID-19 should be further evaluated.

Impacts of the COVID-19 pandemic on deprivation-level differences in cardiovascular hospitalisations: A comparison of England and Denmark using the OpenSAFELY platform and National Registry Data

“…The negative impacts of the pandemic have been compounded by the rising cost-of-living crisis which may have further widened socioeconomic inequalities (10). One systematic review examining the impact of the COVID-19 pandemic on CVD related care (11) highlighted reduced and delayed CVD-related hospital admissions, except for cardiac arrests, and increased CVD mortality. However, a Swiss study of deprivation and CVD found that there were no changes in the relative patterning of inequalities resulting from the pandemic (12).…”

Stakeholder perspectives on contributors to delayed and inaccurate diagnosis of cardiovascular disease and their implications for digital health technologies: a UK-based qualitative study

“… 11 There are also likely to be issues related to healthcare access and diagnosis following the COVID-19 pandemic, which led to reduced CVD admissions and increased CVD mortality. 12 Delayed or misdiagnosis contributes to inappropriate treatments or unnecessary evaluations. 13 14 Adverse outcomes such as hospitalisation or death may result from effective treatment not being received until the disease is more advanced.…”