Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK

被引：82

作者：

Ball, Simon ^{[1
,2
]}

Banerjee, Amitava ^{[3
,4
,5
]}

Berry, Colin ^{[6
,7
]}

Boyle, Jonathan R. ^{[8
,9
]}

Bray, Benjamin ^{[10
]}

Bradlow, William ^{[11
]}

Chaudhry, Afzal ^{[12
]}

Crawley, Rikki ^{[13
]}

Danesh, John ^{[12
]}

Denniston, Alastair ^{[1
,2
]}

Falter, Florian ^{[14
]}

Figueroa, Jonine D. ^{[15
]}

Hall, Christopher ^{[16
]}

Hemingway, Harry ^{[3
,5
]}

Jefferson, Emily ^{[17
,18
]}

Johnson, Tom ^{[19
,20
]}

King, Graham ^{[21
]}

Lee, Kuan Ken ^{[22
]}

McKean, Paul ^{[21
]}

Mason, Suzanne ^{[23
,24
]}

Mills, Nicholas L. ^{[15
,18
,25
]}

Pearson, Ewen ^{[17
,18
]}

Pirmohamed, Munir ^{[23
,26
]}

Poon, Michael T. C. ^{[15
,27
]}

Priedon, Rouven ^{[28
]}

Shah, Anoop ^{[29
]}

Sofat, Reecha ^{[4
,30
]}

Sterne, Jonathan A. C. ^{[31
]}

Strachan, Fiona E. ^{[32
]}

Sudlow, Cathie L. M. ^{[18
,28
]}

Szarka, Zsolt ^{[16
]}

Whiteley, William ^{[33
]}

Wyatt, Michael ^{[19
,20
]}

机构：

[1] Univ Hosp Birmingham NHS Trust, Birmingham, W Midlands, England

[2] Hlth Data Res UK Midlands, Birmingham, W Midlands, England

[3] UCL, Inst Hlth Informat, 222 Euston Rd, London NW1 2DA, England

[4] Univ Coll London Hosp NHS Trust, London, England

[5] Hlth Data Res UK, London, England

[6] Univ Glasgow, BHF Glasgow Cardiovasc Res Ctr, Glasgow, Lanark, Scotland

[7] Golden Jubilee Natl Hosp, Dept Cardiol, Clydebank, Scotland

[8] Univ Cambridge, Cambridge, England

[9] Cambridge Univ Hosp NHS Fdn Trust, Cambridge, England

[10] IQVIA Ltd, Reading, Berks, England

[11] Univ Hosp Birmingham NHS Fdn Trust, Dept Cardiol, Birmingham, W Midlands, England

[12] Hlth Data Res UK Cambridge, Cambridge, England

[13] Barnsley Hosp NHS Fdn Trust, Barnsley, England

[14] Royal Papworth Hosp NHS Fdn Trust, Cambridge, England

[15] Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland

[16] Univ Dundee, Hlth Informat Ctr, Dundee, Scotland

[17] Univ Dundee, Populat Hlth & Genom, Dundee, Scotland

[18] Hlth Data Res UK Scotland, Edinburgh, Midlothian, Scotland

[19] Univ Hosp Bristol, Bristol, Avon, England

[20] Weston NHS Fdn Trust, Bristol, Avon, England

[21] Newcastle Tyne Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England

[22] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[23] Hlth Data Res UK North, Sheffield, S Yorkshire, England

[24] Univ Sheffield, Sch Hlth & Related Res, Sheffield, S Yorkshire, England

[25] Univ Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[26] Univ Liverpool, Inst Translat Med, Liverpool, Merseyside, England

[27] Univ Edinburgh, Inst Genom & Mol Med, Canc Res UK Edinburgh Ctr, Edinburgh, Midlothian, Scotland

[28] Hlth Data Res UK, BHF Data Sci Ctr, London, England

[29] Royal Infirm Edinburgh NHS Trust, Univ Ctr Cardiovasc Sci, BHF, Edinburgh, Midlothian, Scotland

[30] UCL, Inst Hlth Informat, London, England

[31] Univ Bristol, Hlth Data Res UK South West, Populat Hlth Sci, Bristol, Avon, England

[32] Univ Edinburgh, British Heart Fdn, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[33] Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland

来源：

HEART | 2020年 / 106卷 / 24期

关键词：

epidemiology; aortic and arterial disease; global health care delivery; health care delivery; heart disease; OUTCOMES;

D O I：

10.1136/heartjnl-2020-317870

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1890 / 1897

页数：8

共 29 条

[1]

Banerjee A, 2020, CARDIOVASCULAR MED

[2] Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study [J].

