Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries

F. Lucy Wright, Kate Cheema, Raph Goldacre, Nick Hall, Naomi Herz, Nazrul Islam, Zainab Karim, David Moreno-Martos, Daniel R. Morales, Daniel O'Connell, Enti Spata, Ashley Akbari, Mark Ashworth, Mark Barber, Norman Briffa, Dexter Canoy, Spiros Denaxas, Kamlesh Khunti, Amanj Kurdi, Mamas MamasRouven Priedon, Cathie Sudlow, Eva J. A. Morris, Ben Lacey, Amitava Banerjee (Lead / Corresponding author), CVD-COVID-UK Consortium

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
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Background: Although morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.

Methods: Analyses used national administrative electronic hospital records in England, Scotland and Wales for 2016-2021. Admissions and procedures during the pandemic (2020-2021) related to six major cardiovascular conditions (acute coronary syndrome, heart failure, stroke/transient ischaemic attack, peripheral arterial disease, aortic aneurysm, and venous thromboembolism) were compared to the annual average in the pre-pandemic period (2016-2019). Differences were assessed by time period and urgency of care.

Results: In 2020, there were 31 064 (-6%) fewer hospital admissions (14 506 [-4%] fewer emergencies, 16 560 [-23%] fewer elective admissions) compared to 2016-2019 for the six major cardiovascular diseases combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries (-10 996 [-15%] fewer admissions). However, these reductions were offset by higher than expected total emergency admissions (+25 878 [+6%] higher admissions), notably for heart failure and stroke in England, and for venous thromboembolism in all three countries. Analyses for procedures showed similar temporal variations to admissions.

Conclusion: This study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.

Original languageEnglish
Pages (from-to)377–388
Number of pages12
JournalEuropean Heart Journal - Quality of Care and Clinical Outcomes
Issue number4
Early online date16 Nov 2022
Publication statusPublished - Jun 2023

ASJC Scopus subject areas

  • General Medicine


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