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Moradi G, Piroozi B, Khayyati F, Moradpour F, Safari H, Mohamadi Bolbanabad A, Fattahi H, Younesi F, Ebrazeh A, Shokri A. The effect of COVID-19 on utilization of chronic diseases services. Chronic Illn 2024; 20:309-319. [PMID: 37488977 PMCID: PMC10372501 DOI: 10.1177/17423953231178168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/08/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES The aim of the present study is to evaluate the impact of Covid-19 on utilization of chronic diseases services. METHODS Interrupted time-series design was used to examine the utilization of chronic diseases services before and during the Covid-19 pandemic among hospitals in Iran. Chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes, heart failure, and chemotherapy were selected as a proxy to indicate the impact of Covid-19 on utilization of chronic diseases services. Data were collected in 24 sites from 12 months before the onset of Covid-19 (from March 2019 to February 2020) to 12 months during the Covid-19 pandemic (February 2020 to March 2021). RESULTS A total of 7,039,378 services were provided, of which 51.92% were provided for women and 62.73% for >65 age group. A sudden decrease was observed in monthly utilization of services during the Covid-19 pandemic; ranging from 13.91 (95% CI = -21.73, 6.10, P = 0.001) for chemotherapy to 606.39 (95% CI = -1040.72, 172.06, P = 0.009) for heart failure services per 100 thousand population. A decrease was observed in COPD services; 15.28 services compared with the period before Covid-19. Subsequently, the monthly utilization trends of asthma, type 2 diabetes, and chemotherapy services increased significantly (P < 0.05). DISCUSSION Although chronic diseases are a factor in more severe form of Covid-19, their failure to seek diagnostic, prevention and treatment services has somewhat complicated the issue.
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Affiliation(s)
- Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bakhtiar Piroozi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fariba Khayyati
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hossein Safari
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
| | - Amjad Mohamadi Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hamed Fattahi
- Centre for Primary Health Care Network Management, Ministry of Health and Medical Education, Tehran Iran
| | - Fatemeh Younesi
- Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Ebrazeh
- Department of Public Health, School of Public Health, Qom University of Medical Sciences, Qom, Iran
| | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Vazirani R, Feltes G, Hoyo RSD, Viana-Llamas MC, Raposeiras-Roubín S, Romero R, Alfonso-Rodríguez E, Uribarri A, Santoro F, Becerra-Muñoz V, Pepe M, Castro-Mejía AF, Signes-Costa J, Gonzalez A, Marín F, Lopez-País J, Cerrato E, Vázquez-Cancela O, Espejo-Paeres C, López Masjuan Á, Velicki L, El-Battrawy I, Ramakrishna H, Fernandez-Ortiz A, Nuñez-Gil IJ. Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes-Results from a Multi-Center International Prospective Registry (HOPE-2). J Clin Med 2024; 13:2596. [PMID: 38731127 PMCID: PMC11084489 DOI: 10.3390/jcm13092596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/31/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Acute cardiac injury (ACI) after COVID-19 has been linked with unfavorable clinical outcomes, but data on the clinical impact of elevated cardiac troponin on discharge during follow-up are scarce. Our objective is to elucidate the clinical outcome of patients with elevated troponin on discharge after surviving a COVID-19 hospitalization. Methods: We conducted an analysis in the prospective registry HOPE-2 (NCT04778020). Only patients discharged alive were selected for analysis, and all-cause death on follow-up was considered as the primary endpoint. As a secondary endpoint, we established any long-term COVID-19 symptoms. HOPE-2 stopped enrolling patients on 31 December 2021, with 9299 patients hospitalized with COVID-19, of which 1805 were deceased during the acute phase. Finally, 2382 patients alive on discharge underwent propensity score matching by relevant baseline variables in a 1:3 fashion, from 56 centers in 8 countries. Results: Patients with elevated troponin experienced significantly higher all-cause death during follow-up (log-rank = 27.23, p < 0.001), and had a higher chance of experiencing long-term COVID-19 cardiovascular symptoms. Specifically, fatigue and dyspnea (57.7% and 62.8%, with p-values of 0.009 and <0.001, respectively) are among the most common. Conclusions: After surviving the acute phase, patients with elevated troponin on discharge present increased mortality and long-term COVID-19 symptoms over time, which is clinically relevant in follow-up visits.
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Affiliation(s)
- Ravi Vazirani
- Cardiology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (R.V.); (A.F.-O.)
