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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish implantable cardioverter-defibrillator registry. 19th official report of Heart Rhythm Association of the Spanish Society of Cardiology (2022). REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:922-935. [PMID: 37774946 DOI: 10.1016/j.rec.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents data on implantable cardioverter-defibrillator implants in Spain in 2022. METHODS The data were collected from implantation centers, which voluntarily completed a data collection sheet during the implantation process, either manually or through a web page. RESULTS In 2022, 170 hospitals participated in the registry. A total of 7693 forms were received compared with the 7970 reported by Eucomed (European Confederation of Medical Suppliers Associations), representing 96.5% of the devices. The total rate of registered implants was 162/million inhabitants (168 according to Eucomed), showing a slight increase compared with previous years. Disparities persisted among autonomous communities and Spain continued to have the lowest implantation rate among countries participating in Eucomed. CONCLUSIONS The data from the registry for 2022 reflect the complete recovery of activity after the impact of the COVID-19 pandemic in 2020. Despite a slight improvement, there was no significant change in our position in Europe or in the substantial differences among autonomous communities.
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Manglus L, Lenz P, Dasch B. [Places of death of COVID-19 patients: an observational study based on evaluated death certificates from the city of Muenster, Germany (2021)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:962-971. [PMID: 37233810 PMCID: PMC10214335 DOI: 10.1007/s00103-023-03702-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/12/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The places of death of COVID-19 patients have so far hardly been investigated in Germany. METHODS In a places of death study in Westphalia (Germany), statistical evaluations were carried out in the city of Muenster on the basis of all death certificates from 2021. Persons who had died with or from a COVID-19 infection were identified by medical information on cause of death and analyzed with descriptive statistical methods using SPSS. RESULTS A total of 4044 death certificates were evaluated, and 182 deceased COVID-19 patients were identified (4.5%). In 159 infected patients (3.9%), the viral infection was fatal, whereby the distribution of places of death was as follows: 88.1% in hospital (57.2% in the intensive care unit; 0.0% in the palliative care unit), 0.0% in hospice, 10.7% in nursing homes, 1.3% at home, and 0.0% in other places. All infected patients < 60 years and 75.4% of elderly patients ≥ 80 years died in hospital. Only two COVID-19 patients, both over 80 years old, died at home. COVID-19 deaths in nursing homes (17) affected mostly elderly female residents. Ten of these residents had received end-of-life care from a specialized outpatient palliative care team. DISCUSSION The majority of COVID-19 patients died in hospital. This can be explained by the rapid course of the disease with a high symptom burden and the frequent young age of the patients. Inpatient nursing facilities played a certain role as a place of death in local outbreaks. COVID-19 patients rarely died at home. Infection control measures may be one reason why no patients died in hospices or palliative care units.
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Affiliation(s)
- Lukas Manglus
- Zentrale Einrichtung Palliativmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W30, 48149, Münster, Deutschland
| | - Philipp Lenz
- Zentrale Einrichtung Palliativmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W30, 48149, Münster, Deutschland
| | - Burkhard Dasch
- Zentrale Einrichtung Palliativmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W30, 48149, Münster, Deutschland.
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Krug D, Zaman A, Eidinger L, Grehn M, Boda-Heggemann J, Rudic B, Mehrhof F, Boldt LH, Hohmann S, Merten R, Buergy D, Fleckenstein J, Kluge A, Rogge A, Both M, Rades D, Tilz RR, Olbrich D, König IR, Siebert FA, Schweikard A, Vonthein R, Bonnemeier H, Dunst J, Blanck O. Radiosurgery for ventricular tachycardia (RAVENTA): interim analysis of a multicenter multiplatform feasibility trial. Strahlenther Onkol 2023:10.1007/s00066-023-02091-9. [PMID: 37285038 DOI: 10.1007/s00066-023-02091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/23/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Single-session cardiac stereotactic radiation therapy (SBRT) has demonstrated promising results for patients with refractory ventricular tachycardia (VT). However, the full safety profile of this novel treatment remains unknown and very limited data from prospective clinical multicenter trials are available. METHODS The prospective multicenter multiplatform RAVENTA (radiosurgery for ventricular tachycardia) study assesses high-precision image-guided cardiac SBRT with 25 Gy delivered to the VT substrate determined by high-definition endocardial and/or epicardial electrophysiological mapping in patients with refractory VT ineligible for catheter ablation and an implanted cardioverter defibrillator (ICD). Primary endpoint is the feasibility of full-dose application and procedural safety (defined as an incidence of serious [grade ≥ 3] treatment-related complications ≤ 5% within 30 days after therapy). Secondary endpoints comprise VT burden, ICD interventions, treatment-related toxicity, and quality of life. We present the results of a protocol-defined interim analysis. RESULTS Between 10/2019 and 12/2021, a total of five patients were included at three university medical centers. In all cases, the treatment was carried out without complications. There were no serious potentially treatment-related adverse events and no deterioration of left ventricular ejection fraction upon echocardiography. Three patients had a decrease in VT episodes during follow-up. One patient underwent subsequent catheter ablation for a new VT with different morphology. One patient with local VT recurrence died 6 weeks after treatment in cardiogenic shock. CONCLUSION The interim analysis of the RAVENTA trial demonstrates early initial feasibility of this new treatment without serious complications within 30 days after treatment in five patients. Recruitment will continue as planned and the study has been expanded to further university medical centers. TRIAL REGISTRATION NUMBER NCT03867747 (clinicaltrials.gov). Registered March 8, 2019. Study start: October 1, 2019.
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Affiliation(s)
- David Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany.
| | - Adrian Zaman
- Klinik für Innere Medizin III, Kardiologie, Abteilung für Elektrophysiologie und Rhythmologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Lina Eidinger
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
- Klinik für Innere Medizin III, Kardiologie, Abteilung für Elektrophysiologie und Rhythmologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Melanie Grehn
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Judit Boda-Heggemann
- Universitätsmedizin Mannheim, Klinik für Strahlentherapie und Radioonkologie, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Boris Rudic
- Universitätsmedizin Mannheim, Medizinische Klinik I, Abteilung für Elektrophysiologie und Rhythmologie, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Felix Mehrhof
- Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Leif-Hendrik Boldt
- Medizinische Klinik mit Schwerpunkt Kardiologie (CVK), Abteilung für Elektrophysiologie und Rhythmologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Stephan Hohmann
- Hannover Herzrhythmus Centrum, Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Roland Merten
- Klinik für Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Daniel Buergy
- Universitätsmedizin Mannheim, Klinik für Strahlentherapie und Radioonkologie, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Jens Fleckenstein
- Universitätsmedizin Mannheim, Klinik für Strahlentherapie und Radioonkologie, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Anne Kluge
- Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Annette Rogge
- Klinisches Ethikkomitee, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Marcus Both
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Dirk Rades
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Roland Richard Tilz
- Klinik für Rhythmologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Denise Olbrich
- Zentrum für Klinische Studien, Universität zu Lübeck, Lübeck, Germany
| | - Inke R König
- Institut für Medizinische Biometrie und Statistik, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Frank-Andre Siebert
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Achim Schweikard
- Institut für Robotik und Kognitive Systeme, Universität zu Lübeck, Lübeck, Germany
| | - Reinhard Vonthein
- Institut für Medizinische Biometrie und Statistik, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Hendrik Bonnemeier
- Klinik für Innere Medizin III, Kardiologie, Abteilung für Elektrophysiologie und Rhythmologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
- Klinik für Kardiologie, Helios Klinik Cuxhaven, Cuxhaven, Germany
| | - Jürgen Dunst
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
| | - Oliver Blanck
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus L, 24105, Kiel, Germany
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Schranz M, Boender TS, Greiner T, Kocher T, Wagner B, Greiner F, Bienzeisler J, Diercke M, Grabenhenrich L, Aigner A, Ullrich A. Changes in emergency department utilisation in Germany before and during different phases of the COVID-19 pandemic, using data from a national surveillance system up to June 2021. BMC Public Health 2023; 23:799. [PMID: 37131165 PMCID: PMC10152015 DOI: 10.1186/s12889-023-15375-7] [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: 05/06/2022] [Accepted: 03/06/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic and associated public health and social measures, decreasing patient numbers have been described in various healthcare settings in Germany, including emergency care. This could be explained by changes in disease burden, e.g. due to contact restrictions, but could also be a result of changes in utilisation behaviour of the population. To better understand those dynamics, we analysed routine data from emergency departments to quantify changes in consultation numbers, age distribution, disease acuity and day and hour of the day during different phases of the COVID-19 pandemic. METHODS We used interrupted time series analyses to estimate relative changes for consultation numbers of 20 emergency departments spread throughout Germany. For the pandemic period (16-03-2020 - 13-06-2021) four different phases of the COVID-19 pandemic were defined as interruption points, the pre-pandemic period (06-03-2017 - 09-03-2020) was used as the reference. RESULTS The most pronounced decreases were visible in the first and second wave of the pandemic, with changes of - 30.0% (95%CI: - 32.2%; - 27.7%) and - 25.7% (95%CI: - 27.4%; - 23.9%) for overall consultations, respectively. The decrease was even stronger for the age group of 0-19 years, with - 39.4% in the first and - 35.0% in the second wave. Regarding acuity levels, consultations assessed as urgent, standard, and non-urgent showed the largest decrease, while the most severe cases showed the smallest decrease. CONCLUSIONS The number of emergency department consultations decreased rapidly during the COVID-19 pandemic, without extensive variation in the distribution of patient characteristics. Smallest changes were observed for the most severe consultations and older age groups, which is especially reassuring regarding concerns of possible long-term complications due to patients avoiding urgent emergency care during the pandemic.
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Affiliation(s)
- Madlen Schranz
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Public Health, Berlin, Germany.
| | - T Sonia Boender
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Timo Greiner
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Theresa Kocher
- Department for Methods Development, Research Infrastructure and Information Technology, Robert Koch Institute, Berlin, Germany
| | - Birte Wagner
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Felix Greiner
- Department of Trauma Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jonas Bienzeisler
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Michaela Diercke
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Linus Grabenhenrich
- Department for Methods Development, Research Infrastructure and Information Technology, Robert Koch Institute, Berlin, Germany
| | - Annette Aigner
- Charité - Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Alexander Ullrich
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Balikji J, Koyun AH, Hendriksen PA, Kiani P, Stock AK, Garssen J, Hoogbergen MM, Verster JC. The Impact of COVID-19 Lockdowns in Germany on Mood, Attention Control, Immune Fitness, and Quality of Life of Young Adults with Self-Reported Impaired Wound Healing. J Clin Med 2023; 12:jcm12093205. [PMID: 37176643 PMCID: PMC10179723 DOI: 10.3390/jcm12093205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Previous studies in Dutch young adults revealed that individuals with self-reported impaired wound healing reported poorer mood, increased inattention and impulsivity, poorer quality of life, and poorer immune fitness compared to healthy controls. Another study revealed that the negative impact of lockdowns during the 2019 coronavirus disease (COVID-19) pandemic was significantly more profound among the impaired wound healing group than the control group. The purpose of the current study was to replicate and extend these findings among young adults living in Germany. METHODS A retrospective, cross-sectional survey was conducted among N = 317 young adults living in Germany, 18-35 years old. They were allocated to the IWH group (N = 66) or the control group (N-251). Participants completed the Attention Control Scale, and mood, quality of life, and immune fitness were assessed with single-item ratings. All assessments were made for (1) the period before the COVID-19 pandemic, (2) the first lockdown period, March-May 2020, (3) the first no-lockdown period, summer 2020, (4) the second lockdown, November 2020 to May 2021, and (5) the second no-lockdown period, summer 2021. RESULTS The impaired wound healing group reported significantly poorer mood, quality of life, and immune fitness. The effects were evident before the pandemic. The impaired wound healing group scored significantly poorer on attention focusing, but no significant differences between the groups were found for attention shifting. During the pandemic, negative lockdown effects (i.e., further aggravation of mood and immune fitness and lower quality of life) were evident in both groups but significantly more profound in the impaired wound healing group. No differences between the groups were found for the no-lockdown periods. CONCLUSION Individuals with self-reported impaired wound healing have significantly poorer mood, attention focusing, and immune fitness and report a poorer quality of life than healthy controls. The impact of COVID-19 lockdowns was significantly more profound in the impaired wound-healing group.
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Affiliation(s)
- Jessica Balikji
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Anna H Koyun
- Cognitive Neurophysiology Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, University of Dresden, D-01307 Dresden, Germany
| | - Pauline A Hendriksen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Pantea Kiani
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, University of Dresden, D-01307 Dresden, Germany
- Biopsychology, Department of Psychology, School of Science, TU Dresden, 01062 Dresden, Germany
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
- Global Centre of Excellence Immunology, Nutricia Danone Research, 3584 CT Utrecht, The Netherlands
| | - Maarten M Hoogbergen
- Division of Plastic Surgery, Catharina Ziekenhuis, 5623 EJ Eindhoven, The Netherlands
| | - Joris C Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia
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Thiele H, Zeymer U. The changing spectrum of cardiovascular emergencies during the COVID-19 pandemic. Herz 2023:10.1007/s00059-023-05174-6. [PMID: 37097477 PMCID: PMC10127984 DOI: 10.1007/s00059-023-05174-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 04/26/2023]
Abstract
The outbreak of the COVID-19 pandemic in March 2020 influenced treatment strategies and behaviors, particularly cardiovascular emergencies, which may have led to cardiovascular collateral damage. This review article covers aspects of the changing spectrum of cardiac emergencies with a focus on acute coronary syndrome rates and cardiovascular mortality and morbidity based on a selected literature review including the most recent comprehensive meta-analyses.
