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Ostrowska A, Wojciechowska W, Rajzer M, Weber T, Bursztyn M, Persu A, Stergiou G, Kiełbasa G, Chrostowska M, Doumas M, Parati G, Bilo G, Grassi G, Mancia G, Januszewicz A, Kreutz R. The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study). Eur J Intern Med 2024:S0953-6205(24)00376-5. [PMID: 39261181 DOI: 10.1016/j.ejim.2024.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/29/2024] [Accepted: 08/31/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). DESIGN AND METHODS Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9-15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits. RESULTS Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period. CONCLUSION These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.
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Affiliation(s)
- Aleksandra Ostrowska
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Wiktoria Wojciechowska
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland.
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Thomas Weber
- Cardiology Department Klinikum Wels-Grieskirchen, Wels, Austria
| | - Michael Bursztyn
- Hypertension Clinic, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, and Faculty of Medicine, Hadassah-Hebrew University, School of Medicine, Jerusalem, Israel
| | - Alexandre Persu
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique and Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - George Stergiou
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Grzegorz Kiełbasa
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Marzena Chrostowska
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of, Gdansk, Poland
| | - Michaelis Doumas
- 2nd Prop Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | - Gianfranco Parati
- Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Grzegorz Bilo
- Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Guido Grassi
- Clinica Medica, S. Gerardo dei Tintori Hospital, University Milano-Bicocca, Monza, Italy
| | - Giuseppe Mancia
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Reinhold Kreutz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
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Kuwajima S, Itoh T, Sato T, Ino S, Shibata S, Ohno K, Hotta H, Matsumoto T, Ooiwa H, Kubo H, Miki T. Influence of the COVID-19 pandemic on the achievement of guideline targets for HbA1c, blood pressure, and LDL cholesterol in people with diabetes in Japan. Diabetol Int 2024; 15:507-517. [PMID: 39101168 PMCID: PMC11291788 DOI: 10.1007/s13340-024-00715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/18/2024] [Indexed: 08/06/2024]
Abstract
Objective In this study, we investigated whether the COVID-19 pandemic affected achievement of guideline targets for HbA1c, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol in people with diabetes mellitus (DM). Materials and methods Data for 556 people with DM who were treated regularly for 4 years before and during the COVID-19 pandemic in Japan were analyzed in this retrospective study. Achieved targets were defined as HbA1c < 7.0%, BP < 130/80 mmHg, and LDL cholesterol < 100 or < 120 mg/dL depending on the presence or absence of coronary artery disease. Results In 2019, before the start of the COVID-19 pandemic, achievement rates of guideline targets for HbA1c, BP and LDL cholesterol were 53.4%, 45.9% and 75.7%, respectively. In 2020, the achievement rates for HbA1c and BP targets were significantly decreased to 40.8% and 31.3%, respectively. The achievement rates for the HbA1c target gradually recovered to 49.3% in 2021 and to 51.1% in 2022. However, recovery in achieving the BP target was slow, remaining at 40.5% even in 2022. On the other hand, the achievement rate for the LDL cholesterol target was not affected and remained relatively high during the COVID-19 pandemic. Conclusions The rates of achieving therapeutic targets for HbA1c and BP have not been high enough in people with DM, and the rates were further reduced by lifestyle changes due to the COVID-19 pandemic. Although there has been a trend toward improvement with the lifting of behavioral restrictions, more intensified treatment is necessary to achieve good control. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-024-00715-8.
