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

Lookup NU author(s): Dr Dexter CanoyORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

© 2022 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology. 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 and results: Analyses used national administrative electronic hospital records in England, Scotland, and Wales for 2016-21. Admissions and procedures during the pandemic (2020-21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016-19). Differences were assessed by time period and urgency of care. In 2020, there were 31 064 (-6%) fewer hospital admissions [14 506 (-4%) fewer emergencies, 16 560 (-23%) fewer elective admissions] compared with 2016-19 for the six major cardiovascular diseases (CVDs) 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 HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions. Conclusion: The present 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.


Publication metadata

Author(s): Wright FL, Cheema K, Goldacre R, Hall N, Herz N, Islam N, Karim Z, Moreno-Martos D, Morales DR, O'Connell D, Spata E, Akbari A, Ashworth M, Barber M, Briffa N, Canoy D, Denaxas S, Khunti K, Kurdi A, Mamas M, Priedon R, Sudlow C, Morris EJA, Lacey B, Banerjee A

Publication type: Article

Publication status: Published

Journal: European Heart Journal - Quality of Care and Clinical Outcomes

Year: 2023

Volume: 9

Issue: 4

Pages: 377-388

Print publication date: 01/06/2022

Online publication date: 16/11/2022

Acceptance date: 14/11/2022

Date deposited: 01/03/2024

ISSN (print): 2058-5225

ISSN (electronic): 2058-1742

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ehjqcco/qcac077

DOI: 10.1093/ehjqcco/qcac077

Data Access Statement: The data used in this study are available in NHS Digital's TRE for England, but as restrictions apply they are not publicly available (https://digital.nhs.uk/coronavirus/coronavirus-data-services-updates/trusted-research-environment-service-for-england). Please see the article for further details on data availability and access instructions (https://doi.org/10.1093/ehjqcco/qcac077)

PubMed id: 36385522


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Funding

Funder referenceFunder name
ADR Wales
British Heart Foundation Data Science Centre
ES/S007393/1
Health Data Research UK
MR/V028367/1
MRC
SP/19/3/34 678

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