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Affiliation(s)
- Holger Thiele
- Heart Center Leipzig, Department of Internal Medicine/Cardiology, University of Leipzig, Strümpellstraße 39, 04289, Leipzig, Germany.
| | - Uwe Zeymer
- Institut für Herzinfarktforschung, Klinikum Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen, Germany
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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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Hansen H, Schäfer I, Dröge F, Menzel A, Tajdar D, Mayer-Runge U, Lühmann D, Scherer M. Association between patient-related factors and avoided consultations due to fear of COVID-19 during the first lockdown in northern Germany: Results of a cross-sectional observational study. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023:S1865-9217(23)00005-3. [PMID: 36973162 PMCID: PMC10039736 DOI: 10.1016/j.zefq.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 03/28/2023]
Abstract
Introduction During the COVID-19 pandemic, many people were anxious about a coronavirus infection due to the high infection rate and the mortality risk associated with the disease. Fear of COVID-19 might have influenced patients’ utilisation of medical services, even if it meant that a postponed therapy had severe consequences. Our aims were to analyse (a) to what extent fear of COVID-19 contributes to forgone consultations, (b) if patient characteristics, health literacy and social support influence the effect of fear of COVID-19 on the utilisation behaviour and (c) whether interactions between these possible predictor variables are responsible for a higher extent of avoided consultations due to fear of COVID-19. Methods We conducted a retrospective, cross-sectional observational study in an emergency department. The study was based on personal standardized interviews of patients. The interviews took place between July 15 and August 5, 2020. Patients over the age of 18 were included if there was no urgent need for treatment on the day of the interview, no severe functional limitations, sufficient knowledge of German, ability to consent and health problems requiring treatment between March 13 and June 13, 2020. Differences between patient subgroups were described and analysed using the t-test and chi2 test. Data were analysed by logistic regression including socio-demographic data, health literacy and social support assessed by standardised instruments. Additionally, we assessed interactions between possible predictor variables by a descriptive tree analysis. Results 103 patients participated in personal standardized interviews. 46 patients (44.6%) reported that at least one necessary consultation did not take place in the observation period. Among those, 29 patients (63.0%) avoided consultations due to fear of COVID-19. Women had 3.36 times higher odds (95% confidence interval: 1.25 to 9.04, p = 0.017) for avoiding a consultation due to fear of COVID-19. There were no other statistically significant predictors in our analysis. Discussion Almost half of the required consultations did not take place. Avoidance of consultations needs to be closely monitored during the pandemic. Policy makers as well as health care providers should give consideration to the collateral effects of COVID-19 and COVID-19-related reactions of patients, especially women. Conclusion In the course of the COVID-19 pandemic, physicians should ensure that their patients take advantage of necessary consultations in order to avoid negative effects of a delayed examination or treatment. Particular attention should be paid to anxious female patients. Studies are needed to analyse the association between health literacy, social support and avoidance of consultations triggered by fear of COVID-19.
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Affiliation(s)
- Heike Hansen
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ingmar Schäfer
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Finn Dröge
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Agata Menzel
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Tajdar
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Mayer-Runge
- Central Emergency Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Lühmann
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lee WE, Woo Park S, Weinberger DM, Olson D, Simonsen L, Grenfell BT, Viboud C. Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022. eLife 2023; 12:77562. [PMID: 36811598 PMCID: PMC9946455 DOI: 10.7554/elife.77562] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 01/15/2023] [Indexed: 02/24/2023] Open
Abstract
Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we use time series approaches to separate the direct contribution of SARS-CoV-2 infection on mortality from the indirect consequences of the pandemic in the United States. We estimate excess deaths occurring above a seasonal baseline from March 1, 2020 to January 1, 2022, stratified by week, state, age, and underlying mortality condition (including COVID-19 and respiratory diseases; Alzheimer's disease; cancer; cerebrovascular diseases; diabetes; heart diseases; and external causes, which include suicides, opioid overdoses, and accidents). Over the study period, we estimate an excess of 1,065,200 (95% Confidence Interval (CI) 909,800-1,218,000) all-cause deaths, of which 80% are reflected in official COVID-19 statistics. State-specific excess death estimates are highly correlated with SARS-CoV-2 serology, lending support to our approach. Mortality from 7 of the 8 studied conditions rose during the pandemic, with the exception of cancer. To separate the direct mortality consequences of SARS-CoV-2 infection from the indirect effects of the pandemic, we fit generalized additive models (GAM) to age- state- and cause-specific weekly excess mortality, using covariates representing direct (COVID-19 intensity) and indirect pandemic effects (hospital intensive care unit (ICU) occupancy and measures of interventions stringency). We find that 84% (95% CI 65-94%) of all-cause excess mortality can be statistically attributed to the direct impact of SARS-CoV-2 infection. We also estimate a large direct contribution of SARS-CoV-2 infection (≥67%) on mortality from diabetes, Alzheimer's, heart diseases, and in all-cause mortality among individuals over 65 years. In contrast, indirect effects predominate in mortality from external causes and all-cause mortality among individuals under 44 years, with periods of stricter interventions associated with greater rises in mortality. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups and in mortality from external causes. Further research on the drivers of indirect mortality is warranted as more detailed mortality data from this pandemic becomes available.
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Affiliation(s)
- Wha-Eum Lee
- Department of Ecology and Evolutionary Biology, Princeton UniversityPrincetonUnited States
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton UniversityPrincetonUnited States
| | | | - Donald Olson
- New York City Department of Health and Mental HygieneNew YorkUnited States
| | - Lone Simonsen
- Department of Science and Environment, Roskilde UniversityRoskildeDenmark
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton UniversityPrincetonUnited States
- Princeton School of Public Affairs, Princeton UniversityPrincetonUnited States
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of HealthBethesdaUnited States
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10
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Boriani G, Guerra F, De Ponti R, D'Onofrio A, Accogli M, Bertini M, Bisignani G, Forleo GB, Landolina M, Lavalle C, Notarstefano P, Ricci RP, Zanotto G, Palmisano P, De Bonis S, Pangallo A, Talarico A, Maglia G, Aspromonte V, Nigro G, Bianchi V, Rapacciuolo A, Ammendola E, Solimene F, Stabile G, Biffi M, Ziacchi M, Malpighi PSO, Saporito D, Casali E, Turco V, Malavasi VL, Vitolo M, Imberti JF, Bertini M, Anna AS, Zardini M, Placci A, Quartieri F, Bottoni N, Carinci V, Barbato G, De Maria E, Borghi A, Ramazzini OB, Bronzetti G, Tomasi C, Boggian G, Virzì S, Sassone B, Corzani A, Sabbatani P, Pastori P, Ciccaglioni A, Adamo F, Scaccia A, Spampinato A, Patruno N, Biscione F, Cinti C, Pignalberi C, Calò L, Tancredi M, Di Belardino N, Ricciardi D, Cauti F, Rossi P, Cardinale M, Ansalone G, Narducci ML, Pelargonio G, Silvetti M, Drago F, Santini L, Pentimalli F, Pepi P, Caravati F, Taravelli E, Belotti G, Rordorf R, Mazzone P, Bella PD, Rossi S, Canevese LF, Cilloni S, Doni LA, Vergara P, Baroni M, Perna E, Gardini A, Negro R, Perego GB, Curnis A, Arabia G, Russo AD, Marchese P, Dell’Era G, Occhetta E, Pizzetti F, Amellone C, Giammaria M, Devecchi C, Coppolino A, Tommasi S, Anselmino M, Coluccia G, Guido A, Rillo M, Palamà Z, Luzzi G, Pellegrino PL, Grimaldi M, Grandinetti G, Vilei E, Potenza D, Scicchitano P, Favale S, Santobuono VE, Sai R, Melissano D, Candida TR, Bonfantino VM, Di Canda D, Gianfrancesco D, Carretta D, Pisanò ECL, Medico A, Giaccari R, Aste R, Murgia C, Nissardi V, Sanna GD, Firetto G, Crea P, Ciotta E, Sgarito G, Caramanno G, Ciaramitaro G, Faraci A, Fasheri A, Di Gregorio L, Campsi G, Muscio G, Giannola G, Padeletti M, Del Rosso A, Notarstefano P, Nesti M, Miracapillo G, Giovannini T, Pieragnoli P, Rauhe W, Marini M, Guarracini F, Ridarelli M, Fedeli F, Mazza A, Zingarini G, Andreoli C, Carreras G, Zorzi A, Zanotto G, Rossillo A, Ignatuk B, Zerbo F, Molon G, Fantinel M, Zanon F, Marcantoni L, Zadro M, Bevilacqua M. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing). Intern Emerg Med 2023; 18:137-149. [PMID: 36352300 PMCID: PMC9646282 DOI: 10.1007/s11739-022-03140-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care. METHODS A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched. RESULTS A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined. CONCLUSIONS The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo 71, 41121, Modena, Italy.
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital Umberto I-Lancisi-Salesi, Ancona, Italy
| | - Roberto De Ponti
- Department of Heart and Vessels, Ospedale di Circolo-University of Insubria, Varese, Italy
| | - Antonio D'Onofrio
- Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy
| | | | - Matteo Bertini
- Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara "Arcispedale S. Anna", Cona, Ferrara, Italy
| | - Giovanni Bisignani
- Cardiology Division, Castrovillari Hospital, ASP Cosenza, Castrovillari, Italy
| | | | | | - Carlo Lavalle
- Department of Cardiology, Policlinico Universitario Umberto I, Rome, Italy
| | | | | | - Gabriele Zanotto
- Department of Cardiology, Mater Salutis Hospital, Legnago, Verona, Italy
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11
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Abduljawwad N, Pamnani S, Stoffel M, Kraft CN, Hegewald AA, Dörre R, Heese O, Gerlach R, Rosahl S, Maier B, Burger R, Wutzler S, Carl B, Ryang YM, Hau KT, Stein G, Gulow J, Kuhlen R, Hohenstein S, Bollmann A, Dengler J. Effects of the COVID-19 Pandemic on Spinal Fusion Procedures for Spinal Infections in a Nationwide Hospital Network in Germany. J Neurol Surg A Cent Eur Neurosurg 2023; 84:58-64. [PMID: 35760290 DOI: 10.1055/s-0042-1749353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with spinal fusion procedures in the treatment of spinal infections (SI) during different phases of the pandemic. METHODS In this retrospective observational study, we examined the in-hospital prevalence and outcomes of spinal fusion procedures for SI (along with patient characteristics, rates of transfer to intensive care units, and mortality rates) during the first four waves of the pandemic compared with the corresponding prepandemic periods in 2019. We used administrative data from a nationwide network of 76 hospitals managing 7% of all in-hospital cases in Germany. RESULTS We observed no significant change in the prevalence of SI fusion procedures during the pandemic, neither in total numbers (349 vs. 373) nor for each wave separately. On a patient level, we found no differences in age, sex, and the prevalence of paresis, and no relevant differences in associated comorbidities. The rate of mechanical ventilation did not change during any of the examined pandemic waves: it ranged between 9.5 and 18.6% during the pandemic and 3.1 and 16.0% during the corresponding prepandemic control periods. The rate of transfer to intensive care changed only during wave 4 (from 70.4 to 54.8%; p = 0.046) but not in any other pandemic phases. We observed no changes in in-hospital mortality rates (range: 2.9-9.7% vs. 6.2-11.3%) or in duration of hospital stay (range: 26.2-30.8 days vs. 20.8-29.2 days). CONCLUSIONS The main finding of our study is that within this nationwide network of spine care centers in Germany, the delivery of surgical treatment of SI by means of spinal fusion procedures was maintained throughout the first four waves of the pandemic. Furthermore, there were no relevant changes in patient demographics, in-hospital processes, and mortality rates.
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Affiliation(s)
- Nehad Abduljawwad
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bad Saarow, Germany.,Department of Neurosurgery, HELIOS Hospital Bad Saarow, Bad Saarow, Germany
| | - Sunisha Pamnani
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bad Saarow, Germany.,Department of Neurosurgery, HELIOS Hospital Bad Saarow, Bad Saarow, Germany
| | - Michael Stoffel
- Department of Neurosurgery, HELIOS Hospital Krefeld, Krefeld, Germany
| | - Clayton N Kraft
- Department of Orthopedics, Trauma Surgery and Hand Unit, HELIOS Klinikum Krefeld, Krefeld, Germany
| | - Aldemar A Hegewald
- Department of Neurosurgery, VAMED Ostsee Hospital Damp, Ostseebad Damp, Germany
| | - Ralf Dörre
- Department of Neurosurgery, HELIOS Hospital St. Marienberg, Helmstedt, Germany
| | - Oliver Heese
- Department of Neurosurgery and Spinal Surgery, HELIOS Hospital Schwerin - University Campus of MSH Medical School Hamburg, Schwerin, Germany
| | - Rüdiger Gerlach
- Department of Neurosurgery, HELIOS Hospital Erfurt, Erfurt, Germany
| | - Steffen Rosahl
- Department of Neurosurgery, HELIOS Hospital Erfurt, Erfurt, Germany
| | - Bernd Maier
- Department of Trauma and Orthopedic Surgery, HELIOS Hospital Pforzheim, Pforzheim, Germany
| | - Ralf Burger
- Department of Neurosurgery, HELIOS Hospital Uelzen, Uelzen, Germany
| | - Sebastian Wutzler
- Department of Trauma, Hand and Orthopedic Surgery, HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - Barbara Carl
- Department of Neurosurgery, University of Marburg, Marburg, Germany.,Marburg Center for Mind, Brain and Behavior (MCMBB), Marburg, Germany.,Department of Neurosurgery, HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany
| | - Yu-Mi Ryang
- Department of Neurosurgery and Spine Center, HELIOS Hospital Berlin Buch, Berlin, Germany.,Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Khanh Toan Hau
- Department of Spine Surgery, HELIOS Hospital Duisburg, Duisburg, Germany
| | - Gregor Stein
- Department of Orthopaedic, Trauma and Spine Surgery, HELIOS Hospital Siegburg, Siegburg, Germany
| | - Jens Gulow
- Department of Spine Surgery, HELIOS Park-Klinikum Leipzig, Leipzig, Germany
| | | | | | - Andreas Bollmann
- Helios Health Institute, Leipzig, Germany.,Department of Electrophysiology, Heart Center Leipzig at Leipzig University, Germany
| | - Julius Dengler
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bad Saarow, Germany.,Department of Neurosurgery, HELIOS Hospital Bad Saarow, Bad Saarow, Germany
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Effects of a multilayered crisis on psychiatric hospitalizations in a university hospital in Lebanon; a retrospective study. Psychiatry Res 2022; 318:114940. [PMID: 36375330 DOI: 10.1016/j.psychres.2022.114940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 11/05/2022]
Abstract
Lebanon is struggling with a multilayered crisis following the COVID-19 breakout, the economic crisis, and the Beirut port explosion. The aim of this article is to assess the effect of these crisis on the characteristics of patients hospitalized in psychiatry. This is a retrospective study conducted at the psychiatric ward of Hotel Dieu de France in Beirut between January 2017 and march 2022. The population was divided into three groups according to specific time events indicating the start of a certain crisis. Data regarding patients' demographics, psychiatric history and their present hospitalization was collected. A total of 1655 patient files were included in the study. Overall, the rate of hospitalized women increased following the Beirut port explosion, together with the rate of patients younger than 18 years old. Moreover, during the COVID-19 breakout and the start of the economic crisis, alcohol use decreased, as well as the length of stay in the hospital. In conclusion, in the event of a multilayered crisis children and adolescents, as well as women are the most at risk of being affected in terms of mental health.