| | - Gisela Feltes
- Cardiology Department, Hospital Vithas Arturo Soria, 28043 Madrid, Spain;
| | - Rafael Sánchez-del Hoyo
- Research Methodological Support Unit and Preventive Department, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain;
| | - María C. Viana-Llamas
- Cardiology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain;
| | | | - Rodolfo Romero
- Emergency Department, Hospital Isabel Zendal, Hospital Universitario de Getafe, 28905 Madrid, Spain;
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Emilio Alfonso-Rodríguez
- Cardiology Department, Bellvitge Biomedical Research Institute (IDIBELL), Hospital Universitario de Bellvitge, 08908 Barcelona, Spain;
| | - Aitor Uribarri
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | | | - Víctor Becerra-Muñoz
- Cardiology Department, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain;
| | - Martino Pepe
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Alex F. Castro-Mejía
- Hospital General del Norte de Guayaquil IESS “Los Ceibos”, Guayaquil 090615, Ecuador;
| | - Jaime Signes-Costa
- Pneumology Department, Hospital Clínico de Valencia, INCLIVA, University of Valencia, 46010 Valencia, Spain;
| | - Adelina Gonzalez
- Anesthesiology Department, Hospital Universitario Infanta Sofia, 28702 Madrid, Spain;
| | - Francisco Marín
- Cardiology Department, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, 30120 Murcia, Spain;
| | - Javier Lopez-País
- Cardiology Department, Complejo Hospitalario Universitario de Ourense, 32004 Orense, Spain;
| | - Enrico Cerrato
- Cardiology Department, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, 10098 Rivoli, Italy;
| | - Olalla Vázquez-Cancela
- Preventive Department, Hospital Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Carolina Espejo-Paeres
- Cardiology and Emergency Department, Hospital Universitario Príncipe de Asturias, 28805 Madrid, Spain;
| | - Álvaro López Masjuan
- Cardiology Department, Hospital Universitario Juan Ramón Jimenez, 21005 Huelva, Spain;
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
- Institute of Cardiovascular Diseases Vojvodina, 21204 Sremska Kamenica, Serbia
| | - Ibrahim El-Battrawy
- Institute of Physiology, Department of Cellular and Translational Physiology, Medical Faculty, Ruhr University of Bochum, 44801 Bochum, Germany;
- Institut für Forschung und Lehre (IFL),Molecular and Experimental Cardiology, Ruhr University of Bochum, 44801 Bochum, Germany
- Department of Cardiology, St. Josef-Hospital of the Ruhr University Bochum, 44801 Bochum, Germany
| | | | | | - Ivan J. Nuñez-Gil
- Cardiology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (R.V.); (A.F.-O.)
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
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Siegel N, Lambrechts MJ, Brush PL, Tomlak A, Lee Y, Karamian BA, Canseco JA, Woods BI, Kaye ID, Hilibrand AS, Kepler CK, Vaccaro AR, Schroeder GD. A Longitudinal Evaluation of Coronavirus Disease 2019 and Its Effects on Spinal Decompressions With or Without Fusion. Clin Spine Surg 2024; 37:E131-E136. [PMID: 38530390 DOI: 10.1097/bsd.0000000000001556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/03/2023] [Indexed: 03/28/2024]
Abstract
STUDY DESIGN Retrospective cohort. OBJECTIVE The objectives were to (1) compare the safety of spine surgery before and after the emergence of coronavirus disease 2019 (COVID-19) and (2) determine whether patients with a history of COVID-19 were at increased risk of adverse events. SUMMARY AND BACKGROUND DATA The COVID-19 pandemic had a tremendous impact on several health care services. In spine surgery, elective cases were canceled and patients received delayed care due to the uncertainty of disease transmission and surgical outcomes. As new coronavirus variants arise, health care systems require guidance on how to provide optimal patient care to all those in need of our services. PATIENTS AND METHODS A retrospective review of patients undergoing spine surgery between January 1, 2019 and June 30, 2021 was performed. Patients were split into pre-COVID or post-COVID cohorts based on local government guidelines. Inpatient complications, 90-day readmission, and 90-day mortality were compared between groups. Secondary analysis included multiple logistic regression to determine independent predictors of each outcome. RESULTS A total of 2976 patients were included for analysis with 1701 patients designated as pre-COVID and 1275 as post-COVID. The pre-COVID cohort had fewer patients undergoing revision surgery (16.8% vs 21.9%, P < 0.001) and a lower home discharge rate (84.5% vs 88.2%, P = 0.008). Inpatient complication (9.9% vs 9.2%, P = 0.562), inpatient mortality (0.1% vs 0.2%, P = 0.193), 90-day readmission (3.4% vs 3.2%, P = 0.828), and 90-day mortality rates (0.8% vs 0.8%, P = 0.902) were similar between groups. Patients with positive COVID-19 tests before surgery had similar complication rates (7.7% vs 6.1%, P = 1.000) as those without a positive test documented. CONCLUSIONS After the emergence of COVID-19, patients undergoing spine surgery had a greater number of medical comorbidities, but similar rates of inpatient complications, readmission, and mortality. Prior COVID-19 infection was not associated with an increased risk of postsurgical complications or mortality. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Nicholas Siegel
- Department of Orthopedic Surgery, Rothman Orthopedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA
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Flores-Sandoval C, Sibbald SL, Ryan BL, Adams TL, Suskin N, McKelvie R, Elliott J, Orange JB. Virtual care during COVID-19: The perspectives of older adults and their healthcare providers in a cardiac rehabilitation setting. Can J Aging 2024:1-8. [PMID: 38389488 DOI: 10.1017/s0714980824000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
The present study aimed to explore the perspectives of older adults and health providers on cardiac rehabilitation care provided virtually during COVID-19. A qualitative exploratory methodology was used. Semi-structured interviews were conducted with 15 older adults and 6 healthcare providers. Five themes emerged from the data: (1) Lack of emotional intimacy when receiving virtual care, (2) Inadequacy of virtual platforms, (3) Saving time with virtual care, (4) Virtual care facilitated accessibility, and (5) Loss of connections with patients and colleagues. Given that virtual care continues to be implemented, and in some instances touted as an optimal option for the delivery of cardiac rehabilitation, it is critical to address the needs of older adults living with cardiovascular disease and their healthcare providers. This is particularly crucial related to issues accessing and using technology, as well as older adults' need to build trust and emotional connection with their providers.
