Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK.
COVID-19
Cardiology Service, Hospital
/ trends
Cardiovascular Diseases
/ diagnosis
Cross-Sectional Studies
Delivery of Health Care, Integrated
/ trends
Emergency Service, Hospital
/ trends
Health Services Needs and Demand
/ trends
Humans
Needs Assessment
/ trends
Patient Admission
/ trends
Retrospective Studies
Time Factors
United Kingdom
aortic and arterial disease
epidemiology
global health care delivery
health care delivery
heart disease
Journal
Heart (British Cardiac Society)
ISSN: 1468-201X
Titre abrégé: Heart
Pays: England
ID NLM: 9602087
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
29
07
2020
revised:
16
09
2020
accepted:
18
09
2020
pubmed:
7
10
2020
medline:
17
12
2020
entrez:
6
10
2020
Statut:
ppublish
Résumé
To monitor hospital activity for presentation, diagnosis and treatment of cardiovascular diseases during the COVID-19) pandemic to inform on indirect effects. Retrospective serial cross-sectional study in nine UK hospitals using hospital activity data from 28 October 2019 (pre-COVID-19) to 10 May 2020 (pre-easing of lockdown) and for the same weeks during 2018-2019. We analysed aggregate data for selected cardiovascular diseases before and during the epidemic. We produced an online visualisation tool to enable near real-time monitoring of trends. Across nine hospitals, total admissions and emergency department (ED) attendances decreased after lockdown (23 March 2020) by 57.9% (57.1%-58.6%) and 52.9% (52.2%-53.5%), respectively, compared with the previous year. Activity for cardiac, cerebrovascular and other vascular conditions started to decline 1-2 weeks before lockdown and fell by 31%-88% after lockdown, with the greatest reductions observed for coronary artery bypass grafts, carotid endarterectomy, aortic aneurysm repair and peripheral arterial disease procedures. Compared with before the first UK COVID-19 (31 January 2020), activity declined across diseases and specialties between the first case and lockdown (total ED attendances relative reduction (RR) 0.94, 0.93-0.95; total hospital admissions RR 0.96, 0.95-0.97) and after lockdown (attendances RR 0.63, 0.62-0.64; admissions RR 0.59, 0.57-0.60). There was limited recovery towards usual levels of some activities from mid-April 2020. Substantial reductions in total and cardiovascular activities are likely to contribute to a major burden of indirect effects of the pandemic, suggesting they should be monitored and mitigated urgently.
Identifiants
pubmed: 33020224
pii: heartjnl-2020-317870
doi: 10.1136/heartjnl-2020-317870
pmc: PMC7536637
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1890-1897Subventions
Organisme : Medical Research Council
ID : G0902393
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_19005
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S010351/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M501633/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K006584/1
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : SCAF/17/01
Pays : United Kingdom
Organisme : Department of Health
ID : RP-PG-0407-10314
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/16/14/32023
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/19/17/34172
Pays : United Kingdom
Organisme : Department of Health
ID : 05/40/04
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_13041
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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