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13
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Jiang J, Zhao S, Cheng C, Lin N, Li P, Ning X, Zhang S. Impact of COVID-19 pandemic on catheter ablation in China: A spatiotemporal analysis. Front Public Health 2022; 10:1027926. [PMID: 36504945 PMCID: PMC9727188 DOI: 10.3389/fpubh.2022.1027926] [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: 08/25/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background The COVID-19 pandemic has significantly impacted routine cardiovascular health assessments and services. We aim to depict the temporal trend of catheter ablation (CA) and provide experience in dealing with the negative impact of the COVID-19 pandemic. Methods Data on CA between January 2019, and December 2021, were extracted from the National Center for Cardiovascular Quality Improvement platform. CA alterations from 2019 to 2021 were assessed with a generalized estimation equation. Results A total of 347,924 patients undergoing CA were included in the final analysis. The CA decreased remarkably from 122,839 in 2019 to 100,019 (-18.58%, 95% CI: -33.40% to -3.75%, p = 0.02) in 2020, and increased slightly to 125,006 (1.81%, 95% CI: -7.01% to 3.38%, p = 0.49) in 2021. The CA experienced the maximal reduction in February 2020 (-88.78%) corresponding with the peak of monthly new COVID-19 cases and decreased by 54.32% (95%CI: -71.27% to -37.37%, p < 0.001) during the 3-month lockdown and increased firstly in June 2020 relative to 2019. Since then, the CA in 2020 remained unchanged relative to 2019 (-0.06%, 95% CI: -7.01% to 3.38%, p = 0.98). Notably, the recovery of CA in 2021 to pre-COVID-19 levels was mainly driven by the growth of CA in secondary hospitals. Although there is a slight increase (2167) in CA in 2021 relative to 2019, both the absolute number and proportion of CA in the top 50 hospitals nationwide [53,887 (43.09%) vs. 63,811 (51.95%), p < 0.001] and top three hospitals in each province [66,152 (52.73%) vs. 72,392 (59.28%), p < 0.001] still declined significantly. Conclusions The CA experienced a substantial decline during the early phase of the COVID-19 pandemic, and then gradually returned to pre-COVID-19 levels. Notably, the growth of CA in secondary hospitals plays an important role in the overall resumption, which implies that systematic guidance of secondary hospitals with CA experience may aid in mitigating the negative impact of the COVID-19 pandemic.
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Affiliation(s)
- Jiang Jiang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Zhao
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chendi Cheng
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Lin
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,National Center for Cardiovascular Quality Improvement Committee, Fuwai Hospital, Beijing, China
| | - Ping Li
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohui Ning
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Xiaohui Ning
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,National Center for Cardiovascular Quality Improvement Committee, Fuwai Hospital, Beijing, China,Chinese Society of Arrhythmia, Beijing, China,Chinese Society of Pacing and Electrophysiology, Beijing, China,Shu Zhang
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14
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Koo CY, Chan SP, Tung BWL, Poh KK, Tan HC, Loh PH. ST-segment elevation myocardial infarction hospitalisations remain unchanged during COVID-19. Singapore Med J 2022; 63:684-685. [PMID: 33256353 PMCID: PMC9815168 DOI: 10.11622/smedj.2020157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Chieh Yang Koo
- Department of Cardiology, National University Heart Centre Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Siew Pang Chan
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | | | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Huay-Cheem Tan
- Department of Cardiology, National University Heart Centre Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Heart Centre Singapore, Singapore
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish implantable cardioverter-defibrillator registry. 18th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021). REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:933-945. [PMID: 36155845 DOI: 10.1016/j.rec.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents the data corresponding to implantable cardioverter-defibrillator (ICD) implantations in Spain in 2021. METHODS The data were drawn from implanting centers, which voluntarily completed a data collection sheet during the procedure. RESULTS In 2021, 7496 implant data sheets were received, compared with 7743 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 96.8% of the devices implanted in Spain. Data completion ranged from 99.9% for "name of implanting hospital" to 8.9% for "implanting hospital". In 2021, 199 hospitals participated in the registry, exceeding the figures of previous years, with around 170 participating hospitals. The total rate of registered implants was 158/million inhabitants (163 according to Eucomed), making 2021 the year with the highest activity. However, the registry continues to show significant differences among the various autonomous communities and the lowest implantation rate of all the European countries participating in Eucomed. CONCLUSIONS The Spanish implantable cardioverter-defibrillator registry for 2021 recorded an increase in the number of ICD implantations, reflecting the recovery of hospital activity after the initial impact of the COVID-19 pandemic in 2020. Although the total number of implants has increased in Spain, figures are still much lower than the European Union average, with differences persisting among Spanish autonomous communities.
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Vidal-Perez R, Brandão M, Pazdernik M, Kresoja KP, Carpenito M, Maeda S, Casado-Arroyo R, Muscoli S, Pöss J, Fontes-Carvalho R, Vazquez-Rodriguez JM. Cardiovascular disease and COVID-19, a deadly combination: A review about direct and indirect impact of a pandemic. World J Clin Cases 2022; 10:9556-9572. [PMID: 36186196 PMCID: PMC9516905 DOI: 10.12998/wjcc.v10.i27.9556] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is known to present with respiratory symptoms, which can lead to severe pneumonia and respiratory failure. However, it can have multisystem complications such as cardiovascular manifestations. The cardiovascular manifestations reported comprise myocarditis, cardiogenic shock, arrhythmias, pulmonary embolism, deep vein embolism, acute heart failure, and myocardial infarction. There is also an indirect impact of the pandemic on the management of cardiovascular care that has been shown clearly in multiple publications. In this review, we summarize the deadly relation of COVID-19 with cardiovascular events and the wider impact on several cardiovascular care areas by the pandemic situation
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Affiliation(s)
- Rafael Vidal-Perez
- Servicio de Cardiología, Unidad de Imagen y Función Cardíaca, Complexo Hospitalario Universitario A Coruña Centro de Investigación Biomédica en Red-Instituto de Salud Carlos III, A Coruña 15006, Spain
| | - Mariana Brandão
- Department of Cardiology, Centro Hospitalar de Gaia, Gaia 4400-020, Portugal
| | - Michal Pazdernik
- Intensive Care Unit, Department of Cardiology, Institute for Clinical and Experimental Medicine Prague, Prague 14021, Czech Republic
| | | | - Myriam Carpenito
- Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome 00128, Italy
| | - Shingo Maeda
- Arrhythmia Advanced Therapy Center, AOI Universal Hospital, Kawasaki 210-0822, Japan
| | - Rubén Casado-Arroyo
- Department of Cardiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels 1070, Belgium
| | - Saverio Muscoli
- Unit of Cardiology, Policlinico Tor Vergata, Rome 00133, Italy
| | - Janine Pöss
- Heart Center Leipzig, University of Leipzig, Leipzig 04289, Germany
| | - Ricardo Fontes-Carvalho
- Department of Cardiology, Centro Hospitalar de Gaia, Gaia 4400-020, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto 4200-319, Portugal
| | - Jose Manuel Vazquez-Rodriguez
- Servicio de Cardiología, Unidad de Imagen y Función Cardíaca, Complexo Hospitalario Universitario A Coruña Centro de Investigación Biomédica en Red-Instituto de Salud Carlos III, A Coruña 15006, Spain
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Registro español de desfibrilador automático implantable. XVIII informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2021). Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Effects of the COVID-19 pandemic on acute coronary syndromes in Germany during the first wave: the COVID-19 collateral damage study. Clin Res Cardiol 2022; 112:539-549. [PMID: 35978111 PMCID: PMC9385100 DOI: 10.1007/s00392-022-02082-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/03/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Reports about the influence of the COVID-19 pandemic on the number of hospital admissions and in-hospital mortality during the first wave between March and May 2020 showed conflicting results and are limited by single-center or limited regional multicenter datasets. Aim of this analysis covering all German federal states was the comprehensive description of hospital admissions and in-hospital mortality during the first wave of the COVID-19 pandemic. METHODS AND RESULTS We conducted an observational study on hospital routine data (§21 KHEntgG) and included patients with the main diagnosis of acute myocardial infarction (ICD 21 and ICD 22). A total of 159 hospitals included 36,329 patients in the database, with 12,497 patients admitted with ST-elevation myocardial infarction (STEMI) and 23,832 admitted with non-ST-elevation myocardial infarction (NSTEMI). There was a significant reduction in the number of patients admitted with STEMI (3748 in 2020, 4263 in 2019 and 4486 in 2018; p < 0.01) and NSTEMI (6957 in 2020, 8437 in 2019 and 8438 in 2020; p < 0.01). These reductions were different between the Federal states of Germany. Percutaneous coronary intervention was performed more often in 2020 than in 2019 (odds ratio 1.13, 95% confidence interval [CI] 1.06-1.21) and 2018 (odds ratio 1.20, 95% CI 1.12-1.29) in NSTEMI and more often than in 2018 (odds ratio 1.26, 95% CI 1.10-1.43) in STEMI. The in-hospital mortality did not differ between the years for STEMI and NSTEMI, respectively. CONCLUSIONS In this large representative sample size of hospitals in Germany, we observed significantly fewer admissions for NSTEMI and STEMI during the first COVID-19 wave, while quality of in-hospital care and in-hospital mortality were not affected. Admissions for STEMI and NSTEMI during the months March to May over 3 years and corresponding in-hospital mortality for patients with STEMI and NSTEMI in 159 German hospitals. (p-value for admissions 2020 versus 2019 and 2018: < 0.01; p-value for mortality: n.s.).
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Clinical Support through Telemedicine in Heart Failure Outpatients during the COVID-19 Pandemic Period: Results of a 12-Months Follow Up. J Clin Med 2022; 11:jcm11102790. [PMID: 35628916 PMCID: PMC9147859 DOI: 10.3390/jcm11102790] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/02/2023] Open
Abstract
Background: Heart failure (HF) patients are predisposed to recurrences and disease destabilizations, especially during the COVID-19 outbreak period. In this scenario, telemedicine could be a proper way to ensure continuous care. The purpose of the study was to compare two modalities of HF outpatients’ follow up, the traditional in-person visits and telephone consultations, during the COVID-19 pandemic period in Italy. Methods: We conducted an observational study on consecutive HF outpatients. The follow up period was 12 months, starting from the beginning of the COVID-19 Italy lockdown. According to the follow up modality, and after the propensity matching score, patients were divided into two groups: those in G1 (n = 92) were managed with traditional in-person visits and those in G2 (n = 92) were managed with telephone consultation. Major adverse cardiovascular events (MACE) were the primary endpoints. Secondary endpoints were overall mortality, cardiovascular death, cardiovascular hospitalization, and hospitalization due to HF. Results: No significant differences between G1 and G2 have been observed regarding MACE (p = 0.65), cardiovascular death (p = 0.39), overall mortality (p = 0.85), hospitalization due to acute HF (p = 0.07), and cardiovascular hospitalization (p = 0.4). Survival analysis performed by the Kaplan–Meier method also did not show significant differences between G1 and G2. Conclusions: Telephone consultations represented a valid option to manage HF outpatients during COVID-19 pandemic, comparable to traditional in-person visits.
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Baigent C, Windecker S, Andreini D, Arbelo E, Barbato E, Bartorelli AL, Baumbach A, Behr ER, Berti S, Bueno H, Capodanno D, Cappato R, Chieffo A, Collet JP, Cuisset T, de Simone G, Delgado V, Dendale P, Dudek D, Edvardsen T, Elvan A, González-Juanatey JR, Gori M, Grobbee D, Guzik TJ, Halvorsen S, Haude M, Heidbuchel H, Hindricks G, Ibanez B, Karam N, Katus H, Klok FA, Konstantinides SV, Landmesser U, Leclercq C, Leonardi S, Lettino M, Marenzi G, Mauri J, Metra M, Morici N, Mueller C, Petronio AS, Polovina MM, Potpara T, Praz F, Prendergast B, Prescott E, Price S, Pruszczyk P, Rodríguez-Leor O, Roffi M, Romaguera R, Rosenkranz S, Sarkozy A, Scherrenberg M, Seferovic P, Senni M, Spera FR, Stefanini G, Thiele H, Tomasoni D, Torracca L, Touyz RM, Wilde AA, Williams B. European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis. Cardiovasc Res 2022; 118:1385-1412. [PMID: 34864874 PMCID: PMC8690255 DOI: 10.1093/cvr/cvab342] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIMS Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. METHODS AND RESULTS A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. CONCLUSION This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities.
