Faculty of Medicine, University of Novi Sad.
Institute of Cardiovascular Diseases of Vojvodina.
Int Heart J. 2022 Jul 30;63(4):749-754. doi: 10.1536/ihj.21-750. Epub 2022 Jul 14.
In 2020, decreased emergency department (ED) visits and hospitalization rates during the COVID-19 outbreak were reported. There is no data about cardiovascular emergencies and mortality for the whole COVID-19 year.This study aimed to compare the rates of cardiology ED visits, hospital admissions, and intrahospital mortality between the pre-COVID-19 and COVID-19 years in a single high-volume center.The retrospective observational cross-sectional study analyzed data on the number of ED visits, hospital admissions by different cardiovascular diagnoses, and outcomes.A total of 11744 patients visited the cardiology ED in the pre-COVID-19 year compared with 9145 in the COVID-19 year, indicating an overall decrease of 22.1% (P = 0.02) (IR 78.76 versus 61.33; incidence rate ratios (IRR) 1.28, P = 0.00), with an observed decrease of 25.5% in the number of hospitalizations (33.1% versus 31.6%, P = 0.02). A marked decrease in hospitalizations for cardiovascular emergencies was observed for hypertensive heart disease (-72.8%, P < 0.0001), acute coronary syndrome (-17.8%, P < 0.0001), myocardial and pericardial diseases and endocarditis (-61.2%, P = 0.00), and valvular heart disease (-70.8%, P < 0.0001). In the COVID-19 year, patients had increased need for mechanical ventilatory support (7% versus 6.3%, P = 0.03) with no overall difference in intrahospital mortality (IR 2.71 versus 2.78, IRR 0.98, 95% CI 0.82-1.16, P = 0.39).Decreased ED visits and hospitalizations not just in outbreaks but through the whole COVID-19 year highlight the risk of continuous delay of needed care for emergency life-threatening cardiovascular diseases. Urgent comprehensive strategies that will address patient- and system-related factors to decrease morbidity and mortality and prevent collateral damage of the pandemic are needed.
2020 年，有报道称 COVID-19 爆发期间急诊科（ED）就诊率和住院率下降。关于整个 COVID-19 年期间心血管急症和死亡率的数据尚不清楚。本研究旨在比较一家高容量中心在 COVID-19 前一年和 COVID-19 年期间的心脏病学 ED 就诊率、住院率和院内死亡率。这项回顾性观察性横断面研究分析了 ED 就诊次数、不同心血管诊断的住院人数和结局的数据。与 COVID-19 年的 9145 人相比，COVID-19 前一年有 11744 名患者到心脏病学 ED 就诊，总体下降 22.1%（P = 0.02）（IR 78.76 与 61.33；发病率比（IRR）为 1.28，P = 0.00），住院人数观察到下降 25.5%（33.1%与 31.6%，P = 0.02）。心血管急症住院人数显著下降，高血压性心脏病下降 72.8%（P < 0.0001），急性冠状动脉综合征下降 17.8%（P < 0.0001），心肌和心包疾病及心内膜炎下降 61.2%（P = 0.00），瓣膜性心脏病下降 70.8%（P < 0.0001）。在 COVID-19 年，患者需要机械通气支持的比例增加（7%比 6.3%，P = 0.03），但院内死亡率无总体差异（IR 2.71 与 2.78，IRR 0.98，95%CI 0.82-1.16，P = 0.39）。ED 就诊率和住院率不仅在疫情爆发期间下降，而且在整个 COVID-19 年期间都呈下降趋势，这突显了对危及生命的紧急心血管疾病持续延误治疗的风险。需要制定全面的综合策略，解决患者和系统相关因素，以降低发病率和死亡率，并防止大流行带来的附带损害。