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Affiliation(s)
| | - Shannon L Sibbald
- Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- School of Health Studies, Western University, London, Ontario, Canada
- Interfaculty Program in Public Health, Western University, London, Ontario, Canada
| | - Bridget L Ryan
- Departments of Family Medicine and Epidemiology and Biostatistics, Centre for Studies in Family Medicine
| | - Tracey L Adams
- Department of Sociology, Western University, London, Ontario, Canada
| | - Neville Suskin
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- St Joseph's Hospital Cardiac Rehabilitation & Secondary Prevention Program, London, Ontario, Canada
- St. Joseph's Health Care London, Ontario, Canada
| | - Robert McKelvie
- St Joseph's Hospital Cardiac Rehabilitation & Secondary Prevention Program, London, Ontario, Canada
- St. Joseph's Health Care London, Ontario, Canada
| | - Jacobi Elliott
- Lawson Health Research Institute, London, Ontario, Canada
| | - Joseph B Orange
- Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
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Taylor JK, Ahmed FZ. Clinical Pathways Guided by Remotely Monitoring Cardiac Device Data: The Future of Device Heart Failure Management? Arrhythm Electrophysiol Rev 2023; 12:e15. [PMID: 37427299 PMCID: PMC10326671 DOI: 10.15420/aer.2022.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/03/2022] [Indexed: 07/11/2023] Open
Abstract
Research examining the utility of cardiac device data to manage patients with heart failure (HF) is rapidly evolving. COVID-19 has reignited interest in remote monitoring, with manufacturers each developing and testing new ways to detect acute HF episodes, risk stratify patients and support self-care. As standalone diagnostic tools, individual physiological metrics and algorithm-based systems have demonstrated utility in predicting future events, but the integration of remote monitoring data with existing clinical care pathways for device HF patients is not well described. This narrative review provides an overview of device-based HF diagnostics available to care providers in the UK, and describes the current state of play with regard to how these systems fit in with current HF management.
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Affiliation(s)
- Joanne K Taylor
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Fozia Zahir Ahmed
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Cardiology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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6
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The impact of COVID-19 on heart failure admissions in Suriname-A call for action. J Natl Med Assoc 2023:S0027-9684(22)00182-1. [PMID: 37024313 PMCID: PMC10071347 DOI: 10.1016/j.jnma.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 04/07/2023]
Abstract
Introduction During the height of the COVID-19 pandemic, there was a worldwide reorganization of healthcare systems focusing on limiting the spread of the virus. The impact of these measures on heart failure (HF) admissions is scarcely reported in Low and Middle Income Countries (LMICs) including Suriname. We therefore assessed HF hospitalizations before and during the pandemic and call for action to improve healthcare access in Suriname through the development and implementation of telehealth strategies. Methods Retrospectively collected clinical (# hospitalizations per patient, in hospital mortality, comorbidities) and demographic (sex, age, ethnicity) data of people hospitalized with a primary or secondary HF discharge ICD10 code in the Academic Hospital Paramaribo (AZP) from February to December 2019 (pre-pandemic) and February to December 2020 (during the pandemic) were used for analysis. Data are presented as frequencies with corresponding percentages. T-tests were used to analyze continuous variables and the two-sample test for proportions for categorical variables. Results There was an overall slight decrease of 9.1% HF admissions (N pre-pandemic:417 vs N during the pandemic: 383). Significantly less patients (18.3%, p-value<0.00) were hospitalized during the pandemic (N: 249 (65.0%)) compared to pre-pandemic (N: 348 (83.3%)), while readmissions increased statistically significantly for both readmissions within 90 days (75 (19.6%) vs 55 (13.2%), p-value = 0.01) and readmissions within 365 days (122 (31.9%) vs 70 (16.7%), p-value = 0.00) in 2020 compared to 2019. Patients admitted during the pandemic also had significantly more of the following comorbidities: hypertension (46.2% vs 30.6%, p-value = 0.00), diabetes (31.9% vs 24.9%, p-value = 0.03) anemia (12.8% vs 3.1%, p-value = 0.00), and atrial fibrillation (22.7% vs 15.1%, p-value = 0.00). Conclusion HF admissions were reduced during the pandemic while HF readmissions increased compared to the pre-pandemic period. Due to in-person consultation restrictions, the HF clinic was inactive during the pandemic period. Distance monitoring of HF patients via telehealth tools could help in reducing these adverse effects. This call for action identifies key elements (digital and health literacy, telehealth legislation, integration of telehealth tools within the current healthcare sector) needed for the successful development and implementation of these tools in LMICs.