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Affiliation(s)
- Colin Baigent
- MRC Population Health Research Unit, Nuffield Department of Population Health, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, Freiburgstrasse 4, 3010 Bern, Switzerland
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, Hospital Clínic
| | - Elena Arbelo
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- ECGen, the Cardiogenetics Focus Group of EHRA
| | - Emanuele Barbato
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
- Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Andreas Baumbach
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, UK
- Yale University School of Medicine, New Haven, CT, USA
| | - Elijah R Behr
- ECGen, the Cardiogenetics Focus Group of EHRA
- Cardiology Clinical Academic Group, Institute of Molecular and Clinical Sciences, St George's, University of London, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARDHEART)
| | - Sergio Berti
- U.O.C. Cardiologia Diagnostica e Interventistica, Dipartimento Cardiotoracico, Fondazione Toscana G. Monasterio - Ospedale del Cuore G. Pasquinucci, Massa, Italy
| | - Héctor Bueno
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Davide Capodanno
- Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco" University of Catania, Catania, Italy
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Center, IRCCS Gruppo MultiMedica, Sesto San Giovanni, Milan, Italy
| | | | - Jean-Philippe Collet
- Sorbonne Université, ACTION study group, Institut de Cardiologie, Pitié Salpêtrière Hospital (AP-HP), Paris, France
| | - Thomas Cuisset
- Département de Cardiologie, CHU Timone, Marseille, France
- INSERM, UMR1062, Nutrition, Obesity and Risk of Thrombosis, Marseille, France
- Faculté de Médecine, Aix-Marseille Université, Marseille, France
| | - Giovanni de Simone
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
- Hypertension Research Center, Federico II University Hospital, Naples, Italy
| | - Victoria Delgado
- Heart Lung Centrum, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Uhasselt, Diepenbeek, Belgium
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Maria Cecilia Hospital, GVM Care&Research, Cotignola (RA), Ravenna, Italy
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Arif Elvan
- Isala Heart Center, Zwolle, The Netherlands
| | - José R González-Juanatey
- Cardiology Department, University Hospital, IDIS, CIBERCV, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mauro Gori
- Cardiovascular Department and Cardiology Unit, Papa Giovanni XXIII Hospital-Bergamo, Bergamo, Italy
| | - Diederick Grobbee
- Julius Global Health, the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Department of Medicine, Jagiellonian University College of Medicine, Kraków, Poland
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway
- University of Oslo, Oslo, Norway
| | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
| | - Hein Heidbuchel
- Department of Cardiology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - Gerhard Hindricks
- Department of Internal Medicine/Cardiology/Electrophysiology, Heart Center Leipzig, University Hospital Leipzig, Leipzig, Germany
- Leipzig Heart Institute (LHI), Leipzig, Germany
| | - Borja Ibanez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain
| | - Nicole Karam
- Université de Paris, PARCC, INSERM, Paris, France
- European Hospital Georges Pompidou, Paris, France
| | - Hugo Katus
- Department of Internal Medicine, University Hospital of Heidelberg, Heidelberg, Germany
| | - Fredrikus A Klok
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Stavros V Konstantinides
- Center for Thrombosis and Hemostasis, Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ulf Landmesser
- Department of Cardiology, Charite University Medicine Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), German Center of Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | | | - Sergio Leonardi
- University of Pavia, Pavia, Italy
- Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | | | - Josepa Mauri
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Health Department of the Government of Catalonia, Barcelona, Spain
| | - Marco Metra
- Institute of Cardiology, ASST Spedali Civili di Brescia, Brescia, Italy
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Nuccia Morici
- Unità di Cure Intensive Cardiologiche e De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi, Milan, Italy
| | - Christian Mueller
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anna Sonia Petronio
- Cardiothoracic and Vascular Department, University of Pisa, Ospedale Cisanello, Pisa, Italy
| | - Marija M Polovina
- Faculty of Medicine, Belgrade University, Belgrade, Serbia
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Tatjana Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Intensive Arrhythmia Care, Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia
| | - Fabien Praz
- Department of Cardiology, University Hospital Bern, Bern, Switzerland
| | | | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Susanna Price
- Royal Brompton Hospital, London, UK
- National Heart & Lung Institute, Imperial College, London, UK
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Oriol Rodríguez-Leor
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Health Department of the Government of Catalonia, Barcelona, Spain
| | - Marco Roffi
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Rafael Romaguera
- Servicio de Cardiología, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Stephan Rosenkranz
- Clinic III for Internal Medicine (Cardiology) and Cologne Cardiovascular Research Center (CCRC), Heart Center at the University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Andrea Sarkozy
- Department of Cardiology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - Martijn Scherrenberg
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Uhasselt, Diepenbeek, Belgium
| | - Petar Seferovic
- Faculty of Medicine, Belgrade University, Belgrade, Serbia
- Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - Michele Senni
- Cardiovascular Department and Cardiology Unit, Papa Giovanni XXIII Hospital-Bergamo, Bergamo, Italy
| | - Francesco R Spera
- Department of Cardiology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - Giulio Stefanini
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, Pieve Emanuele - Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano - Milan, Italy
| | - Holger Thiele
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
- Leipzig Heart Institute (LHI), Leipzig, Germany
| | - Daniela Tomasoni
- Institute of Cardiology, ASST Spedali Civili di Brescia, Brescia, Italy
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luccia Torracca
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, Humanitas University, Pieve Emanuele - Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano - Milan, Italy
| | - Rhian M Touyz
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Arthur A Wilde
- ECGen, the Cardiogenetics Focus Group of EHRA
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARDHEART)
- Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
- Department of Clinical Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Bryan Williams
- Institute of Cardiovascular Sciences, University College London, London, UK
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21
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Jones ID. The impact of Covid-19 on cardiovascular health. Nurs Crit Care 2022; 27:141-144. [PMID: 35384184 PMCID: PMC9115423 DOI: 10.1111/nicc.12756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Ian D Jones
- Liverpool Centre for Cardiovascular Science, School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, United Kingdom
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22
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Baigent C, Windecker S, Andreini D, Arbelo E, Barbato E, Bartorelli AL, Baumbach A, Behr ER, Berti S, Bueno H, Capodanno D, Cappato R, Chieffo A, Collet JP, Cuisset T, de Simone G, Delgado V, Dendale P, Dudek D, Edvardsen T, Elvan A, González-Juanatey JR, Gori M, Grobbee D, Guzik TJ, Halvorsen S, Haude M, Heidbuchel H, Hindricks G, Ibanez B, Karam N, Katus H, Klok FA, Konstantinides SV, Landmesser U, Leclercq C, Leonardi S, Lettino M, Marenzi G, Mauri J, Metra M, Morici N, Mueller C, Petronio AS, Polovina MM, Potpara T, Praz F, Prendergast B, Prescott E, Price S, Pruszczyk P, Rodríguez-Leor O, Roffi M, Romaguera R, Rosenkranz S, Sarkozy A, Scherrenberg M, Seferovic P, Senni M, Spera FR, Stefanini G, Thiele H, Tomasoni D, Torracca L, Touyz RM, Wilde AA, Williams B. European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis. Eur Heart J 2022; 43:1033-1058. [PMID: 34791157 PMCID: PMC8690026 DOI: 10.1093/eurheartj/ehab696] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/08/2021] [Accepted: 09/13/2021] [Indexed: 01/08/2023] Open
Abstract
AIMS Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. METHODS AND RESULTS A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. CONCLUSION This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities.
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23
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Schwab JO, Wiese J, Hauser T. The influence of the 2020 COVID-19 pandemic on the implantation rates of cardiac implantable electronic devices in Germany: changes between 2020 Q1-Q3 and 2019 Q1-Q3. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2022; 8:104-112. [PMID: 34849668 PMCID: PMC8690261 DOI: 10.1093/ehjqcco/qcab091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/16/2021] [Accepted: 11/26/2021] [Indexed: 12/12/2022]
Abstract
Aim During the early phase of the COVID-19 pandemic, hospital admissions for several medical and surgical conditions have declined. Few data are available with respect to elective cardiac implantable electronic devices (CIEDs) implantation. The aim of the present study was to determine the impact of the COVID-19 pandemic on the monthly CIED implantation rates in Germany. Methods and Results The monthly rates of CIED implantation for the 2019 pre- and 2020 pandemic periods were retrieved from the “Institute für das Entgeltsystem im Krankenhaus” (InEK) using OPS codes to identify pacemakers (PMs), implantable cardioverter/defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) systems. Compared with 2019, the COVID-19 pandemic was associated with an overall decline of CIED implantation rates of -2.6%, reaching -22,9% in April 2020. Stratified by device type, the patterns of implantation were similar between PMs and ICDs, with maximal declines of -24.3% and -23.2% in April, respectively. Thereafter, the implantation rates gradually increased before stabilizing to rates similar to those observed in 2019. CRT implantation rates also declined in the early pandemic wave, but the overall 2020 rates increased by +4.3% likely driven by an increase of +16.5% (June to September). All observed percentage differences of monthly device type related implantation rates demonstrated a statistical significance. Conclusions The COVID-19 pandemic had a significant impact on the implantation of CIEDs in Germany. A differential pattern of resource utilization was observed with a catch-up effect for PMs and ICDs. The implantation rates of CRT also declined, but they increased rapidly and remained higher than those of 2019.
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Affiliation(s)
- Jörg Otto Schwab
- Department of Therapeutic and Interventional Cardiology, Preventive Medicine, Beta Clinic International Hospital, Joseph-Schumpeter-Allee 15, 53227 Bonn, Germany
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Lee WE, Park SW, Weinberger DM, Olson D, Simonsen L, Grenfell BT, Viboud C. Direct and indirect mortality impacts of the COVID-19 pandemic in the US, March 2020-April 2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.02.10.22270721. [PMID: 35194617 PMCID: PMC8863161 DOI: 10.1101/2022.02.10.22270721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we used time series approaches to separate the direct contribution of SARS-CoV-2 infections on mortality from the indirect consequences of pandemic interventions and behavior changes in the United States. We estimated deaths occurring in excess of seasonal baselines stratified by state, age, week and cause (all causes, COVID-19 and respiratory diseases, Alzheimer's disease, cancer, cerebrovascular disease, diabetes, heart disease, and external causes, including suicides, opioids, accidents) from March 1, 2020 to April 30, 2021. Our estimates of COVID-19 excess deaths were highly correlated with SARS-CoV-2 serology, lending support to our approach. Over the study period, we estimate an excess of 666,000 (95% Confidence Interval (CI) 556000, 774000) all-cause deaths, of which 90% could be attributed to the direct impact of SARS-CoV-2 infection, and 78% were reflected in official COVID-19 statistics. Mortality from all disease conditions rose during the pandemic, except for cancer. The largest direct impacts of the pandemic were seen in mortality from diabetes, Alzheimer's, and heart diseases, and in age groups over 65 years. In contrast, the largest indirect consequences of the pandemic were seen in deaths from external causes, which increased by 45,300 (95% CI 30,800, 59,500) and were statistically linked to the intensity of non-pharmaceutical interventions. Within this category, increases were most pronounced in mortality from accidents and injuries, drug overdoses, and assaults and homicides, while the rate of death from suicides remained stable. Younger age groups suffered the brunt of these indirect effects. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups, in periods of stricter interventions, and in mortality from external causes. Further research on the drivers of indirect mortality is warranted to optimize interventions in future pandemics.
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Affiliation(s)
- Wha-Eum Lee
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, USA, 08544
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, USA, 08544
| | | | - Donald Olson
- Department of Health and Mental Hygiene, New York, New York
| | - Lone Simonsen
- Department of Science and Environment, Roskilde University, Denmark
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, USA, 08544
- Princeton School of Public Affairs, Princeton University, Princeton, USA, 08544
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA. 20892
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Cholecystectomies in the COVID-19 Pandemic During and After the First Lockdown in Germany: an Analysis of 8561 Patients. J Gastrointest Surg 2022; 26:408-413. [PMID: 34671914 PMCID: PMC8528474 DOI: 10.1007/s11605-021-05157-0] [Citation(s) in RCA: 4] [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] [Received: 05/25/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE The COVID-19 pandemic has led to global changes in healthcare systems. The purpose of this study was to investigate the effects on surgical care of patients. METHODS We performed a retrospective analysis of routine data from the largest hospital group in Germany (68 acute hospitals). Included were inpatients who underwent cholecystectomy between March 19, 2020 (beginning of the first lockdown in Germany) and September 22, 2020. These patients were compared with those treated in the same interval in 2019. RESULTS In the 2020 study period, 4035 patients met the inclusion criteria (2019: 4526 patients). During the first lockdown, there was a significant reduction in the number of cholecystectomies performed (51.1% decrease). More patients with a higher risk profile underwent urgent operations, which were accompanied by a significant increase in conversion from laparoscopic to open cholecystectomy. The patients were treated as inpatients for a longer duration than 2019, and the mortality rate increased significantly to 1.3% (2019: 0.1%). The complication rate also showed a significant increase. After the end of the first lockdown, daily admission rates normalized very quickly. However, it was not possible to fully address the backlog of operations. CONCLUSION There is still a "patient stagnation" 6 months after the first German lockdown. Extrapolated to the national level, this corresponds to almost 21,000 fewer cholecystectomies performed in Germany in 2020. It remains to be seen whether surgical rates will return to pre-pandemic levels and whether complications will arise in the future due to the lack of operations.
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Müssigbrodt A, Demoniere F, Banydeen R, Finoly S, Mommarche M, Inamo J. Feasibility of remote technical support for electrophysiological ablation procedures during the current COVID-19 pandemic. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 3:77-80. [PMID: 36713987 PMCID: PMC8755332 DOI: 10.1093/ehjdh/ztab107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/29/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
Aims The treatment of heart rhythm disorders has been significantly impacted by direct consequences of the current COVID-19 pandemic, as well as by restrictions aimed towards constraining viral spread. Methods and results Usually, catheter ablations of cardiac arrhythmias are guided by electro-anatomic mapping (EAM) systems. Technical staff with medical training, or medical staff with technical training, are needed to assist the operator. Travel restrictions due to the current COVID-19 pandemic have limited the in-person availability of technical support staff. To overcome these limitations, we explored the feasibility of a trans-atlantic remote technical support for EAM, with an internet-based communication platform, for complex electrophysiological ablation procedures. Conclusion Our first experience, based on nine ablation procedures of different arrhythmias, highlights the feasibility of this approach. Remote support for EAM might therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemic, particularly in insular settings. Beyond COVID-19-related challenges, this approach will likely play a greater role in the cardiology field in years to come, due to its significant advantages.