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Affiliation(s)
- Shingo Kuwajima
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Takahito Itoh
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Tatsuya Sato
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shoya Ino
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Satoru Shibata
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Kouhei Ohno
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Hiroyuki Hotta
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Tomoaki Matsumoto
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
- Medical Record Administration Center, Oji General Hospital, Tomakomai, Japan
| | - Hitoshi Ooiwa
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Hirofumi Kubo
- Medical Record Administration Center, Oji General Hospital, Tomakomai, Japan
| | - Takayuki Miki
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
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Wojciechowska W, Rajzer M, Kreutz R, Weber T, Bursztyn M, Persu A, Stergiou G, Parati G, Bilo G, Pac A, Grassi G, Mancia G, Januszewicz A, Chrostowska M, Narkiewicz K, Dubiela A, Doumas M, Imprialos K, Stavropoulos K, de Freminville JB, Azizi M, Cunha PG, Lewandowski J, Strzelczyk J, Wuerzner G, Gosk-Przybyłek M, Szwench-Pietrasz E, Prejbisz A, Van der Niepen P, Kahan T, Jekell A, Spaak J, Tsioufis K, Ehret G, Doroszko A, Kubalski P, Polonia J, Styczkiewicz K, Styczkiewicz M, Mazur S, Veglio F, Rabbia F, Eula E, Águila FJ, Sarzani R, Spannella F, Jarai Z, Papadopoulos D, Lopez-Sublet M, Ostrowska A, Grassos C, Kahrimanidis I, Eugenia G, Areti T, Tomasz G, Barbara W, Aleksandra S, Beata M, Angeliki N, Robles NR, Widmiski J, Zbroch E. The impact of the COVID-19 pandemic on blood pressure control in patients with treated hypertension-results of the European Society of Hypertension Study (ESH ABPM COVID-19 Study). J Hypertens 2024:00004872-990000000-00488. [PMID: 39248094 DOI: 10.1097/hjh.0000000000003752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
BACKGROUND We aimed to determine the influence of coronavirus disease 2019 (COVID-19) pandemic on blood pressure (BP) control assessed by ambulatory blood pressure monitoring (ABPM). METHODS Office BP and ABPM data from two visits conducted within a 9-15 months interval were collected from patients treated for hypertension. In the prepandemic group, both visits took place before, while in the pandemic group, Visit-1 was done before and Visit-2 during the pandemic period. RESULTS Of 1811 collected patients 191 were excluded because they did not meet the required ABPM time frames. Thus, the study comprised 704 patients from the pandemic and 916 from the prepandemic group. Groups did not differ in sex, age, duration of hypertension, frequency of first line antihypertensive drug use and mean 24 h BP on Visit-1. The prevalence of sustained uncontrolled hypertension was similar in both groups. On Visit-2 mean 24 h BP, daytime and nighttime systolic BP and diastolic BP were higher in the pandemic compared to the prepandemic group ( P < 0.034). The prevalence of sustained uncontrolled hypertension on Visit-2 was higher in the pandemic than in the prepandemic group [0.29 (95% confidence interval (95% CI): 0.26-0.33) vs. 0.25 (95% CI: 0.22-0.28), P < 0.037]. In multivariable adjusted analyses a significant difference in BP visit-to-visit change was observed, with a more profound decline in BP between visits in the prepandemic group. CONCLUSIONS This study using ABPM indicates a negative impact of the COVID-19 pandemic on BP control. It emphasizes the need of developing strategies to maintain BP control during a pandemic such as the one induced by COVID-19.
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Affiliation(s)
- Wiktoria Wojciechowska
- Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Krakow, Poland
| | - Marek Rajzer
- Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Krakow, Poland
| | - Reinhold Kreutz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
| | - Thomas Weber
- Cardiology Department Klinikum Wels-Grieskirchen, Wels, Austria
| | - Michael Bursztyn
- Faculty of Medicine, Hadassah-Hebrew University Jerusalem, Hadassah-Hebrew University Medical Center Mount-Scopus, Jerusalem, Israel
| | - Alexandre Persu
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - George Stergiou
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca
- Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Grzegorz Bilo
- Department of Medicine and Surgery, University of Milano-Bicocca
- Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Agnieszka Pac
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Guido Grassi
- Clinica Medica, Dept of Medicine and Surgery, University of Milano Bicocca, Milan Italy
| | - Giuseppe Mancia
- Department of Medicine and Surgery, University of Milano-Bicocca
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Marzena Chrostowska
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Narkiewicz
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Andżelina Dubiela
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Michaelis Doumas
- 2nd Prop Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | | | | | - Jean-Baptiste de Freminville
- Université Paris Cité, F75006, Paris, France; APHP, Hôpital Européen Georges Pompidou, Hypertension department, F-75015, Paris, France
| | - Michel Azizi
- Université Paris Cité, F75006, Paris, France; APHP, Hôpital Européen Georges Pompidou, Hypertension department, F-75015, Paris, France
| | - Pedro Guimarães Cunha
- Centre for the Research and Treatment of Arterial Hypertension, Guimarães, Portugal, Minho Medical School, Minho University, Portugal