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Correale M, Croella F, Leopizzi A, Mazzeo P, Tricarico L, Mallardi A, Fortunato M, Magnesa M, Ceci V, Puteo A, Iacoviello M, Di Biase M, Brunetti ND. The Evolving Phenotypes of Cardiovascular Disease during COVID-19 Pandemic. Cardiovasc Drugs Ther 2023; 37:341-351. [PMID: 34328581 PMCID: PMC8322635 DOI: 10.1007/s10557-021-07217-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
COVID-19 pandemic has negatively impacted the management of patients with acute and chronic cardiovascular disease: acute coronary syndrome patients were often not timely reperfused, heart failure patients not adequately followed up and titrated, atrial arrhythmias not efficaciously treated and became chronic. New phenotypes of cardiovascular patients were more and more frequent during COVID-19 pandemic and are expected to be even more frequent in the next future in the new world shaped by the pandemic. We therefore aimed to briefly summarize the main changes in the phenotype of cardiovascular patients in the COVID-19 era, focusing on new clinical challenges and possible therapeutic options.
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Affiliation(s)
| | - Francesca Croella
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Alessandra Leopizzi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pietro Mazzeo
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lucia Tricarico
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Adriana Mallardi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Martino Fortunato
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Michele Magnesa
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Ceci
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Massimo Iacoviello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Matteo Di Biase
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Post-COVID-19 Symptoms and Heart Disease: Incidence, Prognostic Factors, Outcomes and Vaccination: Results from a Multi-Center International Prospective Registry (HOPE 2). J Clin Med 2023; 12:jcm12020706. [PMID: 36675633 PMCID: PMC9863454 DOI: 10.3390/jcm12020706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Heart disease is linked to worse acute outcomes after coronavirus disease 2019 (COVID-19), although long-term outcomes and prognostic factor data are lacking. We aim to characterize the outcomes and the impact of underlying heart diseases after surviving COVID-19 hospitalization. METHODS We conducted an analysis of the prospective registry HOPE-2 (Health Outcome Predictive Evaluation for COVID-19-2, NCT04778020). We selected patients discharged alive and considered the primary end-point all-cause mortality during follow-up. As secondary main end-points, we included any readmission or any post-COVID-19 symptom. Clinical features and follow-up events are compared between those with and without cardiovascular disease. Factors with p < 0.05 in the univariate analysis were entered into the multivariate analysis to determine independent prognostic factors. RESULTS HOPE-2 closed on 31 December 2021, with 9299 patients hospitalized with COVID-19, and 1805 died during this acute phase. Finally, 7014 patients with heart disease data were included in the present analysis, from 56 centers in 8 countries. Heart disease (+) patients were older (73 vs. 58 years old), more frequently male (63 vs. 56%), had more comorbidities than their counterparts, and suffered more frequently from post-COVID-19 complications and higher mortality (OR heart disease: 2.63, 95% CI: 1.81-3.84). Vaccination was found to be an independent protector factor (HR all-cause death: 0.09; 95% CI: 0.04-0.19). CONCLUSIONS After surviving the acute phase, patients with underlying heart disease continue to present a more complex clinical profile and worse outcomes including increased mortality. The COVID-19 vaccine could benefit survival in patients with heart disease during follow-up.
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Rosano GM, Seferovic P, Savarese G, Spoletini I, Lopatin Y, Gustafsson F, Bayes‐Genis A, Jaarsma T, Abdelhamid M, Miqueo AG, Piepoli M, Tocchetti CG, Ristić AD, Jankowska E, Moura B, Hill L, Filippatos G, Metra M, Milicic D, Thum T, Chioncel O, Ben Gal T, Lund LH, Farmakis D, Mullens W, Adamopoulos S, Bohm M, Norhammar A, Bollmann A, Banerjee A, Maggioni AP, Voors A, Solal AC, Coats AJ. Impact analysis of heart failure across European countries: an ESC-HFA position paper. ESC Heart Fail 2022; 9:2767-2778. [PMID: 35869679 PMCID: PMC9715845 DOI: 10.1002/ehf2.14076] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 06/09/2022] [Accepted: 06/30/2022] [Indexed: 11/07/2022] Open
Abstract
Heart failure (HF) is a long-term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC-HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs-in terms of quality of life-in European countries.