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Affiliation(s)
| | - Fabrice Demoniere
- Department of Cardiology, CHU Martinique (University Hospital of Martinique), Boulevard Pasteur, 97200 Fort de France, Martinique, France
| | - Rishika Banydeen
- Clinical Research Department, CHU Martinique (University Hospital of Martinique), Boulevard Pasteur, 97200 Fort de France, Martinique, France
| | - Steeve Finoly
- Department of Cardiology, CHU Martinique (University Hospital of Martinique), Boulevard Pasteur, 97200 Fort de France, Martinique, France
| | - Max Mommarche
- Department of Cardiology, CHU Martinique (University Hospital of Martinique), Boulevard Pasteur, 97200 Fort de France, Martinique, France
| | - Jocelyn Inamo
- Department of Cardiology, CHU Martinique (University Hospital of Martinique), Boulevard Pasteur, 97200 Fort de France, Martinique, France
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König S, Pellissier V, Leiner J, Hohenstein S, Ueberham L, Meier-Hellmann A, Kuhlen R, Hindricks G, Bollmann A. Expected and observed in-hospital mortality in heart failure patients before and during the COVID-19 pandemic: Introduction of the machine learning-based standardized mortality ratio at Helios hospitals. Clin Cardiol 2021; 45:75-82. [PMID: 34951030 PMCID: PMC8799043 DOI: 10.1002/clc.23762] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Reduced hospital admission rates for heart failure (HF) and evidence of increased in-hospital mortality were reported during the COVID-19 pandemic. The aim of this study was to apply a machine learning (ML)-based mortality prediction model to examine whether the latter is attributable to differing case mixes and exceeds expected mortality rates. METHODS AND RESULTS Inpatient cases with a primary discharge diagnosis of HF non-electively admitted to 86 German Helios hospitals between 01/01/2016 and 08/31/2020 were identified. Patients with proven or suspected SARS-CoV-2 infection were excluded. ML-based models were developed, tuned, and tested using cases of 2016-2018 (n = 64,440; randomly split 75%/25%). Extreme gradient boosting showed the best model performance indicated by a receiver operating characteristic area under the curve of 0.882 (95% confidence interval [CI]: 0.872-0.893). The model was applied on data sets of 2019 and 2020 (n = 28,556 cases) and the hospital standardized mortality ratio (HSMR) was computed as the observed to expected death ratio. Observed mortality rates were 5.84% (2019) and 6.21% (2020), HSMRs based on an individual case-based mortality probability were 100.0 (95% CI: 93.3-107.2; p = 1.000) for 2019 and 99.3 (95% CI: 92.5-106.4; p = .850) for 2020. Within subgroups of age or hospital volume, there were no significant differences between observed and expected deaths. When stratified for pandemic phases, no excess death during the COVID-19 pandemic was observed. CONCLUSION Applying an ML algorithm to calculate expected inpatient mortality based on administrative data, there was no excess death above expected event rates in HF patients during the COVID-19 pandemic.
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Affiliation(s)
- Sebastian König
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.,Leipzig Heart Institute, Leipzig Heart Digital, Leipzig, Germany
| | | | - Johannes Leiner
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.,Leipzig Heart Institute, Leipzig Heart Digital, Leipzig, Germany
| | - Sven Hohenstein
- Leipzig Heart Institute, Leipzig Heart Digital, Leipzig, Germany
| | - Laura Ueberham
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.,Leipzig Heart Institute, Leipzig Heart Digital, Leipzig, Germany
| | | | | | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.,Leipzig Heart Institute, Leipzig Heart Digital, Leipzig, Germany
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.,Leipzig Heart Institute, Leipzig Heart Digital, Leipzig, Germany
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Kubica J, Ostrowska M, Stolarek W, Kasprzak M, Grzelakowska K, Kryś J, Kubica A, Adamski P, Podhajski P, Navarese EP, Anielska-Michalak E, Brycht O, Curzytek A, Dudek A, Gromadziński L, Grzelakowski P, Kamiński L, Kleinrok A, Kostkiewicz M, Koziński M, Król P, Kulawik T, Minczew G, Mindykowski M, Pawlak A, Prokopczuk J, Skonieczny G, Sobkowicz B, Sowiński S, Stankala S, Szymański P, Wester A, Wilczewski P, Bartuś S, Budaj A, Gąsior M, Gruchała M, Drożdż J, Jaguszewski M, Jankowski P, Legutko J, Lesiak M, Leszek P, Mitkowski P, Nessler J, Tomaszuk-Kazberuk A, Tycińska A, Zdrojewski T, Kaźmierczak J. Impact of COVID-19 pandemic on acute heart failure admissions and mortality: a multicentre study (COV-HF-SIRIO 6 study). ESC Heart Fail 2021; 9:721-728. [PMID: 34786869 PMCID: PMC8652676 DOI: 10.1002/ehf2.13680] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 12/15/2022] Open
Abstract
Aims The coronavirus disease‐2019 (COVID‐19) pandemic has changed the landscape of medical care delivery worldwide. We aimed to assess the influence of COVID‐19 pandemic on hospital admissions and in‐hospital mortality rate in patients with acute heart failure (AHF) in a retrospective, multicentre study. Methods and results From 1 January 2019 to 31 December 2020, a total of 101 433 patients were hospitalized in 24 Cardiology Departments in Poland. The number of patients admitted due to AHF decreased by 23.4% from 9853 in 2019 to 7546 in 2020 (P < 0.001). We noted a significant reduction of self‐referrals in the times of COVID‐19 pandemic accounting 27.8% (P < 0.001), with increased number of AHF patients brought by an ambulance by 15.9% (P < 0.001). The length of hospital stay was overall similar (7.7 ± 2.8 vs. 8.2 ± 3.7 days; P = not significant). The in‐hospital all‐cause mortality in AHF patients was 444 (5.2%) in 2019 vs. 406 (6.5%) in 2020 (P < 0.001). A total number of AHF patients with concomitant COVID‐19 was 239 (3.2% of AHF patients hospitalized in 2020). The rate of in‐hospital deaths in AHF patients with COVID‐19 was extremely high accounting 31.4%, reaching up to 44.1% in the peak of the pandemic in November 2020. Conclusions Our study indicates that the COVID‐19 pandemic led to (i) reduced hospital admissions for AHF; (ii) decreased number of self‐referred AHF patients and increased number of AHF patients brought by an ambulance; and (iii) increased in‐hospital mortality for AHF with very high mortality rate for concomitant AHF and COVID‐19.
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Affiliation(s)
- Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Małgorzata Ostrowska
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Wioleta Stolarek
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Klaudyna Grzelakowska
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Jacek Kryś
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Aldona Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Piotr Adamski
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Przemysław Podhajski
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Eliano Pio Navarese
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Edyta Anielska-Michalak
- Department of Cardiology, Marian Zyndram-Kościałkowski Ministry of Interior and Administration Hospital, Białystok, Poland
| | - Oliwia Brycht
- II Department of Cardiology, Chair of Cardiology, Cardiac Surgery and Vascular Diseases, Medical University of Lodz, Lodz, Poland
| | - Andrzej Curzytek
- Department of Cardiology, Hospital of the Ministry of Interior and Administration, Rzeszów, Poland
| | - Aneta Dudek
- 1st Department of Cardiology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Paweł Grzelakowski
- Department of Cardiology and Cardiac Surgery, 10th Military Hospital and Polyclinic, Bydgoszcz, Poland
| | - Leszek Kamiński
- Department of Cardiology Independent Public Healthcare in Przeworsk, Przeworsk, Poland
| | - Andrzej Kleinrok
- Cardiology Department, Pope John Paul II District Hospital in Zamość, Zamosc, Poland
| | | | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Paweł Król
- Department of Cardiology, Tertiary Care Hospital, Ciechanów, Poland
| | - Tomasz Kulawik
- Department of Cardiology, Masovian Rehabilitation Center "STOCER", Dr. Włodzimierz Roefler Hospital, Pruszków, Poland
| | - Gleb Minczew
- Department of Cardiology, District Hospital, Tuchola, Poland
| | - Marcin Mindykowski
- Department of Cardiology, Dr. Emil Warmiński Tertiary Care Municipal Hospital, Bydgoszcz, Poland
| | - Agnieszka Pawlak
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.,Mossakowski Medical Research Centre Polish Academy of Science, Warsaw, Poland
| | - Janusz Prokopczuk
- Department of Cardiology, Polish Hospitals, Kędzierzyn-Koźle, Poland
| | - Grzegorz Skonieczny
- Department of Cardiology and Intensive Cardiac Care Unit, District Polyclinic Hospital, Toruń, Poland
| | - Bożena Sobkowicz
- Department of Cardiology, Medical University in Białystok, Białystok, Poland
| | - Sergiusz Sowiński
- Department of Cardiology and Cardiac Intensive Care, Tertiary Care Municipal Hospital, Toruń, Poland
| | - Sebastian Stankala
- Cardiology Subdivision of Heart Failure, St. Elizabeth Hospital, Biała, Poland
| | - Paweł Szymański
- Department of Cardiology, Interventional Cardiology and Electrophysiology with Cardiac Intensive Care Unit, Tertiary Care Hospital, Grudziądz, Poland
| | - Andrzej Wester
- 1st Department of Physiology, Institute of Medical Sciences, University of Opole, Cardiology Center of Kluczbork SCANMED SA, Opole, Poland
| | | | - Stanisław Bartuś
- 2nd Department of Cardiology, Collegium Medicum, Jagiellonian University, Cracow, Poland
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Jarosław Drożdż
- II Department of Cardiology, Chair of Cardiology, Cardiac Surgery and Vascular Diseases, Medical University of Lodz, Lodz, Poland
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Jankowski
- 1st Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantology, National Institute of Cardiology, Warsaw, Poland
| | | | - Jadwiga Nessler
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Agnieszka Tycińska
- Department of Cardiology, Medical University in Białystok, Białystok, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
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Burton S, Hayes JA, Morrell-Scott N, Sanders J, Walthall H, Wright DJ, Jones ID. Should I stay or should I go? An exploration of the decision-making behavior of acute cardiac patients during the COVID-19 pandemic. Heart Lung 2021; 52:16-21. [PMID: 34823051 PMCID: PMC8606948 DOI: 10.1016/j.hrtlng.2021.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 11/10/2022]
Abstract
Background During the SARS-COV-2 (COVID-19) pandemic efforts to reduce virus transmission resulted in non-emergency patients being deterred from seeking help. The number of patients presenting with acute cardiac conditions reduced, significantly Objectives To explore the decision-making process, and influential factors in that process, of patients and their family during an acute cardiac event. Methods A qualitative research design was employed using purposive sampling of patients who experienced an acute cardiac event during the social containment mandates. Semi-structured interviews were conducted, with thematic analysis of interview transcripts. Results Twenty-five participants were recruited from three UK hospitals. Themes identified were reliance on informal support network, lack of awareness of cardiac symptoms leading to delayed help-seeking, and an indirect COVID-19 effect (e.g. avoiding treatment). Conclusions These results highlight the need for informed public health messages, targeting patients and their support networks, that allow those in need of treatment to access care.
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Affiliation(s)
- S Burton
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom
| | - J A Hayes
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom
| | - N Morrell-Scott
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom; Liverpool Centre for Cardiovascular Science, United Kingdom
| | - J Sanders
- Barts Health NHS Trust William Harvey Research Institute, St Bartholomew's Hospital, Queen Mary University of London, United Kingdom
| | - H Walthall
- Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - D J Wright
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Liverpool Centre for Cardiovascular Science, United Kingdom
| | - I D Jones
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom; Liverpool Centre for Cardiovascular Science, United Kingdom.
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Registro Español de Desfibrilador Automático Implantable. XVII Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2020). Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2021.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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31
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish Implantable Cardioverter-defibrillator Registry. 17th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2020). REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:971-982. [PMID: 34583912 DOI: 10.1016/j.rec.2021.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/13/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES We present the data corresponding to implantable cardioverter-defibrillator (ICD) implants in Spain in 2020. METHODS The data in this registry were drawn from implantation centers, which voluntarily completed a data collection sheet. RESULTS In 2020, 7056 implant sheets were received compared with 7106 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 99% of the devices implanted in Spain. Completion of the implant sheet ranged from 99.8% for the field "name of the implanting hospital" to 2.6% for the variable "referral hospital". A total of 173 hospitals performed ICD implants and participated in the registry, which is a similar figure to that in 2019 (n=172). The total rate of registered implants was 149/million inhabitants (150 according to Eucomed), revealing a slight reduction in implants in Spain in 2020 as a result of the impact of the COVID-19 pandemic. This reduction was uneven among the autonomous communities. CONCLUSIONS The Spanish Implantable Cardioverter Defibrillator Registry for 2020 shows an improvement in the rate of implants reported and a reduction in the number of ICD implants, which likely reflects the decrease in hospital activity not related to the treatment of COVID-19 infection. Similar to previous years, the total number of implants in Spain is still much lower than the average for the European Union, with an increase in the differences between Spanish autonomous communities.
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Pothineni NVK, Santangeli P. Electrophysiology and Interventional Cardiology Procedure Volumes During the Coronavirus Disease 2019 Pandemic. Card Electrophysiol Clin 2021; 14:105-110. [PMID: 35221077 PMCID: PMC8556575 DOI: 10.1016/j.ccep.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has imposed an unprecedented health care crisis across the globe. Health care efforts across the world have been diverted to tackling the pandemic since early 2020. Hospitals and health care systems have undertaken major restructuring in an effort to deliver health care to an increasing number of patients affected by COVID-19. Although great focus has been placed on treating those individuals suffering from COVID-19, clinicians must simultaneously balance caring for patients who are not actively infected. In anticipation of an exponential increase in COVID-19 cases, health care systems developed strategies to channel available resources to meet the rapidly rising demands of COVID-19. This change was noticed significantly in the field of invasive cardiology as well. Many cardiac catheterization and electrophysiology (EP) laboratories canceled elective procedures to limit the burden on hospital resources and preserve personal protective equipment (PPE). Major societies published guidance statements delineating patient selection for procedures during the exponential phase of the pandemic growth. Patient care was triaged and those waiting for elective procedures were managed with expectant care or noninvasive approaches to preserve hospital resources and personnel. In the current article, we review the impact of the COVID-19 pandemic and its response to the volume of interventional cardiology (IC) and EP procedures across the world.
