RT Journal Article
SR Electronic
T1 Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2020-317870
DO 10.1136/heartjnl-2020-317870
A1 Simon Ball
A1 Amitava Banerjee
A1 Colin Berry
A1 Jonathan R Boyle
A1 Benjamin Bray
A1 William Bradlow
A1 Afzal Chaudhry
A1 Rikki Crawley
A1 John Danesh
A1 Alastair Denniston
A1 Florian Falter
A1 Jonine D Figueroa
A1 Christopher Hall
A1 Harry Hemingway
A1 Emily Jefferson
A1 Tom Johnson
A1 Graham King
A1 Kuan Ken Lee
A1 Paul McKean
A1 Suzanne Mason
A1 Nicholas L Mills
A1 Ewen Pearson
A1 Munir Pirmohamed
A1 Michael T C Poon
A1 Rouven Priedon
A1 Anoop Shah
A1 Reecha Sofat
A1 Jonathan A C Sterne
A1 Fiona E Strachan
A1 Cathie L M Sudlow
A1 Zsolt Szarka
A1 William Whiteley
A1 Michael Wyatt
A1 ,
YR 2020
UL http://heart.bmj.com/content/early/2020/10/19/heartjnl-2020-317870.abstract
AB Objective To monitor hospital activity for presentation, diagnosis and treatment of cardiovascular diseases during the COVID-19) pandemic to inform on indirect effects.Methods Retrospective serial cross-sectional study in nine UK hospitals using hospital activity data from 28 October 2019 (pre-COVID-19) to 10 May 2020 (pre-easing of lockdown) and for the same weeks during 2018–2019. We analysed aggregate data for selected cardiovascular diseases before and during the epidemic. We produced an online visualisation tool to enable near real-time monitoring of trends.Results Across nine hospitals, total admissions and emergency department (ED) attendances decreased after lockdown (23 March 2020) by 57.9% (57.1%–58.6%) and 52.9% (52.2%–53.5%), respectively, compared with the previous year. Activity for cardiac, cerebrovascular and other vascular conditions started to decline 1–2 weeks before lockdown and fell by 31%–88% after lockdown, with the greatest reductions observed for coronary artery bypass grafts, carotid endarterectomy, aortic aneurysm repair and peripheral arterial disease procedures. Compared with before the first UK COVID-19 (31 January 2020), activity declined across diseases and specialties between the first case and lockdown (total ED attendances relative reduction (RR) 0.94, 0.93–0.95; total hospital admissions RR 0.96, 0.95–0.97) and after lockdown (attendances RR 0.63, 0.62–0.64; admissions RR 0.59, 0.57–0.60). There was limited recovery towards usual levels of some activities from mid-April 2020.Conclusions Substantial reductions in total and cardiovascular activities are likely to contribute to a major burden of indirect effects of the pandemic, suggesting they should be monitored and mitigated urgently.