| | - Jacek Lewandowski
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Strzelczyk
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Gregoire Wuerzner
- Hypertension Centre of the Lausanne University Hospital, Service of Nephrology and Hypertension, Lausanne, Switzerland
| | | | | | | | - Patricia Van der Niepen
- Department of Nephrology and Hypertension, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Thomas Kahan
- Cardiovascular Risk Assessment Unit, Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Andreas Jekell
- Cardiovascular Risk Assessment Unit, Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Jonas Spaak
- Cardiovascular Risk Assessment Unit, Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Konstantinos Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Georg Ehret
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Adrian Doroszko
- Clinical Department of Internal Diseases, Hypertension and Clinical Oncology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | | | - Jorge Polonia
- Faculty of Medicine, University of Porto, & Hypertension, HTA and Cardiovascular Risk Unit, ULS Matosinhos, Matosinhos, Portugal
| | - Katarzyna Styczkiewicz
- Department of Internal Medicine, Institute of Medical Sciences, Medical College, University of Rzeszów, Poland
| | - Marek Styczkiewicz
- Department of Cardiology, The Pope John Paul II Province Hospital of Zamość, Zamość, Poland
| | | | - Franco Veglio
- Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, AO 'Città della Salute e della Scienza' University Hospital, Turin, Italy
| | - Franco Rabbia
- Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, AO 'Città della Salute e della Scienza' University Hospital, Turin, Italy
| | - Elisabetta Eula
- Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, AO 'Città della Salute e della Scienza' University Hospital, Turin, Italy
| | - Fernando Jaen Águila
- Vascular Risk Unit. Internal Medicine. Virgen de las Nieves University Hospital. Granada. Spain
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, University Politecnica delle Marche, and IRCCS INRCA, Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, University Politecnica delle Marche, and IRCCS INRCA, Ancona, Italy
| | - Zoltan Jarai
- Department of Cardiology, South-Buda Center Hospital - St Imre University Teaching Hospital, Budapest, Hungary
| | | | - Marilucy Lopez-Sublet
- AP-HP, Hôpital Avicenne, Centre d'Excellence Européen en Hypertension Artérielle, Service de Médecine Interne, Bobigny, France. INSERM UMR 942 MASCOT, Paris 13-Université Paris Nord. FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Aleksandra Ostrowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland
| | - Charalampos Grassos
- Hypertension Clinic, Department of Cardiology, KAT General Hospital, Athens, Greece
| | - Ioannis Kahrimanidis
- Hypertension Clinic, Department of Cardiology, KAT General Hospital, Athens, Greece
| | - Gkaliagkousi Eugenia
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Triantafyllou Areti
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grodzicki Tomasz
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Wizner Barbara
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Seweryn Aleksandra
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Moczulska Beata
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Ntineri Angeliki
- Hypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Greece
| | | | - Jiri Widmiski
- Center for Hypertension, Charles University, Prague, Czech Republic
| | - Edyta Zbroch
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, Bialystok, Poland
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Wang C, Tan W, Liu X, He M, Zeng S, Sun M, Yan L, Li M, Zhan K, Wang K, Li Q. Habitual salt preference worsens blood pressure in hospitalized hypertensive patients with omicron infection under epidemic-related stress. BMC Public Health 2024; 24:134. [PMID: 38195459 PMCID: PMC10777613 DOI: 10.1186/s12889-023-17633-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND We investigated the synergistic effect of stress and habitual salt preference (SP) on blood pressure (BP) in the hospitalized Omicron-infected patients. METHODS From 15,185 hospitalized Omicron-infected patients who reported having high BP or hypertension, we recruited 662 patients. All patients completed an electronic questionnaire on diet and stress, and were required to complete morning BP monitoring at least three times. RESULTS The hypertensive group (n = 309) had higher habitual SP (P = 0.015) and COVID-19 related stress (P < 0.001), and had longer hospital stays (7.4 ± 1.5 days vs. 7.2 ± 0.5 days, P = 0.019) compared with controls (n = 353). After adjusting for a wide range of covariates including Omicron epidemic-related stress, habitual SP was found to increase both systolic (4.9 [95% confidence interval (CI), 2.3-7.4] mmHg, P < 0.001) and diastolic (2.1 [95%CI, 0.6-3.6] mmHg, P = 0.006) BP in hypertensive patients, and increase diastolic BP (2.0 [95%CI, 0.2-3.7] mmHg, P = 0.026) in the control group. 31 (8.8%) patients without a history of hypertension were discovered to have elevated BP during hospitalization, and stress was shown to be different in those patients (P < 0.001). In contrast, habitual SP was more common in hypertensive patients with uncontrolled BP, compared with patients with controlled BP (P = 0.002). CONCLUSIONS Habitual SP and psychosocial stress were associated with higher BP in Omicron-infected patients both with and without hypertension. Nonpharmaceutical intervention including dietary guidance and psychiatric therapy are crucial for BP control during the long COVID-19 period.