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Affiliation(s)
- Naga Venkata K Pothineni
- Section of Electrophysiology, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Pasquale Santangeli
- Section of Electrophysiology, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Koch F, Hohenstein S, Bollmann A, Meier-Hellmann A, Kuhlen R, Ritz JP. [Has the COVID19 Pandemic Changed the Emergency Situation in German Clinics? A Nationwide Analysis of Routine Data from 73 Acute Hospitals]. Zentralbl Chir 2021; 146:570-578. [PMID: 34587644 DOI: 10.1055/a-1592-2234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
COVID-19 has led to profound changes in the world as we have known it. Due to the sharp increase in intensive care, COVID patients, elective admissions and interventions have been postponed. But emergencies such as myocardial infarction have also decreased. The present study deals with the effects of the COVID pandemic on visceral surgical emergencies on the basis of 5 indicator operations. Routine data from 73 acute hospitals of the Helios Group were evaluated for this purpose. The interventions that were carried out between March 13, 2020 and March 12, 2021 were included. The data was compared with the period from March 13, 2019 to March 12, 2020. The number of interventions in serious emergencies (ileus, mesenteric ischemia and ulcer perforation) has remained constant. However, the length of stay in hospital in the pandemic year 2020 was significantly shorter than in the reference year 2019. The number of cholecystectomies and appendectomies in the pandemic year was significantly lower than in the reference year 2019. The outcome parameters intensive care, invasive ventilation and hospital mortality were comparable for the two periods for these interventions.
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Affiliation(s)
- Franziska Koch
- Klinik für Allgemein- und Viszeralchirurgie, HELIOS Kliniken Schwerin, Schwerin, Germany
| | - Sven Hohenstein
- Herzzentrum, Herzzentrum Leipzig Universitätsklinik, Leipzig, Germany
| | - Andreas Bollmann
- Herzzentrum, Herzzentrum Leipzig Universitätsklinik, Leipzig, Germany
| | | | - Ralf Kuhlen
- Zentrale, HELIOS Kliniken GmbH, Berlin, Germany
| | - Jörg-Peter Ritz
- Klinik für Allgemein- und Viszeralchirurgie, HELIOS Kliniken Schwerin, Schwerin, Germany
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Bollmann A, Hohenstein S, Pellissier V, König S, Ueberham L, Hindricks G, Meier-Hellmann A, Kuhlen R. Hospitalisations for emergency-sensitive conditions in Germany during the COVID-19 pandemic: insights from the German-wide Helios hospital network. Emerg Med J 2021; 38:846-850. [PMID: 34544781 DOI: 10.1136/emermed-2021-211183] [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: 01/14/2021] [Accepted: 09/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND While there are numerous reports that describe emergency care during the early COVID-19 pandemic, there is scarcity of data for later stages. This study analyses hospitalisation rates for 37 emergency-sensitive conditions in the largest German-wide hospital network during different pandemic phases. METHODS Using claims data of 80 hospitals, consecutive cases between 1 January and 17 November 2020 were analysed and compared with a corresponding period in 2019. Incidence rate ratios (IRRs) comparing the two periods were calculated using Poisson regression to model the number of hospitalisations per day. RESULTS There was a reduction in hospitalisations between 12 March and 13 June 2020 (coinciding with the first pandemic wave) with 32 807 hospitalisations (349.0/day) as opposed to 39 379 (419.0/day) in 2019 (IRR 0.83, 95% CI 0.82 to 0.85, p<0.01). During the following period (14 June-17 November 2020, including the start of second wave), hospitalisations were reduced from 63 799 (406.4/day) in 2019 to 59 910 (381.6/day) in 2020, but this reduction was not as pronounced (IRR 0.94, 95% CI 0.93 to 0.95, p<0.01). During the first wave hospitalisations for acute myocardial infarction, aortic aneurysm/dissection, pneumonitis, paralytic ileus/intestinal obstruction and pulmonary embolism declined but subsequently increased compared with the corresponding periods in 2019. In contrast, hospitalisations for sepsis, pneumonia, obstructive pulmonary disease and intracranial injuries were reduced during the entire observation period. CONCLUSIONS There was an overall reduction of absolute hospitalisations for emergency-sensitive conditions in Germany during the first 10 months of the COVID-19 pandemic with heterogeneous effects on different disease categories. The increase in hospitalisations for acute myocardial infarction, aortic aneurysm/dissection and pulmonary embolism requires attention and further studies.
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Affiliation(s)
- Andreas Bollmann
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Sven Hohenstein
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Vincent Pellissier
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Sebastian König
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Laura Ueberham
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Gerhard Hindricks
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
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Bollmann A, Pellissier V, Hohenstein S, König S, Ueberham L, Meier-Hellmann A, Kuhlen R, Thiele H, Hindricks G. Cumulative hospitalization deficit for cardiovascular disorders in Germany during the COVID-19 pandemic: insights from the German-wide Helios hospital network. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2021; 7:e5-e6. [PMID: 32857835 PMCID: PMC7499594 DOI: 10.1093/ehjqcco/qcaa071] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Andreas Bollmann
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Vincent Pellissier
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Sven Hohenstein
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Sebastian König
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Laura Ueberham
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
| | | | - Ralf Kuhlen
- Helios Health, Friedrichstraße 136, 10117 Berlin, Germany
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Gerhard Hindricks
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Strümpellstr. 39, 04289 Leipzig, Germany
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Schäfer I, Hansen H, Menzel A, Eisele M, Tajdar D, Lühmann D, Scherer M. The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study. BMC FAMILY PRACTICE 2021; 22:125. [PMID: 34162343 PMCID: PMC8221278 DOI: 10.1186/s12875-021-01471-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/21/2021] [Indexed: 12/27/2022]
Abstract
Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.
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Affiliation(s)
- Ingmar Schäfer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Heike Hansen
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Agata Menzel
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Daniel Tajdar
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Ueberham L, König S, Pellissier V, Hohenstein S, Meier-Hellmann A, Kuhlen R, Hindricks G, Bollmann A. Admission rates and care pathways in patients with atrial fibrillation during the COVID-19 pandemic-insights from the German-wide Helios hospital network. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2021; 7:257-264. [PMID: 33729489 PMCID: PMC7989580 DOI: 10.1093/ehjqcco/qcab011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/01/2021] [Accepted: 02/25/2021] [Indexed: 11/13/2022]
Abstract
Introduction Several reports indicate lower rates of emergency admissions in the cardiovascular sector and reduced admissions of patients with chronic diseases during the COVID-19 pandemic. The aim of this study was therefore to evaluate numbers of admissions in incident and prevalent atrial fibrillation and flutter (AF) and to analyze care pathways in comparison to 2019. Methods A retrospective analysis of claims data of 74 German Helios hospitals was performed to identify consecutive patients hospitalized with a main discharge diagnosis of AF. A study period including the start of the German national protection phase (13th March 2020 to 16th July 2020) was compared to a previous year control cohort (15th March 2019 to 18th July 2019), with further sub-division into early and late phase. Incidence rate ratios (IRR) were calculated. Numbers of admission per day (A/day) for incident and prevalent AF and care pathways including readmissions, numbers of transesophageal echocardiogram (TEE), electrical cardioversion (CV) and catheter ablation (CA) were analyzed. Results During the COVID-19 pandemic, there was a significant decrease of total AF admissions both in the early (44.4 vs. 77.5 A/day, IRR 0.57 [95% CI 0.54–0.61], p < 0.01) and late phase (59.1 vs. 63.5 A/day, IRR 0.93 [95% CI 0.90–0.96], p < 0.01), length of stay was significantly shorter (3.3 ± 3.1 nigths vs. 3.5 ± 3.6 nigths, p < 0.01), admissions were more frequently in high volume centers (77.0% vs. 75.4%, p = 0.02) and frequency of readmissions was reduced (21.7% vs. 23.6%, p < 0.01) compared to the previous year. Incident AF admission rates were significantly lower both in the early (21.9 admission per day vs. 41.1 A/day, IRR 0.53 [95% CI 0.48 − 0.58]) and late phase (35.5 vs. 39.3 A/day, IRR 0.90 [95% CI 0.86 − 0.95]), whereas prevalent admissions were only lower in the early phase (22.5 vs 36.4 A/day IRR 0.62 [95% CI 0.56 − 0.68]), but not in the late phase (23.6 vs. 24.2 A/day IRR 0.97 [95% CI 0.92 − 1.03]). Analysis of care pathways showed reduced numbers of TEE during the early phase (34.7% vs. 41.4%, OR 0.74 [95% CI 0.64 − 0.86], p < 0.01), but not during the late phase (39.9% vs. 40.2%, OR 0.96 [95% CI 0.88 − 1.03], p = 0.26). Numbers of CV were comparable during early (40.6% vs. 39.7%, OR 1.08 [95% CI 0.94 − 1.25], p = 0.27) and late phase (38.6% vs. 37.5%, OR 1.06 [95% CI 0.98 − 1.14], p = 0.17), compared to the previous year, respectively. Numbers of CA were comparable during the early phase (21.6% vs. 21.1%, OR 0.98 [95% CI 0.82 − 1.17], p = 0.82) with a distinct increase during the late phase (22.9% vs. 21.5%, OR 1.05 [95% CI 0.96–1.16], p = 0.28). Conclusion During the COVID-19 pandemic, AF admission rates declined significantly, with a more pronounced reduction in incident than in prevalent AF. Overall AF care was maintained during early and late pandemic phase with only minor changes, namely less frequent use of TEE. Confirmation of these findings in other study populations as well as identification of underlying causes are required to ensure optimal therapy in patients with AF during the COVID-19 pandemic.
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Affiliation(s)
- Laura Ueberham
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany.,Leipzig Heart Institute, Leipzig, Germany
| | - Sebastian König
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany.,Leipzig Heart Institute, Leipzig, Germany
| | | | | | | | | | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany.,Leipzig Heart Institute, Leipzig, Germany
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, Leipzig 04289, Germany.,Leipzig Heart Institute, Leipzig, Germany
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Husser D, Pellissier V, Hohenstein S, Ueberham L, König S, Hindricks G, Meier-Hellmann A, Kuhlen R, Bollmann A. Hospital care of patients with inherited cardiomyopathies in Germany during the Covid-19 pandemic insights from the German-wide Helios hospital network. Am J Med Genet A 2021; 185:2278-2282. [PMID: 33876564 PMCID: PMC8250485 DOI: 10.1002/ajmg.a.62209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/09/2021] [Accepted: 03/27/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Daniela Husser
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Vincent Pellissier
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Sven Hohenstein
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Laura Ueberham
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Sebastian König
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Gerhard Hindricks
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Andreas Bollmann
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
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Jaehn P, Holmberg C, Uhlenbrock G, Pohl A, Finkenzeller T, Pawlik MT, Quack I, Ernstberger A, Rockmann F, Schreyer AG. Differential trends of admissions in accident and emergency departments during the COVID-19 pandemic in Germany. BMC Emerg Med 2021; 21:42. [PMID: 33823795 PMCID: PMC8022298 DOI: 10.1186/s12873-021-00436-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background Recent studies have shown a decrease of admissions to accident and emergency (A&E) departments after the local outbreaks of COVID-19. However, differential trends of admission counts, for example according to diagnosis, are less well understood. This information is crucial to inform targeted intervention. Therefore, we aimed to compare admission counts in German A&E departments before and after 12th march in 2020 with 2019 according to demographic factors and diagnosis groups. Methods Routine data of all admissions between 02.12.2019–30.06.2020 and 01.12.2018–30.06.2019 was available from six hospitals in five cities from north-western, eastern, south-eastern, and south-western Germany. We defined 10 diagnosis groups using ICD-10 codes: mental disorders due to use of alcohol (MDA), acute myocardial infarction (AMI), stroke or transient ischemic attack (TIA), heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), cholelithiasis or cholecystitis, back pain, fractures of the forearm, and fractures of the femur. We calculated rate ratios comparing different periods in 12.03.2020–30.06.2020 with 12.03.2019–30.06.2019. Results Forty-one thousand three hundred fifty-three cases were admitted between 12.03.2020–30.06.2020 and 51,030 cases between 12.03.2019–30.06.2019. Admission counts prior to 12.03. were equal in 2020 and 2019. In the period after 12.03., the decrease of admissions in 2020 compared to 2019 was largest between 26.03. and 08.04. (− 30%, 95% CI − 33% to − 27%). When analysing the entire period 12.03.-30.06., the decrease of admissions was heterogeneous among hospitals, and larger among people aged 0–17 years compared to older age groups. In the first 8 weeks after 12.03., admission counts of all diagnoses except femur fractures and pneumonia declined. Admissions with pneumonia increased in this early period. Between 07.05. and 30.6.2020, we noted that admissions with AMI (+ 13%, 95% CI − 3% to + 32%) and cholelithiasis or cholecystitis (+ 20%, 95% CI + 1% to + 44%) were higher than in 2019. Conclusions Our results suggest differential trends of admission counts according to age, location, and diagnosis. An initial decrease of admissions with MDA, AMI, stroke or TIA, heart failure, COPD, cholelithiasis or cholecystitis, and back pain imply delays of emergency care in Germany. Finally, our study suggests a delayed increase of admissions with AMI and cholelithiasis or cholecystitis.
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Affiliation(s)
- Philipp Jaehn
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany. .,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany.
