TY - JOUR T1 - Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK JF - Heart JO - Heart SP - 1890 LP - 1897 DO - 10.1136/heartjnl-2020-317870 VL - 106 IS - 24 AU - Simon Ball AU - Amitava Banerjee AU - Colin Berry AU - Jonathan R Boyle AU - Benjamin Bray AU - William Bradlow AU - Afzal Chaudhry AU - Rikki Crawley AU - John Danesh AU - Alastair Denniston AU - Florian Falter AU - Jonine D Figueroa AU - Christopher Hall AU - Harry Hemingway AU - Emily Jefferson AU - Tom Johnson AU - Graham King AU - Kuan Ken Lee AU - Paul McKean AU - Suzanne Mason AU - Nicholas L Mills AU - Ewen Pearson AU - Munir Pirmohamed AU - Michael T C Poon AU - Rouven Priedon AU - Anoop Shah AU - Reecha Sofat AU - Jonathan A C Sterne AU - Fiona E Strachan AU - Cathie L M Sudlow AU - Zsolt Szarka AU - William Whiteley AU - Michael Wyatt A2 - , Y1 - 2020/12/01 UR - http://heart.bmj.com/content/106/24/1890.abstract N2 - 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. ER -