Indirect Impact of COVID-19 Pandemic on Patients and Care for Cardiovascular Disease

Deaths from ischemic heart disease and hypertension in the United States increased year-on-year during the COVID-19 pandemic, but globally, COVID-19 has been associated with significant confusion in cardiovascular disease testing. It was. The results of these surveys are Journal of American University of Cardiology We investigated the indirect effects of pandemics on patients with cardiovascular disease and their care.

The effects of the COVID-19 pandemic are enormous, but there are also concerns about the indirect effects of the pandemic, especially for patients with heart disease. Many reports suggest that the large increase in mortality during a pandemic cannot be explained by COVID-19 alone. During a stay-at-home order in the United States, the hospital reported a reduction in the number of heart attacks and strokes diagnosed and treated at the hospital. It was assumed that some patients were afraid of being infected with COVID-19 in the hospital and chose to delay care or not seek care at all due to an emergency, including a heart attack. The American College of Cardiology issued a statement and infographic on hospital safety during a pandemic of COVID-19, urging people to seek immediate treatment as needed.

Cardiovascular death during COVID-19 pandemic in the United States

In this study, researchers found that population-level deaths from cardiovascular causes (ischemic heart disease, heart failure, hypertensive disease, cerebrovascular disease, and other cardiovascular disease) were in the United States in the early stages of the pandemic. I checked if it changed in. If the same period of the previous year, and these changes were more pronounced in the states that experienced the first surge of COVID-19 cases.

Using data from the National Center for Health Statistics, researchers were able to study from March 18, 2020 to June 2, 2020 (pandemic) and from January 1, 2020 to March 17, 2020 (before the pandemic). We investigated cardiovascular mortality in the United States. And compared with the same period in 2019. They found an increase in deaths from ischemic heart disease and hypertension after the onset of the 2020 pandemic compared to the changes over the same period in 2019. In contrast, death from heart failure has not changed nationally for cardiovascular and other cardiovascular diseases. In New York City, the relative increase in deaths from ischemic heart disease (139%) and hypertensive heart disease (164%) during a pandemic was greatest. The rest of New York, New Jersey, Michigan, and Illinois also saw a significant increase in deaths from these conditions, but Massachusetts and Louisiana showed no change in cardiovascular deaths.

“Our findings suggest that a pandemic may have caused indirect damage to patients.
Cardiovascular disease can be due to avoiding hospitals for fear of exposure to the virus, increased burden on the healthcare system, and postponement of semi-selective treatment and care, “said the lead author. Said Rishi K. Wadhera, MD, MPP, MPhil. As a result of the study, a cardiologist at the Beth Israel Deacones Medical Center and an assistant professor at Harvard Medical School said, “U.S. public health authorities and policy makers are trying to encourage patients in acute conditions to seek medical care. The message needs to be improved. “

International Impact of COVID-19 on the Diagnosis of Heart Disease

The COVID-19 pandemic caused disruption to healthcare delivery worldwide in 2020, including delays in the diagnosis and timely treatment of cardiovascular disease. Heart disease is the number one killer in the world, and results rely on early and effective diagnosis to determine the best possible treatment. In this study, researchers sought to determine the full magnitude of the decline in diagnostic procedures for heart disease in 2020 and how it would affect the outcome of long-term cardiovascular disease.

Survey submitted by 909 Inpatient and Outpatient Centers Performing the Heart
Diagnostic procedures in 108 countries. According to researchers, the procedure decreased by 42% from March 2019 to March 2020 and by 64% from March 2019 to April 2020. Specifically, transthoracic echocardiography was reduced by 59%, transesophageal echocardiography was reduced by 76%, and stress tests were reduced by 78%. Coronary angiography (invasive or computed tomography) was reduced by 55%. Researchers also categorized the country into four economic levels (low, low-middle, high-middle, high), and locations in low / low-middle-income countries have an additional 22% reduction in heart surgery and personal availability. Protective equipment and telemedicine found to be associated with decreased sex.

These findings raise serious concerns about the long-term adverse effects on cardiovascular health resulting from poor diagnosis. Efforts are needed to improve timely patient access to cardiovascular diagnostics in current and future pandemics, especially in low- and middle-income countries. “

Andrew J. Einstein, MD, PhD, Associate Professor, Columbia University Bageros Medical College, and Cardiologist at New York Elders / Columbia University Irving Medical Center