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
| | - Greta Uhlenbrock
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
| | - Andreas Pohl
- Department of Emergency Medicine, Kliniken Nordoberpfalz, Weiden, Germany
| | | | - Michael T Pawlik
- Department of Anesthesiology, Caritaskrankenhaus St. Josef, Regensburg, Germany
| | - Ivo Quack
- Department of Emergency Medicine, Klinikum Konstanz, Konstanz, Germany
| | - Antonio Ernstberger
- Department of Trauma Surgery, Center for Musculoskeletal Surgery, Klinikum Osnabrueck, Osnabrueck, Germany
| | - Felix Rockmann
- Department of Emergency Medicine, Krankenhaus Barmherzige Brüder, Regensburg, Germany
| | - Andreas G Schreyer
- Institute of Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
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40
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Doolub G, Wong C, Hewitson L, Mohamed A, Todd F, Gogola L, Skyrme‐Jones A, Aziz S, Sammut E, Dastidar A. Impact of COVID-19 on inpatient referral of acute heart failure: a single-centre experience from the south-west of the UK. ESC Heart Fail 2021; 8:1691-1695. [PMID: 33410281 PMCID: PMC8006615 DOI: 10.1002/ehf2.13158] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/10/2020] [Accepted: 11/22/2020] [Indexed: 12/22/2022] Open
Abstract
AIMS Healthcare services worldwide have been significantly impacted by the COVID-19 pandemic. Recent reports have shown a decline in hospitalization for emergency cardiac conditions. The impact of the COVID-19 pandemic on hospitalization and particularly mortality due to acute heart failure has not been thoroughly described. METHODS AND RESULTS In this single-centre observational study, we examined referrals to the acute heart failure team over a period of 16 weeks (7 January to 27 April 2020) spanning the ongoing COVID-19 pandemic; 283 patients referred to our acute heart failure services over the study period were included on the basis of typical symptoms, raised BNP, and echocardiogram. There was a substantial but statistically non-significant drop in referrals with 164 referred in the 8 weeks before the first UK death due to COVID-19 on 2 March 2020 (BC), compared with 119 referred after (AC) in the subsequent 8 weeks, representing a 27% reduction overall (P = 0.06). The 30 day case fatality rate was increased from 11% in the BC group compared with 21% in the AC group (risk ratio = 1.9, 95% confidence interval 1.09-3.3). Age, gender, length of stay, left ventricular ejection fraction, and N-terminal pro-brain natriuretic peptide were similar between the groups. Admission creatinine, age, and AC cohort status were found to be univariable predictors of mortality. On multivariate Cox regression analysis, only age (hazard ratio 1.04, P = 0.03) and AC cohort status (hazard ratio 2.1, P = 0.017) remained significant predictors of mortality. On sensitivity analysis, this increased mortality was driven by COVID-19 positive status. CONCLUSIONS There was a reduction in referral of patients with acute heart failure with significant increase in mortality in the 8 weeks following the first reported UK death due to COVID-19. The observation of increased mortality does not appear related to a change in population in terms of demographics, left ventricular ejection fraction, or N-terminal pro-brain natriuretic peptide. The observed increased mortality appears to be related to the coexistence of COVID19 infection with acute heart failure. The study highlights the need for widespread preventative and shielding measures particularly in this group of patients especially in the light of the second wave. Longer follow-up with inclusion of data from other centres and community heart failure services will be needed.
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Affiliation(s)
| | | | | | | | | | | | - Andrew Skyrme‐Jones
- North Bristol NHS TrustBristolUK
- University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
| | - Shahid Aziz
- North Bristol NHS TrustBristolUK
- University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
| | - Eva Sammut
- University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
- University of BristolBristolUK
| | - Amardeep Dastidar
- North Bristol NHS TrustBristolUK
- University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
- University of BristolBristolUK
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41
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Wu J, Mafham M, Mamas MA, Rashid M, Kontopantelis E, Deanfield JE, de Belder MA, Gale CP. Place and Underlying Cause of Death During the COVID-19 Pandemic: Retrospective Cohort Study of 3.5 Million Deaths in England and Wales, 2014 to 2020. Mayo Clin Proc 2021; 96:952-963. [PMID: 33714592 PMCID: PMC7885692 DOI: 10.1016/j.mayocp.2021.02.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To describe the place and cause of death during the coronavirus disease 2019 (COVID-19) pandemic to assess its impact on excess mortality. METHODS This national death registry included all adult (aged ≥18 years) deaths in England and Wales between January 1, 2014, and June 30, 2020. Daily deaths during the COVID-19 pandemic were compared against the expected daily deaths, estimated with use of the Farrington surveillance algorithm for daily historical data between 2014 and 2020 by place and cause of death. RESULTS Between March 2 and June 30, 2020, there was an excess mortality of 57,860 (a proportional increase of 35%) compared with the expected deaths, of which 50,603 (87%) were COVID-19 related. At home, only 14% (2267) of the 16,190 excess deaths were related to COVID-19, with 5963 deaths due to cancer and 2485 deaths due to cardiac disease, few of which involved COVID-19. In care homes or hospices, 61% (15,623) of the 25,611 excess deaths were related to COVID-19, 5539 of which were due to respiratory disease, and most of these (4315 deaths) involved COVID-19. In the hospital, there were 16,174 fewer deaths than expected that did not involve COVID-19, with 4088 fewer deaths due to cancer and 1398 fewer deaths due to cardiac disease than expected. CONCLUSION The COVID-19 pandemic has resulted in a large excess of deaths in care homes that were poorly characterized and likely to be the result of undiagnosed COVID-19. There was a smaller but important and ongoing excess in deaths at home, particularly from cancer and cardiac disease, suggesting public avoidance of hospital care for non-COVID-19 conditions.
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Affiliation(s)
- Jianhua Wu
- Leeds Institute for Data Analytics, University of Leeds, United Kingdom; Division of Clinical and Translational Research, School of Dentistry, University of Leeds, United Kingdom
| | - Marion Mafham
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, United Kingdom
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, United Kingdom; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Muhammad Rashid
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, United Kingdom
| | - Evangelos Kontopantelis
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, United Kingdom
| | - John E Deanfield
- Institute of Cardiovascular Sciences, University College London, United Kingdom
| | - Mark A de Belder
- National Institute for Cardiovascular Outcomes Research, Barts Health NHS Trust, London, United Kingdom
| | - Chris P Gale
- Leeds Institute for Data Analytics, University of Leeds, United Kingdom; Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, United Kingdom; Leeds Teaching Hospitals NHS Trust, United Kingdom.
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Hospitalizations, resource use and outcomes of acute pulmonary embolism in Germany during the Covid-19 pandemic. Thromb Res 2021; 202:145-147. [PMID: 33839381 PMCID: PMC8012160 DOI: 10.1016/j.thromres.2021.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 12/27/2022]
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Bollmann A, Hohenstein S, Pellissier V, Stengler K, Reichardt P, Ritz JP, Thiele H, Borger MA, Hindricks G, Meier-Hellmann A, Kuhlen R. Utilization of in- and outpatient hospital care in Germany during the Covid-19 pandemic insights from the German-wide Helios hospital network. PLoS One 2021; 16:e0249251. [PMID: 33765096 PMCID: PMC7993839 DOI: 10.1371/journal.pone.0249251] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/02/2021] [Indexed: 12/27/2022] Open
Abstract
Background During the early phase of the Covid-19 pandemic, reductions of hospital admissions with a focus on emergencies have been observed for several medical and surgical conditions, while trend data during later stages of the pandemic are scarce. Consequently, this study aims to provide up-to-date hospitalization trends for several conditions including cardiovascular, psychiatry, oncology and surgery cases in both the in- and outpatient setting. Methods and findings Using claims data of 86 Helios hospitals in Germany, consecutive cases with an in- or outpatient hospital admission between March 13, 2020 (the begin of the “protection” stage of the German pandemic plan) and December 10, 2020 (end of study period) were analyzed and compared to a corresponding period covering the same weeks in 2019. Cause-specific hospitalizations were defined based on the primary discharge diagnosis according to International Statistical Classification of Diseases and Related Health Problems (ICD-10) or German procedure classification codes for cardiovascular, oncology, psychiatry and surgery cases. Cumulative hospitalization deficit was computed as the difference between the expected and observed cumulative admission number for every week in the study period, expressed as a percentage of the cumulative expected number. The expected admission number was defined as the weekly average during the control period. A total of 1,493,915 hospital admissions (723,364 during the study and 770,551 during the control period) were included. At the end of the study period, total cumulative hospitalization deficit was -10% [95% confidence interval -10; -10] for cardiovascular and -9% [-10; -9] for surgical cases, higher than -4% [-4; -3] in psychiatry and 4% [4; 4] in oncology cases. The utilization of inpatient care and subsequent hospitalization deficit was similar in trend with some variation in magnitude between cardiovascular (-12% [-13; -12]), psychiatry (-18% [-19; -17]), oncology (-7% [-8; -7]) and surgery cases (-11% [-11; -11]). Similarly, cardiovascular and surgical outpatient cases had a deficit of -5% [-6; -5] and -3% [-4; -3], respectively. This was in contrast to psychiatry (2% [1; 2]) and oncology cases (21% [20; 21]) that had a surplus in the outpatient sector. While in-hospital mortality, was higher during the Covid-19 pandemic in cardiovascular (3.9 vs. 3.5%, OR 1.10 [95% CI 1.06–1.15], P<0.01) and in oncology cases (4.5 vs. 4.3%, OR 1.06 [95% CI 1.01–1.11], P<0.01), it was similar in surgical (0.9 vs. 0.8%, OR 1.06 [95% CI 1.00–1.13], P = 0.07) and in psychiatry cases (0.4 vs. 0.5%, OR 1.01 [95% CI 0.78–1.31], P<0.95). Conclusions There have been varying changes in care pathways and in-hospital mortality in different disciplines during the Covid-19 pandemic in Germany. Despite all the inherent and well-known limitations of claims data use, this data may be used for health care surveillance as the pandemic continues worldwide. While this study provides an up-to-date analysis of utilization of hospital care in the largest German hospital network, short- and long-term consequences are unknown and deserve further studies.
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Affiliation(s)
- Andreas Bollmann
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
- * E-mail:
| | - Sven Hohenstein
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Vincent Pellissier
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Katharina Stengler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Helios Park Hospital, Leipzig, Germany
| | - Peter Reichardt
- Oncology Center Berlin-Buch, Helios Hospital Berlin-Buch and Berlin Cancer Institute, Berlin, Germany
| | - Jörg-Peter Ritz
- Department of Surgery, Helios Hospital Schwerin, Schwerin, Germany
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Michael A. Borger
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Gerhard Hindricks
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
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Arbelo E, Angera I, Trucco E, Rivas-Gándara N, Guerra JM, Bisbal F, Jáuregui-Abularach M, Vallés E, Martin G, Sbraga F, Tolosana JM, Linhart M, Francisco-Pascual J, Montiel-Serrano J, Pereferrer D, Menéndez-Ramírez D, Jiménez J, Elamrani A, Borrás R, Dallaglio PD, Benito E, Santos-Ortega A, Rodríguez-Font E, Sarrias A, González-Matos CE, Martí-Almor J, Cabrera S, Mont L. Reduction in new cardiac electronic device implantations in Catalonia during COVID-19. Europace 2021; 23:456-463. [PMID: 33595062 PMCID: PMC7928966 DOI: 10.1093/europace/euab011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/13/2021] [Indexed: 12/27/2022] Open
Abstract
Aims During the COVID-19 pandemic, concern regarding its effect on the management of non-communicable diseases has been raised. However, there are no data on the impact on cardiac implantable electronic devices (CIED) implantation rates. We aimed to determine the impact of SARS-CoV2 on the monthly incidence rates and type of pacemaker (PM) and implantable cardiac defibrillator (ICD) implantations in Catalonia before and after the declaration of the state of alarm in Spain on 14 March 2020. Methods and results Data on new CIED implantations for 2017–20 were prospectively collected by nine hospitals in Catalonia. A mixed model with random intercepts corrected for time was used to estimate the change in monthly CIED implantations. Compared to the pre-COVID-19 period, an absolute decrease of 56.5% was observed (54.7% in PM and 63.7% in ICD) in CIED implantation rates. Total CIED implantations for 2017–19 and January and February 2020 was 250/month (>195 PM and >55 ICD), decreasing to 207 (161 PM and 46 ICD) in March and 131 (108 PM and 23 ICD) in April 2020. In April 2020, there was a significant fall of 185.25 CIED implantations compared to 2018 [95% confidence interval (CI) 129.6–240.9; P < 0.001] and of 188 CIED compared to 2019 (95% CI 132.3–243.7; P < 0.001). No significant differences in the type of PM or ICD were observed, nor in the indication for primary or secondary prevention. Conclusions During the first wave of the COVID-19 pandemic, a substantial decrease in CIED implantations was observed in Catalonia. Our findings call for measures to avoid long-term social impact.
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Affiliation(s)
- Elena Arbelo
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Ignasi Angera
- Arrhythmia Section, Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Emilce Trucco
- Arrhythmia Section, Cardiology Department, Hospital Universitari Doctor Josep Trueta. Girona, Spain.,Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Nuria Rivas-Gándara
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Centro de investigación biomédica en red de enfermedades cardiovasculares (CIBER-CV), Barcelona, Spain
| | - José M Guerra
- Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Felipe Bisbal
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Arrhythmia Section, Cardiology Department, Heart Institute (iCOR), University Hospital Germans Trias i Pujol, Badalona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Miguel Jáuregui-Abularach
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré (IRBLleida), Lleida, Spain
| | - Ermengol Vallés
- Arrhythmia Section, Cardiology Department, Hospital del Mar-IMIM. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriel Martin
- Arrhythmia Section, Cardiology Department, Hospital Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.,IISPV, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Fabrizio Sbraga
- Department of Cardiac Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - José María Tolosana
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Markus Linhart
- Arrhythmia Section, Cardiology Department, Hospital Universitari Doctor Josep Trueta. Girona, Spain.,Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Jaume Francisco-Pascual
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Centro de investigación biomédica en red de enfermedades cardiovasculares (CIBER-CV), Barcelona, Spain
| | - José Montiel-Serrano
- Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Damià Pereferrer
- Arrhythmia Section, Cardiology Department, Heart Institute (iCOR), University Hospital Germans Trias i Pujol, Badalona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Diego Menéndez-Ramírez
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré (IRBLleida), Lleida, Spain
| | - Jesús Jiménez
- Arrhythmia Section, Cardiology Department, Hospital del Mar-IMIM. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Amin Elamrani
- Arrhythmia Section, Cardiology Department, Hospital Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.,IISPV, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Roger Borrás
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - Paolo Domenico Dallaglio
- Arrhythmia Section, Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Eva Benito
- Arrhythmia Section, Cardiology Department, Hospital Universitari Doctor Josep Trueta. Girona, Spain.,Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Alba Santos-Ortega
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Centro de investigación biomédica en red de enfermedades cardiovasculares (CIBER-CV), Barcelona, Spain
| | - Enrique Rodríguez-Font
- Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Axel Sarrias
- Arrhythmia Section, Cardiology Department, Heart Institute (iCOR), University Hospital Germans Trias i Pujol, Badalona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Carlos E González-Matos
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré (IRBLleida), Lleida, Spain
| | - Julio Martí-Almor
- Arrhythmia Section, Cardiology Department, Hospital del Mar-IMIM. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sandra Cabrera
- Arrhythmia Section, Cardiology Department, Hospital Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.,IISPV, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Lluis Mont
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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45
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Zeymer U, Gitt A, Thiele H. [COVID-19 pandemic : Effects on clinical care of cardiovascular patients in spring 2020]. Herz 2021; 46:115-119. [PMID: 33590283 PMCID: PMC7884099 DOI: 10.1007/s00059-020-05015-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 12/15/2022]
Abstract
Die COVID-19(„coronavirus disease 2019“)-Pandemie hat zu einer Fokussierung der Akutmedizin auf die Versorgung von Patienten mit SARS-CoV-2(„severe acute respiratory syndrome coronavirus type 2“)-infizierten Patienten geführt – mit Auswirkungen auf alle anderen medizinischen Gebiete. In den Monaten von März bis Mai 2020 kam es zu einem Rückgang der Krankenhausaufnahmen sowohl für elektive kardiologische Prozeduren als auch für akute kardiologische Erkrankungen. Die Anzahl von Patienten mit akutem Herzinfarkt, insbesondere mit Nicht-ST-Strecken-Hebungs-Infarkt, ist während dieser Monate zurückgegangen, und es zeigte sich auch teilweise eine Zunahme der Zeit zwischen Symptombeginn und Krankenhausaufnahme. In einigen Untersuchungen wurde auch eine Erhöhung der infarktbezogenen Mortalität beobachtet. Die Gründe sind vielfältig und beinhalten eine Furcht der Patienten vor dem Krankenhausaufenthalt mit möglicher Ansteckung mit SARS-CoV‑2, Missdeutung der Symptome und Fokussierung des Gesundheitssystems auf die Pandemie. Zusätzlich kann SARS-CoV‑2 zu einer höheren Thromboseneigung führen und damit schwerere Verläufe eines Myokardinfarkts induzieren.