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Affiliation(s)
- Giuseppe M.C. Rosano
- Centre for Clinical & Basic ResearchIRCCS San Raffaele Pisanavia della Pisana, 23500163RomeItaly
| | | | - Gianluigi Savarese
- Department of Medicine, Karolinska Institutet, and Heart and Vascular ThemeKarolinska University HospitalStockholmSweden
| | - Ilaria Spoletini
- Centre for Clinical & Basic ResearchIRCCS San Raffaele Pisanavia della Pisana, 23500163RomeItaly
| | - Yuri Lopatin
- Regional Cardiology CentreVolgograd State Medical UniversityVolgogradRussia
| | - Fin Gustafsson
- Department of Cardiology, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
- Department of Clinical Medicine, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Antoni Bayes‐Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, BadalonaCIBERCVBarcelonaSpain
| | - Tiny Jaarsma
- Department of Health, Medicine and CareLinköping University, Linköping Sweden and Julius Center, University Medical Center UtrechtUtrechtThe Netherlands
| | | | - Arantxa Gonzalez Miqueo
- Program of Cardiovascular DiseasesCIMA Universidad de Navarra and Instituto de Investigación Sanitaria de Navarra (IdiSNA)PamplonaSpain
| | - Massimo Piepoli
- Heart Failure Unit, Cardiology DepartmentGuglielmo da Saliceto Polichirurgico Hospital Cantone del CristoPiacenzaItaly
| | - Carlo G. Tocchetti
- Department of Translational Medical Sciences, Interdepartmental Center of Clinical and Translational Research (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA)Federico II UniversityNaplesItaly
| | - Arsen D. Ristić
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Department of CardiologyUniversity Clinical Centre of SerbiaBelgradeSerbia
| | | | - Brenda Moura
- Faculty of MedicineUniversity of PortoPortoPortugal
| | - Loreena Hill
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
| | | | - Marco Metra
- Department of Medical and Surgical Specialities, Radiological Sciences and Public HealthUniversity of BresciaBresciaItaly
| | - Davor Milicic
- University of Zagreb School of MedicineZagrebCroatia
| | - Thomas Thum
- Hannover Medical SchoolInstitute of Molecular and Translational Therapeutic StrategiesHanoverGermany
| | - Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’BucharestRomania
| | - Tuvia Ben Gal
- Department of CardiologyRabin Medical CenterPetah TikvaIsrael
| | - Lars H. Lund
- Department of Medicine, Karolinska Institutet, and Heart and Vascular ThemeKarolinska University HospitalStockholmSweden
| | | | - Wilfried Mullens
- Faculty of Medicine and Life Sciences, BIOMED—Biomedical Research InstituteHasselt UniversityDiepenbeekBelgium
| | | | | | - Anna Norhammar
- Department of Medicine, Karolinska Institutet, and Heart and Vascular ThemeKarolinska University HospitalStockholmSweden
| | - Andreas Bollmann
- Heart Center Leipzig at University of Leipzig and Leipzig Heart InstituteLeipzigGermany
| | | | | | - Adriaan Voors
- University Medical Center GroningenGroningenThe Netherlands
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COVID-19, cardiac involvement and cardiac rehabilitation: Insights from a rehabilitation perspective - State of the Art. Turk J Phys Med Rehabil 2022; 68:317-335. [DOI: 10.5606/tftrd.2022.11435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Since the beginning of the pandemic, many novel coronavirus disease 2019 (COVID-19) patients have experienced multisystem involvement or become critically ill and treated in intensive care units, and even died. Among these systemic effects, cardiac involvement may have very important consequences for the patient’s prognosis and later life. Patients with COVID-19 may develop cardiac complications such as heart failure, myocarditis, pericarditis, vasculitis, acute coronary syndrome, and cardiac arrhythmias or trigger an accompanying cardiac disease. The ratio of COVID-19 cardiac involvement ranges between 7 and 28% in hospitalized patients with worse outcomes, longer stay in the intensive care unit, and a higher risk of death. Furthermore, deconditioning due to immobility and muscle involvement can be seen in post-COVID-19 patients and significant physical, cognitive and psychosocial impairments may be observed in some cases. Considering that the definition of health is “a state of complete physical, mental and social well-being”, individuals with heart involvement due to COVID-19 should be rehabilitated by evaluating all these aspects of the disease effect. In the light of the rehabilitation perspective and given the increasing number of patients with cardiac manifestations of COVID-19, in this review, we discuss the rehabilitation principles in this group of patients.
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11
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Infodemiological study on the impact of the COVID-19 pandemic on increased headache incidences at the world level. Sci Rep 2022; 12:10253. [PMID: 35715461 PMCID: PMC9205282 DOI: 10.1038/s41598-022-13663-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/17/2022] [Indexed: 12/21/2022] Open
Abstract
The analysis of the public interest as reflected by Internet queries has become a highly valuable tool in many fields. The Google Trends platform, providing timely and informative data, has become increasingly popular in health and medical studies. This study explores whether Internet search frequencies for the keyword “headache” have been increasing after the COVID-19 pandemic outbreak, which could signal an increased incidence of the health problem. Weekly search volume data for 5 years spanning February 2017 to February 2022 were sourced from Google Trends. Six statistical and machine-learning methods were implemented on training and testing sets via pre-set automated forecasting algorithms. Holt-Winters has been identified as overperforming in predicting web query trends through several accuracy measures and the DM test for forecasting superiority and has been employed for producing the baseline level in the estimation of excess query level over the first pandemic wave. Findings indicate that the COVID-19 pandemic resulted in an increased global incidence of headache (as proxied by related web queries) in the first 6 months after its outbreak, with an excess occurrence of 4.53% globally. However, the study also concludes that the increasing trend in headache incidence at the world level would have continued in the absence of the pandemic, but it has been accelerated by the pandemic event. Results further show mixed correlations at the country-level between COVID-19 infection rates and population web-search behavior, suggesting that the increased headache incidence is caused by pandemic-related factors (i.e. increased stress and mental health problems), rather than a direct effect of coronavirus infections. Other noteworthy findings entail that in the Philippines, the term "headache" was the most frequently searched term in the period spanning February 2020 to February 2022, indicating that headache occurrences are a significant aspect that defines population health at the country level. High relative interest is also detected in Kenya and South Africa after the pandemic outbreak. Additionally, research findings indicate that the relative interest has decreased in some countries (i.e. US, Canada, and Australia), whereas it has increased in others (i.e. India and Pakistan) after the pandemic outbreak. We conclude that observing Internet search habits can provide timely information for policymakers on collective health trends, as opposed to ex-post statistics, and can furthermore yield valuable information for the pain management drug market key players about aggregate consumer behavior.
