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Mathai SV, Apple SJ, Xu X, Pang L, Flatow E, Friedman A, Rios S, Benites Moya CJ, Alhuarrat MAD, Parker M, Sokol SI, Faillace RT. Differential Mortality Among Heart Failure Patients Across Different COVID-19 Surges in New York City. J Healthc Qual 2024:01445442-990000000-00058. [PMID: 38214648 DOI: 10.1097/jhq.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
ABSTRACT Learning from the healthcare system's response to the COVID-19 pandemic is essential to better prepare for potential future crises. We sought to assess mortality rates for patients admitted for acute decompensated heart failure (HF) and to analyze which factors demonstrated a statistically significant correlation with this primary endpoint. We performed a retrospective analysis of patients hospitalized with a primary diagnosis of acute decompensated HF within the New York City Health and Hospitals 11-hospital system across the different COVID surge periods. Mortality information was collected in 4,405 participants (mean [SD] age 70.54 [14.44] years, 1885 [42.87%] female).The highest mortality existed in the first surge (9.02%), then improved to near prepandemic levels (3.65%) in the second (3.91%) and third surges (5.94%, p < 0.0001). In-hospital mortality inversely correlated with receipt of a COVID-19 vaccination, but had no correlation with left ventricular ejection fraction or the number of vaccination doses. Mortality for acute decompensated HF patients improved after the first surge, suggesting that hospitals adequately adapted to provide quality care. As future infectious outbreaks may occur, emergency preparedness must ensure that adequate focus and resources remain for other clinical entities, such as HF, to ensure optimal care is delivered across all areas of illness.
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Ronco D, Matteucci M, Ravaux JM, Kowalewski M, Massimi G, Torchio F, Trumello C, Naito S, Bonaros N, De Bonis M, Fina D, Kowalówka A, Deja M, Jiritano F, Serraino GF, Kalisnik JM, De Vincentiis C, Ranucci M, Fischlein T, Russo CF, Carrozzini M, Boeken U, Kalampokas N, Golino M, De Ponti R, Pozzi M, Obadia JF, Thielmann M, Scrofani R, Blasi S, Troise G, Antona C, De Martino A, Falcetta G, Actis Dato G, Severgnini P, Musazzi A, Lorusso R. Impact of COVID-19 on incidence and outcomes of post-infarction mechanical complications in Europe. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2023; 37:ivad198. [PMID: 38109676 PMCID: PMC10749759 DOI: 10.1093/icvts/ivad198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/07/2023] [Accepted: 12/17/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVES Post-acute myocardial infarction mechanical complications (post-AMI MCs) represent rare but life-threatening conditions, including free-wall rupture, ventricular septal rupture and papillary muscle rupture. During the coronavirus disease-19 (COVID-19) pandemic, an overwhelming pressure on healthcare systems led to delayed and potentially suboptimal treatments for time-dependent conditions. As AMI-related hospitalizations decreased, limited information is available whether higher rates of post-AMI MCs and related deaths occurred in this setting. This study was aimed to assess how COVID-19 in Europe has impacted the incidence, treatment and outcome of MCs. METHODS The CAUTION-COVID19 study is a multicentre retrospective study collecting 175 patients with post-AMI MCs in 18 centres from 6 European countries, aimed to compare the incidence of such events, related patients' characteristics, and outcomes, between the first year of pandemic and the 2 previous years. RESULTS A non-significant increase in MCs was observed [odds ratio (OR) = 1.15, 95% confidence interval (CI) 0.85-1.57; P = 0.364], with stronger growth in ventricular septal rupture diagnoses (OR = 1.43, 95% CI 0.95-2.18; P = 0.090). No significant differences in treatment types and mortality were found between the 2 periods. In-hospital mortality was 50.9% and was higher for conservatively managed cases (90.9%) and lower for surgical patients (44.0%). Patients admitted during COVID-19 more frequently had late-presenting infarction (OR = 2.47, 95% CI 1.24-4.92; P = 0.010), more stable conditions (OR = 2.61, 95% CI 1.27-5.35; P = 0.009) and higher EuroSCORE II (OR = 1.04, 95% CI 1.01-1.06; P = 0.006). CONCLUSIONS A non-significant increase in MCs incidence occurred during the first year of COVID-19, characterized by a significantly higher rate of late-presenting infarction, stable conditions and EuroSCORE-II if compared to pre-pandemic data, without affecting treatment and mortality.