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Affiliation(s)
- Chenyi Wang
- Department of Urology Surgery, Daping Hospital, Army Medical University, 400042, Chongqing, China
| | - Wanhong Tan
- Chongqing Yuzhong District Daping Street Community Health Service Center, 400042, Chongqing, PR China
| | - Xiaoxiao Liu
- Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Chongqing Institute of Hypertension, Army Medical University, 400042, Chongqing, PR China
- Department of Nephrology, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, 100853, Beijing, China
| | - Miao He
- Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Chongqing Institute of Hypertension, Army Medical University, 400042, Chongqing, PR China
| | - Shi Zeng
- Department of Neurosurgery, People's Hospital of Chongqing Banan District, 401320, Chongqing, PR China
| | - Maojie Sun
- Department of Pharmacy, The Seventh People's Hospital of Chongqing, 400054, Chongqing, PR China
| | - Lijuan Yan
- Department of Urology Surgery, Daping Hospital, Army Medical University, 400042, Chongqing, China
| | - Min Li
- Department of Urology Surgery, Daping Hospital, Army Medical University, 400042, Chongqing, China
| | - Kun Zhan
- Department of Urology Surgery, Daping Hospital, Army Medical University, 400042, Chongqing, China
| | - Kaifa Wang
- School of Mathematics and Statistics, Southwest University, 400715, Chongqing, PR China.
| | - Qiang Li
- Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, Daping Hospital, Chongqing Institute of Hypertension, Army Medical University, 400042, Chongqing, PR China.
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Yamamoto T, Harada K, Yoshino H, Nakamura M, Kobayashi Y, Yoshikawa T, Maejima Y, Otsuka T, Nagao K, Takayama M. Impact of the COVID-19 pandemic on incidence and mortality of emergency cardiovascular diseases in Tokyo. J Cardiol 2023; 82:134-139. [PMID: 36682714 PMCID: PMC9851953 DOI: 10.1016/j.jjcc.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/22/2022] [Accepted: 12/15/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence and in-hospital mortality of emergency cardiovascular disease (CVD) has not been clarified in Japan. METHODS We compared the number of admissions and in-hospital mortality for emergency CVD during the pandemic (from January to December 2020) with those of pre-pandemic periods (from January 2018 to December 2019), using quarterly data from the Tokyo Cardiovascular Care Unit Network. The incidence rate in 2020 is compared with the average incidence rate observed in the same quarter of 2018 and 2019 and is presented as an incidence rate ratio (IRR) with 95 % confidence interval (CI). RESULTS The number of admissions for acute myocardial infarction during the pandemic was significantly lower than before the pandemic, with an IRR of 0.93 (95 % CI; 0.88-0.98). Similarly, the IRR for unstable angina was 0.78 (95 % CI; 0.72-0.83), for acute heart failure was 0.84 (95 % CI; 0.76-0.91), for acute aortic dissection was 0.88 (95 % CI; 0.78-0.98), and for ruptured aortic aneurysm was 0.75 (95 % CI; 0.62-0.88). In quarterly comparisons, the numbers of acute aortic diseases and emergency arrhythmia significantly decreased from July to September 2020, while those of other emergency CVDs significantly declined in the 2020 April-June period, which includes the first wave period in Japan. In-hospital mortality of emergency CVDs was unchanged from the pre-pandemic period, except for acute aortic dissection, which increased in odds ratio of 1.31 (95 % CI 1.10-1.57). CONCLUSIONS The COVID-19 pandemic significantly reduced the number of admissions for all emergency CVDs in all or part of the year. In-hospital mortality was unchanged from the pre-pandemic period, except for acute aortic dissection, which increased.