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Evidence Based Management of Acute Heart Failure in the Era of COVID-19 Pandemic. INTENSIVE CARE RESEARCH 2022. [PMID: 37521441 PMCID: PMC9126099 DOI: 10.1007/s44231-022-00003-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This editorial is to highlight current issues of heart failure management during COVID-19 pandemic.
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Heidenreich PA, Fonarow GC, Opsha Y, Sandhu AT, Sweitzer NK, Warraich HJ. Economic Issues in Heart Failure in the United States. J Card Fail 2022; 28:453-466. [PMID: 35085762 PMCID: PMC9031347 DOI: 10.1016/j.cardfail.2021.12.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/16/2021] [Accepted: 12/20/2021] [Indexed: 12/27/2022]
Abstract
The cost of heart failure care is high owing to the cost of hospitalization and chronic treatments. Heart failure treatments vary in their benefit and cost. The cost effectiveness of therapies can be determined by comparing the cost of treatment required to obtain a certain benefit, often defined as an increase in 1 year of life. This review was sponsored by the Heart Failure Society of America and describes the growing economic burden of heart failure for patients and the health care system in the United States. It also provides a summary of the cost effectiveness of drugs, devices, diagnostic tests, hospital care, and transitions of care for patients with heart failure. Many medications that are no longer under patent are inexpensive and highly cost-effective. These include angiotensin-converting enzyme inhibitors, beta-blockers and mineralocorticoid receptor antagonists. In contrast, more recently developed medications and devices, vary in cost effectiveness, and often have high out-of-pocket costs for patients.
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Affiliation(s)
- Paul A. Heidenreich
- Department of Medicine, Stanford University School of Medicine, Stanford, CA,VA Palo Alto Health Care System, Palo Alto, CA
| | - Gregg C. Fonarow
- Division of Cardiology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA
| | - Yekaterina Opsha
- Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ,Saint Barnabas Medical Center, Livingston, NJ
| | - Alexander T. Sandhu
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Nancy K. Sweitzer
- Division of Cardiology, University of Arizona College of Medicine, Tucson, AZ
| | - Haider J. Warraich
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Medicine, Cardiology Section, VA Boston Healthcare System, Boston, MA
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14
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Bauersachs J, de Boer RA, Lindenfeld J, Bozkurt B. The year in cardiovascular medicine 2021: heart failure and cardiomyopathies. Eur Heart J 2022; 43:367-376. [PMID: 34974611 PMCID: PMC9383181 DOI: 10.1093/eurheartj/ehab887] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/27/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022] Open
Abstract
In the year 2021, the universal definition and classification of heart failure (HF) was published that defines HF as a clinical syndrome with symptoms and/or signs caused by a cardiac abnormality and corroborated by elevated natriuretic peptide levels or objective evidence of cardiogenic congestion. This definition and the classification of HF with reduced ejection fraction (HFrEF), mildly reduced, and HF with preserved ejection fraction (HFpEF) is consistent with the 2021 ESC Guidelines on HF. Among several other new recommendations, these guidelines give a Class I indication for the use of the sodium–glucose co-transporter 2 (SGLT2) inhibitors dapagliflozin and empagliflozin in HFrEF patients. As the first evidence-based treatment for HFpEF, in the EMPEROR-Preserved trial, empagliflozin reduced the composite endpoint of cardiovascular death and HF hospitalizations. Several reports in 2021 have provided novel and detailed analyses of device and medical therapy in HF, especially regarding sacubitril/valsartan, SGLT2 inhibitors, mineralocorticoid receptor antagonists, ferric carboxymaltose, soluble guanylate cyclase activators, and cardiac myosin activators. In patients hospitalized with COVID-19, acute HF and myocardial injury is quite frequent, whereas myocarditis and long-term damage to the heart are rather uncommon.
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Affiliation(s)
- Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - JoAnn Lindenfeld
- Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Biykem Bozkurt
- Winters Center for Heart Failure, Cardiology, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston TX, USA
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15
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Zile MR, Desai AS, Costanzo MR, Ducharme A, Maisel A, Mehra MR, Paul S, Sears SF, Smart F, Chien C, Guha A, Guichard JL, Hall S, Jonsson O, Johnson N, Sood P, Henderson J, Adamson PB, Lindenfeld J. OUP accepted manuscript. Eur Heart J 2022; 43:2603-2618. [PMID: 35266003 PMCID: PMC8992324 DOI: 10.1093/eurheartj/ehac114] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/27/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Aims During the coronavirus disease 2019 (COVID-19) pandemic, important changes in heart failure (HF) event rates have been widely reported, but few data address potential causes for these changes; several possibilities were examined in the GUIDE-HF study. Methods and results From 15 March 2018 to 20 December 2019, patients were randomized to haemodynamic-guided management (treatment) vs. control for 12 months, with a primary endpoint of all-cause mortality plus HF events. Pre-COVID-19, the primary endpoint rate was 0.553 vs. 0.682 events/patient-year in the treatment vs. control group [hazard ratio (HR) 0.81, P = 0.049]. Treatment difference was no longer evident during COVID-19 (HR 1.11, P = 0.526), with a 21% decrease in the control group (0.536 events/patient-year) and no change in the treatment group (0.597 events/patient-year). Data reflecting provider-, disease-, and patient-dependent factors that might change the primary endpoint rate during COVID-19 were examined. Subject contact frequency was similar in the treatment vs. control group before and during COVID-19. During COVID-19, the monthly rate of medication changes fell 19.2% in the treatment vs. 10.7% in the control group to levels not different between groups (P = 0.362). COVID-19 was infrequent and not different between groups. Pulmonary artery pressure area under the curve decreased −98 mmHg-days in the treatment group vs. −100 mmHg-days in the controls (P = 0.867). Patient compliance with the study protocol was maintained during COVID-19 in both groups. Conclusion During COVID-19, the primary event rate decreased in the controls and remained low in the treatment group, resulting in an effacement of group differences that were present pre-COVID-19. These outcomes did not result from changes in provider- or disease-dependent factors; pulmonary artery pressure decreased despite fewer medication changes, suggesting that patient-dependent factors played an important role in these outcomes. Clinical Trials.gov: NCT03387813 Key questions What factors explain the loss of treatment effect and reduction in heart failure events during COVID-19? Key findings The treatment effect change was not due to COVID-19-related events. Patient management was sustained but not intensified during COVID-19. Patient status improved during COVID-19 and pulmonary artery pressure reduced in both groups. Take home message Patient behaviour probably improved during COVID-19, given that patient status and pulmonary artery pressure improved during COVID-19 despite fewer medication changes and without increased contact from providers.
