Mohamed O Mohamed1,2, Amitava Banerjee3, Sarah Clarke4, Mark de Belder5, Ashish Patwala2, Andrew T Goodwin5,6, Chun Shing Kwok1,2, Muhammad Rashid1,2, Chris P Gale7,8,9, Nick Curzen10, Mamas A Mamas1,2. 1. Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Keele, UK ST55BG. 2. Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK. 3. Institute of Health Informatics and Health Data Research UK, University College London, London, UK. 4. Department of Cardiology, Royal Papworth NHS Foundation Trust, Cambridge, UK. 5. National Institute for Cardiovascular Outcomes Research, Barts Health NHS Trust, London, UK. 6. James Cook University Hospital, Middlesbrough, UK. 7. Leeds Institute for Data analytics, University of Leeds, Leeds, UK. 8. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. 9. Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. 10. Wessex Cardiothoracic Unit, Southampton University Hospital Southampton & Faculty of Medicine, University of Southampton, UK.
Abstract
AIMS: Limited data exist on the impact of COVID-19 on national changes in cardiac procedure activity, including patient characteristics and clinical outcomes before and during the COVID-19 pandemic. METHODS AND RESULTS: All major cardiac procedures (n = 374 899) performed between 1 January and 31 May for the years 2018, 2019, and 2020 were analysed, stratified by procedure type and time-period (pre-COVID: January-May 2018 and 2019 and January-February 2020 and COVID: March-May 2020). Multivariable logistic regression was performed to examine the odds ratio (OR) of 30-day mortality for procedures performed in the COVID period. Overall, there was a deficit of 45 501 procedures during the COVID period compared to the monthly averages (March-May) in 2018-2019. Cardiac catheterization and device implantations were the most affected in terms of numbers (n = 19 637 and n = 10 453), whereas surgical procedures such as mitral valve replacement, other valve replacement/repair, atrioseptal defect/ventriculoseptal defect repair, and coronary artery bypass grafting were the most affected as a relative percentage difference (Δ) to previous years' averages. Transcatheter aortic valve replacement was the least affected (Δ -10.6%). No difference in 30-day mortality was observed between pre-COVID and COVID time-periods for all cardiac procedures except cardiac catheterization [OR 1.25 95% confidence interval (CI) 1.07-1.47, P = 0.006] and cardiac device implantation (OR 1.35 95% CI 1.15-1.58, P < 0.001). CONCLUSION: Cardiac procedural activity has significantly declined across England during the COVID-19 pandemic, with a deficit in excess of 45 000 procedures, without an increase in risk of mortality for most cardiac procedures performed during the pandemic. Major restructuring of cardiac services is necessary to deal with this deficit, which would inevitably impact long-term morbidity and mortality. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Limited data exist on the impact of COVID-19 on national changes in cardiac procedure activity, including patient characteristics and clinical outcomes before and during the COVID-19 pandemic. METHODS AND RESULTS: All major cardiac procedures (n = 374 899) performed between 1 January and 31 May for the years 2018, 2019, and 2020 were analysed, stratified by procedure type and time-period (pre-COVID: January-May 2018 and 2019 and January-February 2020 and COVID: March-May 2020). Multivariable logistic regression was performed to examine the odds ratio (OR) of 30-day mortality for procedures performed in the COVID period. Overall, there was a deficit of 45 501 