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Affiliation(s)
- Takeshi Yamamoto
- Tokyo CCU Network Council, Tokyo, Japan; Tokyo CCU Network Scientific Committee, Tokyo, Japan.
| | | | | | | | | | | | | | | | - Ken Nagao
- Tokyo CCU Network Scientific Committee, Tokyo, Japan
| | - Morimasa Takayama
- Tokyo CCU Network Council, Tokyo, Japan; Tokyo CCU Network Scientific Committee, Tokyo, Japan
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COVID-19 pandemic and hypertension: an updated report from the Japanese Society of Hypertension project team on COVID-19. Hypertens Res 2023; 46:589-600. [PMID: 36550205 PMCID: PMC9780104 DOI: 10.1038/s41440-022-01134-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/19/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
The number of reported cases with coronavirus disease 2019 (COVID-19) has exceeded 620 million worldwide, still having a profound impact on people's health and daily lives since its occurrence and outbreak in December 2019. From the early phase of the COVID-19 pandemic, there has been a concern that the rapid spread of this communicable disease can negatively influence non-communicable diseases. Accumulating data indicate that the restriction on the access to medical care, psychological distress, and life-style changes triggered by the pandemic have indeed affected blood pressure control in hypertensive patients. Since our previous report in 2020 that summarized the findings of the literature related to COVID-19 and hypertension, there has been a considerable progress in our understanding of the association between these two disorders; nonetheless, there are remaining challenges and emerging questions in the field. In this article, we aim to summarize the latest information on the impact of the pandemic on blood pressure control, the use of the renin-angiotensin system inhibitors in patients with COVID-19, and the blood pressure changes as one of the possible post-acute sequelae of COVID-19 (also known as long COVID). We also summarize the evidence of telemedicine and COVID-19 vaccination in hypertensive subjects, based on data available as of June 2022.
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The metabolic control and laboratory evaluation in patients with type 2 diabetes during the COVID-19 pandemic and the impact of telemedicine: a single-center experience. REV ROMANA MED LAB 2023. [DOI: 10.2478/rrlm-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Abstract
Objective: The study aimed to evaluate the metabolic control during the COVID-19 pandemic in subjects with type 2 diabetes mellitus (T2DM) and whether care through telemedicine significantly impacted it.
Material and methods: This was a retrospective study for which three time-periods were prespecified: the COVID-19 pandemic period, pre-COVID-19 period, and before pre-COVID-19. The following information were collected: anthropometric and laboratory parameters (glycated hemoglobin (HbA1c), blood glucose, lipid profile, creatinine, eGFR, etc.), self-measured blood glucose (SMBG), blood pressure (BP), diabetes therapy, number of on-site and of telemedicine consultations. The mean values of all available measurements for HbA1c, SMBG, BP, weight, and body mass index (BMI) were calculated.
Results: During the COVID-19 pandemic, the HbA1c values increased (6.78±0.77% to 6.96±0.87%, p<0.0001; + 0.18±0.67%), despite treatment intensification (p<0.01), while BMI and total cholesterol values slightly decreased (32.01±5.5 kg/m2 to 31.7±5.4 kg/m2, p<0.0001, and 178.1±40.8 mg/dl to 170.5±38.4 mg/dl, p<0.05). The deterioration of glycemic control (to HbA1c >7%) were rather seen in males (to 7.01±0.92%, p<0.0001), patients from rural areas (to 7.08±0.96%, p<0.001) and younger than 65 y.o. (to 7.05±0.82%, p<0.001). More male patients had a mean HbA1c increase of >0.5% during the COVID-19 pandemic (32.3% vs 21.5%, p<0.05). Patients who received more diabetes care visits through telemedicine had a more attenuated increase in HbA1c (6.79±0.80% to 6.90±0.83%, p<0.05 vs 6.76±0.72% to 7.08±0.92%, p<0.0001).
Conclusions: The glycemic control slightly deteriorated during the COVID-19 pandemic (but with overall HbA1c within target), with certain patient categories being more affected. Diabetes care though telemedicine allowed the maintenance of the metabolic control.
