Ball, Simon, Banerjee, Amitava, Berry, Colin, Boyle, Jonathan R, Bray, Benjamin, Bradlow, William, Chaudhry, Afzal, Crawley, Rikki, Danesh, John, Denniston, Alastair et al (show 23 more authors)
(2020)
Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK.
HEART, 106 (24).
pp. 1890-1897.
Text
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Abstract
<h4>Objective</h4>To monitor hospital activity for presentation, diagnosis and treatment of cardiovascular diseases during the COVID-19) pandemic to inform on indirect effects.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.
Item Type: | Article |
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Uncontrolled Keywords: | epidemiology, aortic and arterial disease, global health care delivery, health care delivery, heart disease |
Depositing User: | Symplectic Admin |
Date Deposited: | 12 Oct 2020 07:54 |
Last Modified: | 18 Jan 2023 23:29 |
DOI: | 10.1136/heartjnl-2020-317870 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3104027 |