procedures during the COVID period compared to the monthly averages (March-May) in 2018-2019. Cardiac catheterization and device implantations were the most affected in terms of numbers (n = 19 637 and n = 10 453), whereas surgical procedures such as mitral valve replacement, other valve replacement/repair, atrioseptal defect/ventriculoseptal defect repair, and coronary artery bypass grafting were the most affected as a relative percentage difference (Δ) to previous years' averages. Transcatheter aortic valve replacement was the least affected (Δ -10.6%). No difference in 30-day mortality was observed between pre-COVID and COVID time-periods for all cardiac procedures except cardiac catheterization [OR 1.25 95% confidence interval (CI) 1.07-1.47, P = 0.006] and cardiac device implantation (OR 1.35 95% CI 1.15-1.58, P < 0.001). CONCLUSION: Cardiac procedural activity has significantly declined across England during the COVID-19 pandemic, with a deficit in excess of 45 000 procedures, without an increase in risk of mortality for most cardiac procedures performed during the pandemic. Major restructuring of cardiac services is necessary to deal with this deficit, which would inevitably impact long-term morbidity and mortality. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Christian Philip Stickels; Ramesh Nadarajah; Chris P Gale; Houyuan Jiang; Kieran J Sharkey; Ben Gibbison; Nick Holliman; Sara Lombardo; Lars Schewe; Matteo Sommacal; Louise Sun; Jonathan Weir-McCall; Katherine Cheema; James H F Rudd; Mamas Mamas; Feryal Erhun Journal: BMJ Open Date: 2022-06-16 Impact factor: 3.006
Authors: Mohamed O Mohamed; Nick Curzen; Mark de Belder; Andrew T Goodwin; James C Spratt; Lognathen Balacumaraswami; John Deanfield; Glen P Martin; Muhammad Rashid; Ahmad Shoaib; Chris P Gale; Tim Kinnaird; Mamas A Mamas Journal: Catheter Cardiovasc Interv Date: 2021-03-25 Impact factor: 2.585
Authors: Sebastian König; Laura Ueberham; Vincent Pellissier; Sven Hohenstein; Andreas Meier-Hellmann; Holger Thiele; Vusal Ahmadli; Michael A Borger; Ralf Kuhlen; Gerhard Hindricks; Andreas Bollmann Journal: Clin Cardiol Date: 2021-01-26 Impact factor: 3.287
Authors: Louise Y Sun; Anan Bader Eddeen; Harindra C Wijeysundera; Mamas A Mamas; Derrick Y Tam; Thierry G Mesana Journal: CMAJ Date: 2021-08-30 Impact factor: 8.262
Authors: Oholi Tovia-Brodie; Moshe Rav Acha; Bernard Belhassen; Alessio Gasperetti; Marco Schiavone; Giovanni Battista Forleo; Milton E Guevara-Valdivia; David Valdeolivar Ruiz; Nicolas Lellouche; David Hamon; Davide Castagno; Matteo Bellettini; Gaetano M De Ferrari; Mikael Laredo; Jean-Baptiste Carvès; Barbara Ignatiuk; Giampaolo Pasquetto; Paolo De Filippo; Giovanni Malanchini; Behzad B Pavri; Craig Raphael; Luigi Rivetti; Roberto Mantovan; Jason Chinitz; Melissa Harding; Giuseppe Boriani; Edoardo Casali; Elaine Y Wan; Angelo Biviano; Carlos Macias; Stepan Havranek; Pietro Enea Lazzerini; Antonio M Canu; Marco Zardini; Giulio Conte; Óscar Cano; Michela Casella; Boris Rudic; Alexander Omelchenko; Nilesh Mathuria; Gaurav A Upadhyay; Asaf Danon; Arie Lorin Schwartz; Philippe Maury; Shiro Nakahara; Gustavo Goldenberg; Nicolas Schaerli; Sergiy Bereza; Angelo Auricchio; Michael Glikson; Yoav Michowitz Journal: Heart Rhythm Date: 2021-10-26 Impact factor: 6.343
Authors: Evangelos Kontopantelis; Mamas A Mamas; Roger T Webb; Ana Castro; Martin K Rutter; Chris P Gale; Darren M Ashcroft; Matthias Pierce; Kathryn M Abel; Gareth Price; Corinne Faivre-Finn; Harriette G C Van Spall; Michelle M Graham; Marcello Morciano; Glen P Martin; Tim Doran Journal: Lancet Reg Health Eur Date: 2021-06-08