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Marquez NM, Saintila J, Castellanos-Vazquez AJ, Dávila-Villavicencio R, Turpo-Chaparro J, Sánchez-Tarrillo JA, Salinas Arias SA, Calizaya-Milla YE, Morales-García WC. Telehealth-based interventions on lifestyle, body mass index, and glucose concentration in university staff during the coronavirus disease 2019 pandemic: A pre-experimental study. Digit Health 2022; 8:20552076221129719. [PMID: 36211802 PMCID: PMC9537489 DOI: 10.1177/20552076221129719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background: The coronavirus disease 2019 pandemic has impacted the health of the population. Technological advances become alternative tools for the promotion of lifestyle and prevention of non-communicable diseases in university personnel. Objective: This study analyzed the effect of an intervention based on a telehealth program and investigated its efficacy in improving lifestyle, body mass index, and glucose concentration in university staff during the coronavirus disease 2019 pandemic. Methods: A pre-experimental study was conducted between August and December 2021 on 100 workers of a private university located in Tarapoto, Peru. Information was collected on lifestyle practices and beliefs, body mass index, and glucose contraction before and after the intervention. After the intervention, 78 participants were analyzed; 22 workers did not respond to the invitation. Results: Comparison between pretest and follow-up showed an increase in lifestyle practices and beliefs (from 93.33 ± 9.44 to 96.23 ± 9.32, p < 0.01), although this value is considered an unhealthy lifestyle. Moreover, a decrease in body mass index (from 25.23 ± 3.08 to 24.98 ± 2.98, p < 0.05) and glucose concentration (from 98.35 ± 6.70 to 97.45 ± 5.61, p < 0.01) was observed. Conclusion: Telehealth-based educational interventions could be effective in university staff during the coronavirus disease 2019 pandemic, which, in turn, would support improved lifestyles and adequate body mass index and glucose levels.
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Affiliation(s)
- Neidis M. Marquez
- Unidad de Salud Pública, Escuela de Posgrado, Universidad Peruana Unión, Lima, Perú
| | - Jacksaint Saintila
- Escuela de Medicina Humana, Universidad Señor de Sipán, Chiclayo, Perú,Jacksaint Saintila, Escuela de Medicina
Humana, Universidad Señor de Sipán, Km 5, Carretera Pimentel, Chiclayo, Perú.
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9
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Kolkailah AA, Riggs K, Navar AM, Khera A. COVID-19 and Cardiometabolic Health: Lessons Gleaned from the Pandemic and Insights for the Next Wave. Curr Atheroscler Rep 2022; 24:607-617. [PMID: 35773565 PMCID: PMC9247906 DOI: 10.1007/s11883-022-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW To review the current evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiometabolic health, with a focus on strategies to help mitigate adverse effects on population health. RECENT FINDINGS Individuals with cardiometabolic disease are particularly vulnerable to worse outcomes with COVID-19 infection. In addition, the pandemic itself has had significant deleterious impact on the cardiometabolic health of the population, including declines in physical activity, increases in smoking and alcohol use, worsening blood pressure and glycemic control, and detrimental effects on mental health. Targeted interventions at the patient and community level will be needed to mitigate the long-term consequences of the COVID-19 pandemic on population cardiometabolic health. The COVID-19 pandemic has worsened cardiometabolic health, but there are several opportunities and enhanced tools available to counteract these changes.