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Affiliation(s)
- Uwe Zeymer
- Medizinische Klinik B und Institut für Herzinfarktforschung Ludwigshafen, Klinikum Ludwigshafen, Bremser Str. 79, 67063, Ludwigshafen, Deutschland.
| | - Anselm Gitt
- Medizinische Klinik B und Institut für Herzinfarktforschung Ludwigshafen, Klinikum Ludwigshafen, Bremser Str. 79, 67063, Ludwigshafen, Deutschland
| | - Holger Thiele
- Herzzentrum Leipzig, Universität Leipzig, Strümpellstr. 39, 04289, Leipzig, Deutschland.
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46
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Scheidt-Nave C, Barnes B, Beyer AK, Busch MA, Hapke U, Heidemann C, Imhoff M, Mumm R, Paprott R, Steppuhn H, von Berenberg-Gossler P, Kraywinkel K. Care for the chronically ill in Germany - The challenges during the COVID-19 pandemic. JOURNAL OF HEALTH MONITORING 2021; 5:2-27. [PMID: 35146280 PMCID: PMC8734154 DOI: 10.25646/7168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is posing major challenges to the health care sector. This scoping review compiles evidence concerning changes to health care service availability and utilisation as well as possible impacts on health for selected groups of chronically ill people in Germany. The focus is on cancer, cardiovascular diseases, diabetes mellitus and mental disorders. Most empirical data available concerned inpatient care and showed a clear decline in the utilisation of inpatient treatments in March and April 2020 in the areas of oncology and cardiology as well as in mental health. For cardiovascular emergencies such as heart attack and stroke, a decline was observed especially regarding less serious cases. Although there were indications of treatment delays, there was no evidence thus far that emergency care had been generally compromised due to adjustments to inpatient care capacities. In the outpatient setting, extensive adjustments to health care services availability were observed for all disease groups considered. Overall, very limited empirical data were available. In particular, hardly any data were available on how changes in care impacted population health. There is an urgent need for continuous surveillance and evaluation based on health care and epidemiological data.
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47
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Charman SJ, Velicki L, Okwose NC, Harwood A, McGregor G, Ristic A, Banerjee P, Seferovic PM, MacGowan GA, Jakovljevic DG. Insights into heart failure hospitalizations, management, and services during and beyond COVID-19. ESC Heart Fail 2021; 8:175-182. [PMID: 33232587 PMCID: PMC7753441 DOI: 10.1002/ehf2.13061] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/26/2020] [Accepted: 09/25/2020] [Indexed: 12/22/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.
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Affiliation(s)
- Sarah J. Charman
- Cardiovascular Research Division, Translational and Biosciences Research InstitutesNewcastle UniversityNewcastle upon TyneUK
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Lazar Velicki
- Faculty of MedicineUniversity of Novi SadNovi SadSerbia
- Clinic for Cardiovascular SurgeryInstitute of Cardiovascular Diseases VojvodinaSremska KamenicaSerbia
| | - Nduka C. Okwose
- Cardiovascular Research Division, Translational and Biosciences Research InstitutesNewcastle UniversityNewcastle upon TyneUK
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Amy Harwood
- Faculty of Health and Life SciencesCoventry UniversityCoventryUK
- University Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Gordon McGregor
- Faculty of Health and Life SciencesCoventry UniversityCoventryUK
- University Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Arsen Ristic
- Faculty of MedicineUniversity of Belgrade, Clinical Centre SerbiaBelgradeSerbia
| | - Prithwish Banerjee
- Faculty of Health and Life SciencesCoventry UniversityCoventryUK
- University Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Petar M. Seferovic
- Faculty of MedicineUniversity of Belgrade, Clinical Centre SerbiaBelgradeSerbia
| | - Guy A. MacGowan
- Cardiovascular Research Division, Translational and Biosciences Research InstitutesNewcastle UniversityNewcastle upon TyneUK
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Djordje G. Jakovljevic
- Cardiovascular Research Division, Translational and Biosciences Research InstitutesNewcastle UniversityNewcastle upon TyneUK
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
- Faculty of Health and Life SciencesCoventry UniversityCoventryUK
- University Hospitals Coventry and Warwickshire NHS TrustCoventryUK
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48
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König S, Ueberham L, Pellissier V, Hohenstein S, Meier-Hellmann A, Thiele H, Ahmadli V, Borger MA, Kuhlen R, Hindricks G, Bollmann A. Hospitalization deficit of in- and outpatient cases with cardiovascular diseases and utilization of cardiological interventions during the COVID-19 pandemic: Insights from the German-wide helios hospital network. Clin Cardiol 2021; 44:392-400. [PMID: 33497509 PMCID: PMC7943897 DOI: 10.1002/clc.23549] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background Treatment numbers of various cardiovascular diseases were reduced throughout the early phase of the ongoing COVID‐19 pandemic. Aim of this study was to (a) expand previous study periods to examine the long‐term course of hospital admission numbers, (b) provide data for in‐ and outpatient care pathways, and (c) illustrate changes of numbers of cardiovascular procedures. Methods and Results Administrative data of patients with ICD‐10‐encoded primary diagnoses of cardiovascular diseases (heart failure, cardiac arrhythmias, ischemic heart disease, valvular heart disease, hypertension, peripheral vascular disease) and in‐ or outpatient treatment between March, 13th 2020 and September, 10th 2020 were analyzed and compared with 2019 data. Numbers of cardiovascular procedures were calculated using OPS‐codes. The cumulative hospital admission deficit (CumAD) was computed as the difference between expected and observed admissions for every week in 2020. In total, 80 hospitals contributed 294 361 patient cases to the database without relevant differences in baseline characteristics between the studied periods. There was a CumAD of −10% to −16% at the end of the study interval in 2020 for all disease groups driven to varying degrees by both reductions of in‐ and outpatient case numbers. The number of performed interventions was significantly reduced for all examined procedures (catheter ablations: −10%; cardiac electronic device implantations: −7%; percutaneous cardiovascular interventions: −9%; cardiovascular surgery: −15%). Conclusions This study provides data on the long‐term development of cardiovascular patient care during the COVID‐19 pandemic demonstrating a significant CumAD for several cardiovascular diseases and a concomitant performance deficit of cardiovascular interventions.
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Affiliation(s)
- Sebastian König
- Heart Center Leipzig at University of Leipzig, Department of Electrophysiology, Leipzig, Germany.,Leipzig Heart Institute, Leipzig, Germany
| | - Laura Ueberham
- Heart Center Leipzig at University of Leipzig, Department of Electrophysiology, Leipzig, Germany.,Leipzig Heart Institute, Leipzig, Germany
| | | | | | | | - Holger Thiele
- Leipzig Heart Institute, Leipzig, Germany.,Heart Center Leipzig at University of Leipzig, Department of Cardiology, Leipzig, Germany
| | - Vusal Ahmadli
- Leipzig Heart Institute, Leipzig, Germany.,Heart Center Leipzig at University of Leipzig, Department of Cardiology, Leipzig, Germany
| | - Michael A Borger
- Leipzig Heart Institute, Leipzig, Germany.,Heart Center Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany
| | | | - Gerhard Hindricks
- Heart Center Leipzig at University of Leipzig, Department of Electrophysiology, Leipzig, Germany.,Leipzig Heart Institute, Leipzig, Germany
| | - Andreas Bollmann
- Heart Center Leipzig at University of Leipzig, Department of Electrophysiology, Leipzig, Germany.,Leipzig Heart Institute, Leipzig, Germany
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49
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Wu J, Mamas MA, Mohamed MO, Kwok CS, Roebuck C, Humberstone B, Denwood T, Luescher T, de Belder MA, Deanfield JE, Gale CP. Place and causes of acute cardiovascular mortality during the COVID-19 pandemic. Heart 2021; 107:113-119. [PMID: 32988988 PMCID: PMC7523172 DOI: 10.1136/heartjnl-2020-317912] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To describe the place and causes of acute cardiovascular death during the COVID-19 pandemic. METHODS Retrospective cohort of adult (age ≥18 years) acute cardiovascular deaths (n=5 87 225) in England and Wales, from 1 January 2014 to 30 June 2020. The exposure was the COVID-19 pandemic (from onset of the first COVID-19 death in England, 2 March 2020). The main outcome was acute cardiovascular events directly contributing to death. RESULTS After 2 March 2020, there were 28 969 acute cardiovascular deaths of which 5.1% related to COVID-19, and an excess acute cardiovascular mortality of 2085 (+8%). Deaths in the community accounted for nearly half of all deaths during this period. Death at home had the greatest excess acute cardiovascular deaths (2279, +35%), followed by deaths at care homes and hospices (1095, +32%) and in hospital (50, +0%). The most frequent cause of acute cardiovascular death during this period was stroke (10 318, 35.6%), followed by acute coronary syndrome (ACS) (7 098, 24.5%), heart failure (6 770, 23.4%), pulmonary embolism (2 689, 9.3%) and cardiac arrest (1 328, 4.6%). The greatest cause of excess cardiovascular death in care homes and hospices was stroke (715, +39%), compared with ACS (768, +41%) at home and cardiogenic shock (55, +15%) in hospital. CONCLUSIONS AND RELEVANCE The COVID-19 pandemic has resulted in an inflation in acute cardiovascular deaths, nearly half of which occurred in the community and most did not relate to COVID-19 infection suggesting there were delays to seeking help or likely the result of undiagnosed COVID-19.
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Affiliation(s)
- Jianhua Wu
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- Division of Clinical and Translational Research, School of Dentistry, University of Leeds, Leeds, UK
| | - Mamas A Mamas
- Keele Cardiovascular Reserach Group, Keele University, Keele, Staffordshire, UK
| | - Mohamed O Mohamed
- Keele Cardiovascular Research Group, Research Institute for Primary Care and Health Sciences, Keele, UK
| | - Chun Shing Kwok
- Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK
| | | | | | | | | | | | | | - Chris P Gale
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- Leeds Insitutue of Cardiovascualr and Metabolic Medicine, University of Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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50
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Fasshauer JM, Bollmann A, Hohenstein S, Hindricks G, Meier-Hellmann A, Kuhlen R, Broocks A, Schomerus G, Stengler K. Emergency hospital admissions for psychiatric disorders in a German-wide hospital network during the COVID-19 outbreak. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1469-1475. [PMID: 33866383 PMCID: PMC8053025 DOI: 10.1007/s00127-021-02091-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/07/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Psychiatric emergency hospital admissions for distinct psychiatric disorders and length of inpatient stay in the hospital during the Coronavirus disease 2019 (COVID-19) outbreak have not been thoroughly assessed. METHODS A retrospective study was performed analyzing claims data from a large German Hospital network during the COVID-19 outbreak (study period: March 13-May 21, 2020) as compared to periods directly before the outbreak (same year control: January 1-March 12, 2020) and one year earlier (previous year control: March 13-May 21, 2019). RESULTS A total of 13,151 emergency hospital admissions for psychiatric diagnoses were included in the analysis. For all psychiatric diagnoses combined, emergency admissions significantly decreased during the study period with mean (interquartile range) incidence rate ratios (IRRs) of 0.68 (0.65, 0.71) and 0.70 (0.67, 0.73) as compared to the same and previous year controls, respectively (both p < 0.00001). IRR ranged from 0.56 for mood affective disorders (F30-F39) to 0.75 for mental disorders due to psychoactive substance use (F10-F19; all p < 0.00001). Mean (standard deviation) length of hospital stay for all psychiatric diagnoses was significantly shorter during the study period [9.8 (11.6) days] as compared to same [14.7 (18.7) days] and previous [16.4 (23.9) days] year controls (both p < 0.00001). CONCLUSION Both emergency hospital admissions and length of hospital stay significantly decreased for psychiatric disorders during the COVID-19 outbreak. It needs to be assessed in further studies whether healthcare systems will face increased demand for the provision of mental health care in the nearer future.
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Affiliation(s)
- Jonathan Mathias Fasshauer
- grid.452684.9Department of Psychiatry, Psychotherapy and Psychosomatics, Helios Park Hospital Leipzig, Morawitzstraße 2, 04289 Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Andreas Bollmann
- grid.9647.c0000 0004 7669 9786Heart Center Leipzig At University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Sven Hohenstein
- grid.9647.c0000 0004 7669 9786Heart Center Leipzig At University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Gerhard Hindricks
- grid.9647.c0000 0004 7669 9786Heart Center Leipzig At University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Andreas Broocks
- Department of Psychiatry and Psychotherapy, Carl-Friedrich-Flemming-Klinik, Schwerin, Germany
| | - Georg Schomerus
- grid.9647.c0000 0004 7669 9786Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Katarina Stengler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Helios Park Hospital Leipzig, Morawitzstraße 2, 04289, Leipzig, Germany.
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