TY - JOUR
T1 - Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK
AU - CVD-COVID-UK Consortium
AU - Ball, Simon
AU - Banerjee, Amitava
AU - Berry, Colin
AU - Boyle, Jonathan
AU - Bray, Benjamin
AU - Bradlow, William
AU - Chaudhry, Afzal
AU - Crawley, Rikki
AU - Danesh, John
AU - Denniston, Alastair
AU - Falter, Florian
AU - Figueroa, Jonine D.
AU - Hall, Christopher
AU - Hemingway, Harry
AU - Jefferson, Emily
AU - Johnson, Tom
AU - King, Graham
AU - Lee, Kuan Ken
AU - McKean, Paul
AU - Mason, Suzanne
AU - Mills, Nicholas L.
AU - Pearson, Ewen
AU - Pirmohamed, Munir
AU - Poon, Michael T. C.
AU - Priedon, Rouven
AU - Shah, Anoop
AU - Sofat, Reecha
AU - Sterne, Jonathan A. C.
AU - Strachan, Fiona E.
AU - Sudlow, Cathie L. M.
AU - Szarka, Zsolt
AU - Whiteley, William
AU - Wyatt, Michael
N1 - Funding - CB is supported by the British Heart Foundation (RE/18/6134217). CS is supported by the British Heart Foundation and Health Data Research UK. RP is supported by the British Heart Foundation and Health Data Research UK. MP is supported by Health Data Research UK and the MRC Centre for Drug Safety Science. WW is supported by a Scottish Senior Fellowship from the Chief Scientist’s Office (CAF/17/01). JD holds a British Heart Foundation Personal Chair and is supported by grants from the British Heart Foundation, Health Data Research UK and the National Institute for Health Research. AC receives support from the Cambridge NIHR Biomedical Research Centre. MP is supported by Cancer Research UK Brain Tumour Centre of Excellence Aware (C157/A27589).
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020/12/1
Y1 - 2020/12/1
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.
AB - 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.
KW - aortic and arterial disease
KW - epidemiology
KW - global health care delivery
KW - health care delivery
KW - heart disease
UR - http://www.scopus.com/inward/record.url?scp=85092609105&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2020-317870
DO - 10.1136/heartjnl-2020-317870
M3 - Article
C2 - 33020224
SN - 1355-6037
VL - 106
SP - 1890
EP - 1897
JO - Heart (British Cardiac Society)
JF - Heart (British Cardiac Society)
IS - 24
ER -