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Affiliation(s)
- Ahmed A. Kolkailah
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Kayla Riggs
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Ann Marie Navar
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Amit Khera
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
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10
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Ambrož M, de Vries ST, Hoogenberg K, Denig P. Less Timely Initiation of Glucose-Lowering Medication Among Younger and Male Patients With Diabetes and Similar Initiation of Blood Pressure-Lowering Medication Across Age and Sex: Trends Between 2015 and 2020. Front Pharmacol 2022; 13:883103. [PMID: 35645811 PMCID: PMC9133603 DOI: 10.3389/fphar.2022.883103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/13/2022] [Indexed: 11/15/2022] Open
Abstract
Aims: We aimed to assess trends in glycosylated hemoglobin A1c (HbA1c) and systolic blood pressure (SBP) thresholds at initiation of glucose- and blood pressure-lowering medication among patients with type 2 diabetes and assess the influence of age and sex on these trends. Materials and Methods: We used the Groningen Initiative to ANalyze Type 2 diabetes Treatment (GIANTT) primary care database. Patients initiating a first non-insulin glucose-lowering or any blood pressure-lowering medication between 2015 and 2020 with an HbA1c or SBP measurement in the 120 days before initiation were included. We used multilevel regression analyses adjusted for potential confounders to assess the influence of calendar year, age or sex, and the interaction between calendar year and age or sex on trends in HbA1c and SBP thresholds at initiation of medication. Results: We included 2,671 and 2,128 patients in the analyses of HbA1c and SBP thresholds, respectively. The overall mean HbA1c threshold at initiation of glucose-lowering medication significantly increased from 7.4% in 2015 to 8.0% in 2020 (p < 0.001), and particularly in the younger age groups. Compared to patients ≥80 years, patients aged 60-69 years initiated medication at lower levels mainly in the early years. Patients <60 years and between 70-79 years initiated medication at similar levels as patients ≥80 years. Females initiated medication at lower levels than males throughout the study period (p < 0.001). The mean SBP threshold at initiation of blood pressure-lowering medication varied from 145 to 149 mmHg without a clear trend (p = 0.676). There were no differences in SBP thresholds between patients of different ages or sex. Conclusion: The rising trend in the HbA1c threshold for initiating glucose-lowering medication in the lower age groups was unexpected and requires further investigation. Males appear to receive less timely initiation of glucose-lowering medication than females. The lack of higher thresholds for the oldest age group or lower thresholds for the youngest age group in recent years is not in line with the age-related recommendations for personalized diabetes care and calls for health systems interventions.
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Affiliation(s)
- Martina Ambrož
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sieta T. de Vries
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Klaas Hoogenberg
- Department of Internal Medicine, Martini Hospital, Groningen, Netherlands
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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11
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Tomidokoro D, Hiroi Y. Cardiovascular considerations during the COVID-19 pandemic: A focused review for practice in Japan. Glob Health Med 2022; 4:101-107. [PMID: 35586765 PMCID: PMC9066463 DOI: 10.35772/ghm.2022.01006] [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: 02/16/2022] [Revised: 03/14/2022] [Accepted: 03/26/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic is continuing to have drastic consequences for patients, healthcare workers, and the health system. Its cardiovascular implications have been well described in previous studies, but original reports from Japan are sparse. Validating overseas findings in the Japanese clinical settings is crucial to improve local COVID-19 care and to clarify the pandemic's impacts in the country. This review of available literature demonstrates that in Japanese patients and clinical settings too, there is a close relationship between COVID-19 and the cardiovascular system including cardiovascular complications. On the contrary, secondary effects on cardiovascular practice including service disruptions, telemedicine, and epidemiological changes in Japan have been relatively small.
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Affiliation(s)
- Daiki Tomidokoro
- Address correspondence to:Daiki Tomidokoro and Yukio Hiroi, Department of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail: (DT); yhiroi@hosp. ncgm.go.jp (YH)
| | - Yukio Hiroi
- Address correspondence to:Daiki Tomidokoro and Yukio Hiroi, Department of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail: (DT); yhiroi@hosp. ncgm.go.jp (YH)
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12
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Ito S, Kobayashi K, Chin K, Umezawa S, Yamamoto H, Nakano S, Takada N, Hatori N, Tamura K. The impact of the first announced state of emergency owing to coronavirus disease-2019 on stress and blood pressure levels among patients with type 2 diabetes mellitus in Japan. J Diabetes Investig 2022; 13:1607-1616. [PMID: 35437922 PMCID: PMC9114982 DOI: 10.1111/jdi.13813] [Citation(s) in RCA: 2] [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: 02/17/2022] [Revised: 03/31/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
Abstract
Aims/Introduction After the first coronavirus disease 2019 state of emergency announcement, there was an increase in stress that might have affected the self‐management of patients with type 2 diabetes mellitus. This study identified the changes in clinical findings and stress among patients with type 2 diabetes mellitus, and investigated the characteristics of patients who experienced an increase in blood pressure (BP) after the announcement. Materials and Methods Retrospectively, we scrutinized 310 patients with type 2 diabetes mellitus who were treated by the Sagamihara Physicians Association. After the announcement, 164 and 146 patients showed an increase (ΔBP >0 group) and decrease in BP (ΔBP ≤0 group), respectively. The propensity score matching method was used to compare the differences in clinical findings and stress‐related questionnaire responses between the two groups. Results After the announcement, 47% of patients experienced an increase in daily stress. Furthermore, 17% and 36% reported worsening dietary intake and a decrease in exercise, respectively. More patients reported that their dietary and salt intake had worsened in the ΔBP >0 group than in the ΔBP ≤0 group (9% vs 20%, P = 0.02, and 3% vs 10%, P = 0.04, respectively). Additionally, both systolic and diastolic BP measured in the office were significantly increased (P = 0.02 and P = 0.03, respectively); however, systolic BP measured at home significantly decreased (P = 0.01). The total stress scores were higher in the ΔBP >0 group than in the ΔBP ≤0 group (0.05 ± 2.61 and 0.93 ± 2.70, respectively, P = 0.03). Conclusions An increase in stress and, particularly, worsening dietary and salt intake were noted among patients with type 2 diabetes mellitus who experienced an increase in BP after the state of emergency announcement.