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Affiliation(s)
- Michael R. Zile
- Corresponding author. Division of Cardiology, Department of Medicine, RJH Department of Veterans Affairs Medical Center, Medical University of South Carolina, Thurmond/Gazes, Room 323, 30 Courtenay Dr, Charleston, SC 29425, USA. Tel: +1 843 792 4799, Fax: +1 843789 6850,
| | - Akshay S. Desai
- Cardiovascular Division, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, USA
| | | | - Anique Ducharme
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Alan Maisel
- University of California San Diego, La Jolla, CA, USA
| | - Mandeep R. Mehra
- Cardiovascular Division, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, USA
| | - Sara Paul
- Catawba Valley Health System, Conover, NC, USA
| | | | - Frank Smart
- School of Medicine, Louisiana State University, New Orleans, LA, USA
| | - Christopher Chien
- Division of Cardiology, University of North Carolina, Chapel Hill, NC, USA
| | - Ashrith Guha
- Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Jason L. Guichard
- Department of Medicine, Division of Cardiology, Section for Advanced Heart Failure, Pulmonary Hypertension and Mechanical Circulatory Support, Prisma Health-Upstate, Greenville, SC, USA
| | - Shelley Hall
- Baylor University Medical Center, Dallas, TX, USA
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Prasun MA, Blakeman JR, Vuckovic K, Kim M, Albert N, Stamp KD, Jaarsma T, Riegel B. Perceptions of Changes in Practice Patterns and Patient Care among Heart Failure Nurses During the COVID-19 Pandemic. Heart Lung 2022; 52:152-158. [PMID: 35091263 PMCID: PMC8758339 DOI: 10.1016/j.hrtlng.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/18/2021] [Accepted: 01/10/2022] [Indexed: 12/21/2022]
Abstract
Background The Coronavirus (COVID-19) had a profound impact on the delivery of care in both hospital and outpatient settings across the United States. Patients with heart failure (HF) and healthcare providers had to abruptly adapt. Objective To describe how the COVID-19 pandemic affected practice patterns of HF nurses. Methods Practicing HF nurses completed a cross-sectional, anonymous, web-based survey of perceptions of HF practice. Analyses involved descriptive and comparative statistics. Results Of 171 nurses who completed surveys, outpatient HF visits decreased and 63.2% added telehealth visits. Despite spending about 29 min educating patients during visits, 27.5% of nurses perceived that the pandemic decreased patients’ abilities to provide optimal self-care. Nurses reported decreased ability to collect objective data (62.4%; n = 78), although subjective assessment stayed the same (41.6%; n = 52). Conclusion Nurses’ practice patterns provided insight into patient care changes made during COVID-19. Most core components of HF management were retained, but methods of delivery during the pandemic differed.
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Affiliation(s)
- Marilyn A Prasun
- Professor and Carle BroMenn Medical Center Endowed Professor, Illinois State University, Mennonite College of Nursing, 111B Edwards Hall, Campus Box 5810, Normal, IL 61790-5810, United States.