Banerjee, Amitava ;

Pasea, Laura ;

Harris, Steve ;

Gonzalez-Izquierdo, Arturo ;

Torralbo, Ana ;

Shallcross, Laura ;

Noursadeghi, Mahdad ;

Pillay, Deenan ;

Sebire, Neil ;

Holmes, Chris ;

Pagel, Christina ;

Wong, Wai Keong ;

Langenberg, Claudia ;

Williams, Bryan ;

Denaxas, Spiros ;

Hemingway, Harry .

LANCET, 2020, 395 (10238) :1715-1725

[3] An easy to use method to approximate Poisson confidence limits [J].

Bégaud, B ;

Martin, K ;

Abouelfath, A ;

Tubert-Bitter, P ;

Moore, N ;

Moride, Y .

EUROPEAN JOURNAL OF EPIDEMIOLOGY, 2005, 20 (03) :213-216

[4] Fewer Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic [J].

Bhatt, Ankeet S. ;

Moscone, Alea ;

McElrath, Erin E. ;

Varshney, Anubodh S. ;

Claggett, Brian L. ;

Bhatt, Deepak L. ;

Januzzi, James L. ;

Butler, Javed ;

Adler, Dale S. ;

Solomon, Scott D. ;

Vaduganathan, Muthiah .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2020, 76 (03) :280-288

[5]

British Heart Foundation, 2019, IMPR NAT CARD VASC H

[6] The impact ofCOVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic [J].

Bromage, Daniel I. ;

Cannata, Antonio ;

Rind, Irfan A. ;

Gregorio, Caterina ;

Piper, Susan ;

Shah, Ajay M. ;

McDonagh, Theresa A. .

EUROPEAN JOURNAL OF HEART FAILURE, 2020, 22 (06) :978-984

[7]

Clinical Effectiveness Unit, 2019, NAT VASC REG

[8] Global guidance for surgical care during the COVID-19 pandemic [J].

Bhangu A. ;

Lawani I. ;

Ng-Kamstra J.S. ;

Wang Y. ;

Chan A. ;

Futaba K. ;

Ng S. ;

Ebele E. ;

Lederhuber H. ;

Tabiri S. ;

Ghosh D. ;

Gallo G. ;

Pata F. ;

Di Saverio S. ;

Spinelli A. ;

la Medina A.R.-D. ;

Ademuyiwa A.O. ;

Akinbode G. ;

Ingabire J.C.A. ;

Ntirenganya F. ;

Kamara T.B. ;

Goh M. ;

Moore R. ;

Kim H.J. ;

Lee S.-H. ;

Minaya-Bravo A. ;

Abbott T. ;

Chakrabortee S. ;

Denning M. ;

Fitzgerald J.E. ;

Glasbey J. ;

Griffiths E. ;

Halkias C. ;

Harrison E.M. ;

Jones C.S. ;

Kinross J. ;

Lawday S. ;

Li E. ;

Markar S. ;

Morton D.G. ;

Nepogodiev D. ;

Pinkney T.D. ;

Simoes J. ;

Warren O. ;

Wong D.J.N. ;

Bankhead-Kendall B. ;

Breen K.A. ;

Davidson G.H. ;

Kaafarani H. ;

Keller D.S. .

BRITISH JOURNAL OF SURGERY, 2020, 107 (09) :1097-1103

[9]

De Filippo O, 2020, NEW ENGL J MED, V383, P88, DOI 10.1056/NEJMc2009166

[10]

Denaxas S, 2020, OURRISK COV PROTOTYP

← 1 2 3 →