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Multicenter Study Comparative Study
Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK.
- Simon Ball, Amitava Banerjee, Colin Berry, Jonathan R Boyle, Benjamin Bray, William Bradlow, Afzal Chaudhry, Rikki Crawley, John Danesh, Alastair Denniston, Florian Falter, Jonine D Figueroa, Christopher Hall, Harry Hemingway, Emily Jefferson, Tom Johnson, Graham King, Kuan Ken Lee, Paul McKean, Suzanne Mason, Nicholas L Mills, Ewen Pearson, Munir Pirmohamed, Michael T C Poon, Rouven Priedon, Anoop Shah, Reecha Sofat, SterneJonathan A CJACHealth Data Research UK South West, Population Health Sciences, University of Bristol, Bristol, UK., Fiona E Strachan, SudlowCathie L MCLMThe University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK ami.banerjee@ucl.ac.uk cathie.sudlow@hdruk.ac.uk.Health Data Research UK Scotland, Edinburgh, United Kingdom.BHF Data Science Centr, Zsolt Szarka, William Whiteley, Michael Wyatt, and CVD-COVID-UK Consortium.
- University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom.
- Heart. 2020 Dec 1; 106 (24): 1890-1897.
ObjectiveTo monitor hospital activity for presentation, diagnosis and treatment of cardiovascular diseases during the COVID-19) pandemic to inform on indirect effects.MethodsRetrospective 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.ResultsAcross 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.ConclusionsSubstantial 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.© 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.
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