| | - John R Blakeman
- Assistant Professor, Illinois State University, Mennonite College of Nursing, Normal, IL, United States
| | - Karen Vuckovic
- Associate Professor, University of Illinois Chicago, College of Nursing, Chicago, IL, United States
| | - MyoungJin Kim
- Professor, Illinois State University, Mennonite College of Nursing, Normal, IL, United States
| | - Nancy Albert
- Associate Chief Nursing Officer, Office of Nursing Research and Innovation, Cleveland Clinic Health System, United States
| | - Kelly D Stamp
- Professor and Chair, Family and Community Nursing Department, Eloise R. Lewis Excellence Professor, UNC Greensboro, School of Nursing, United States
| | - Tiny Jaarsma
- Professor, Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Barbara Riegel
- Professor and Edith Clemmer Steinbright Chair of Gerontology, School of Nursing, Philadelphia, PA, United States
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Al-Naher A, Downing J, Scott KA, Pirmohamed M. Factors affecting patient and physician engagement in remote healthcare for heart failure: a systematic review (Preprint). JMIR Cardio 2021; 6:e33366. [PMID: 35384851 PMCID: PMC9021943 DOI: 10.2196/33366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/18/2021] [Accepted: 01/08/2022] [Indexed: 02/06/2023] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Ahmed Al-Naher
- Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Jennifer Downing
- Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Kathryn A Scott
- Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Munir Pirmohamed
- Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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18
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Gardner RS, Capodilupo RC, Ahmed R, Stolen CM, An Q, Averina V, Hernandez AF, Boehmer JP. Multiparameter diagnostic sensor measurements in heart failure patients presenting with SARS-CoV-2 infection. ESC Heart Fail 2021; 8:4026-4036. [PMID: 34184428 PMCID: PMC8426935 DOI: 10.1002/ehf2.13500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 12/23/2022] Open
Abstract
Aims Implantable device‐based sensor measurements including heart sounds, markers of ventilation, and thoracic impedance have been shown to predict heart failure (HF) hospitalizations. We sought to assess how these parameters changed prior to COVID‐19 (Cov‐19) and how these compared with those presenting with decompensated HF or pneumonia. Methods and results This retrospective analysis explores patterns of changes in daily measurements by implantable sensors in 10 patients with Cov‐19 and compares these findings with those observed prior to HF (n = 88) and pneumonia (n = 12) hospitalizations from the MultiSENSE, PREEMPT‐HF, and MANAGE‐HF trials. The earliest sensor changes prior to Cov‐19 were observed in respiratory rate (6 days) and temperature (5 days). There was a three‐fold to four‐fold greater increase in respiratory rate, rapid shallow breathing index, and night heart rate compared with those presenting with HF or pneumonia. Furthermore, activity levels fell more in those presenting with Cov‐19, a change that was often sustained for some time. In contrast, there were no significant changes in 1st or 3rd heart sound (S1 and S3) amplitude in those presenting with Cov‐19 or pneumonia compared with the known changes that occur in HF decompensation. Conclusions Multi‐sensor device diagnostics may provide early detection of Cov‐19, distinguishable from worsening HF by an extreme and fast rise in respiratory rate along with no changes in S3.
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Affiliation(s)
- Roy S Gardner
- Golden Jubilee National Hospital, Clydebank, Glasgow, UK
| | - Robert C Capodilupo
- New England Heart and Vascular Institute, Catholic Medical Center, Manchester, NH, USA
| | | | | | - Qi An
- Boston Scientific, Arden Hills, MN, USA
| | | | | | - John P Boehmer
- Penn State Milton S Hershey Medical Center, Hershey, PA, USA
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19
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Smits M, Vernooij MW, Bargalló N, Ramos A, Yousry TA. The impact of the Covid-19 pandemic on adult diagnostic neuroradiology in Europe. Neuroradiology 2021; 64:31-42. [PMID: 33974110 PMCID: PMC8110687 DOI: 10.1007/s00234-021-02722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/19/2021] [Indexed: 12/03/2022]
Abstract
Purpose The purpose of this survey was to understand the impact the Covid-19 pandemic has or has had on the work, training, and wellbeing of professionals in the field of diagnostic neuroradiology. Methods A survey was emailed to all ESNR members and associates as well as distributed via professional social media channels. The survey was held in the summer of 2020 when the first wave had subsided in most of Europe, while the second wave was not yet widespread. The questionnaire featured a total of 46 questions on general demographics, the various phases of the healthcare crisis, and the numbers of Covid-19 patients. Results One hundred sixty-seven responses were received from 48 countries mostly from neuroradiologists (72%). Most commonly taken measures during the crisis phase were reduction of outpatient exams (87%), reduction of number of staff present in the department (83%), reporting from home (62%), and shift work (54%). In the exit phase, these measures were less frequently applied, but reporting from home was still frequent (33%). However, only 22% had access to a fully equipped work station at home. While 81% felt safe at work during the crisis, fewer than 50% had sufficient personal protection equipment for the duration of the entire crisis. Mental wellbeing is an area of concern, with 61% feeling (much) worse than usual. Many followed online courses/congresses and considered these a viable alternative for the future. Conclusion The Covid-19 pandemic substantially affected the professional life as well as personal wellbeing of neuroradiologists. Supplementary Information The online version contains supplementary material available at 10.1007/s00234-021-02722-x.
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Affiliation(s)
- Marion Smits
- Department of Radiology & Nuclear Medicine (Ne-515), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - M W Vernooij
- Department of Radiology & Nuclear Medicine (Ne-515), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - N Bargalló
- Magnetic Resonance Image Core Facility, IDIBAPS and Centre of Diagnostic Imaging (CDIC), Hospital Clinic, Barcelona, Spain
| | - A Ramos
- Department of Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - T A Yousry
- Division of Neuroradiology and Neurophysics, Lysholm Department of Neuroradiology, UCL IoN, UCLH, London, UK
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20
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Feinman J. The Waiting is the Hardest Part: Social Isolation and Delayed Healthcare Delivery During the COVID-19 Pandemic. J Cardiothorac Vasc Anesth 2021; 35:3129-3131. [PMID: 33814248 PMCID: PMC7931734 DOI: 10.1053/j.jvca.2021.02.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Jared Feinman
- Hospital of the University of Pennsylvania, Philadelphia, PA
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