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Affiliation(s)
- Shun Ito
- Sagamihara Physicians Association, Sagamihara, Japan
| | - Kazuo Kobayashi
- Sagamihara Physicians Association, Sagamihara, Japan.,Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Keiichi Chin
- Sagamihara Physicians Association, Sagamihara, Japan
| | | | | | - Shiro Nakano
- Sagamihara Physicians Association, Sagamihara, Japan
| | | | - Nobuo Hatori
- Department of Cardiology, Kobayashi Hospital, Odawara, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
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Lear-Claveras A, González-Álvarez B, Couso-Viana S, Clavería A, Oliván-Blázquez B. Analysis of Clinical Parameters, Drug Consumption and Use of Health Resources in a Southern European Population with Alcohol Abuse Disorder during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1358. [PMID: 35162380 PMCID: PMC8835241 DOI: 10.3390/ijerph19031358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/05/2023]
Abstract
The disruption in healthcare attention to people with alcohol dependence, along with psychological decompensation as a consequence of lockdown derived from the COVID-19 pandemic could have a negative impact on people who suffer from alcohol abuse disorder. Observational real world data pre-post study included 9966 men aged >16 years registered as having the diagnosis of alcohol abuse disorder in the electronic medical records (EMR) of the Aragon Regional Health Service (Spain). Clinical (Glutamate-oxaloacetate -GOT-, Glutamate pyruvate -GPT-, creatinine, glomerular filtration, systolic blood pressure -SBP-, diastolic blood pressure -DBP-, total cholesterol, LDL, HDL, triglycerides, and body mass index -BMI-), pharmacological (dose per inhabitant per day, DHD, of drugs used in addictive disorders, benzodiazepines and antidepressants) and health resource use variables (primary and specialized care) were considered. A Student's t-test for matched samples was performed to analyze the changes in clinical variables between alcohol abuse disorder patients with and without COVID-19. Only creatinine and LDL showed a significant but clinically irrelevant change six months after the end of the strict lockdown. The total number of DHDs for all drugs included in the study (except for benzodiazepines), decreased. In the same way, the use of health services by these patients also decreased. The impact of COVID-19 among this group of patients has been moderate. The reorganization of health and social services after the declaration of the state of alarm in our country made possible the maintenance of care for this vulnerable population.
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Affiliation(s)
- Ana Lear-Claveras
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragon Health Research Institute, 50015 Zaragoza, Spain; (A.L.-C.); (B.O.-B.)
| | | | - Sabela Couso-Viana
- I-Saúde Group, South Galicia Health Research Institute, 36201 Vigo, Spain;
| | - Ana Clavería
- I-Saúde Group, South Galicia Health Research Institute, 36201 Vigo, Spain;
- Vigo Health Area, SERGAS, 36201 Vigo, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 08007 Barcelona, Spain
| | - Bárbara Oliván-Blázquez
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragon Health Research Institute, 50015 Zaragoza, Spain; (A.L.-C.); (B.O.-B.)
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 08007 Barcelona, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
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