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Affiliation(s)
- Daniele Ronco
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Congenital Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy
| | - Matteo Matteucci
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
| | - Justine Mafalda Ravaux
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Mariusz Kowalewski
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Giulio Massimi
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy
| | - Federica Torchio
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
- Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Cinzia Trumello
- Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy
| | - Shiho Naito
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - Nikolaos Bonaros
- Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Michele De Bonis
- Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy
| | - Dario Fina
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Cardiology, Città di Lecce Hospital, GVM Care and Research, Lecce, Italy
| | - Adam Kowalówka
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
- Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
| | - Marek Deja
- Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
- Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
| | - Federica Jiritano
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | | | - Jurij Matija Kalisnik
- Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Carlo De Vincentiis
- Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Marco Ranucci
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Theodor Fischlein
- Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | | | | | - Udo Boeken
- Department of Cardiovascular Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Nikolaos Kalampokas
- Department of Cardiovascular Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Michele Golino
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Roberto De Ponti
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Matteo Pozzi
- Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Lyon, France
| | | | - Matthias Thielmann
- Department of Thoracic and Cardiovascular Surgery, West-German Heart Center, University of Duisburg-Essen, Essen, Germany
| | - Roberto Scrofani
- Cardiac Surgery Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Blasi
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Giovanni Troise
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Carlo Antona
- Cardiac Surgery Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giosuè Falcetta
- Section of Cardiac Surgery, University Hospital, Pisa, Italy
| | | | - Paolo Severgnini
- Department of Biotechnology and Sciences of Life, Circolo Hospital, University of Insubria, Varese, Italy
| | | | - Roberto Lorusso
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands
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3
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Khan Y, Verhaeghe N, Devleesschauwer B, Cavillot L, Gadeyne S, Pauwels N, Van den Borre L, De Smedt D. The impact of the COVID-19 pandemic on delayed care of cardiovascular diseases in Europe: a systematic review. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2023; 9:647-661. [PMID: 37667483 DOI: 10.1093/ehjqcco/qcad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023]
Abstract
AIMS Cardiovascular diseases (CVD) are the leading cause of death worldwide. The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems, causing delays in essential medical services, and potentially impacting CVD treatment. This study aims to estimate the impact of the pandemic on delayed CVD care in Europe by providing a systematic overview of the available evidence. METHODS AND RESULTS PubMed, Embase, and Web of Science were searched until mid-September 2022 for studies focused on the impact of delayed CVD care due to the pandemic in Europe among adult patients. Outcomes were changes in hospital admissions, mortality rates, delays in seeking medical help after symptom onset, delays in treatment initiation, and change in the number of treatment procedures. We included 132 studies, of which all were observational retrospective. Results were presented in five disease groups: ischaemic heart diseases (IHD), cerebrovascular accidents (CVA), cardiac arrests (CA), heart failures (HF), and others, including broader CVD groups. There were significant decreases in hospital admissions for IHD, CVA, HF and urgent and elective cardiac procedures, and significant increases for CA. Mortality rates were higher for IHD and CVA. CONCLUSION The pandemic led to reduced acute CVD hospital admissions and increased mortality rates. Delays in seeking medical help were observed, while urgent and elective cardiac procedures decreased. Adequate resource allocation, clear guidelines on how to handle care during health crises, reduced delays, and healthy lifestyle promotion should be implemented. The long-term impact of pandemics on delayed CVD care, and the health-economic impact of COVID-19 should be further evaluated.
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Affiliation(s)
- Yasmine Khan
- Department of Public Health and Primary Care, Ghent University, Ghent 9000, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels 1050, Belgium
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | - Nick Verhaeghe
- Department of Public Health and Primary Care, Ghent University, Ghent 9000, Belgium
- Research Institute for Work and Society, KU Leuven, Leuven 3000, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent 9000, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels 1050, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke 9000, Belgium
| | - Lisa Cavillot
- Department of Epidemiology and Public Health, Sciensano, Brussels 1050, Belgium
- Research Institute of Health and Society, University of Louvain, Brussels 1200, Belgium
| | - Sylvie Gadeyne
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | - Nele Pauwels
- Faculty of Medicine, Ghent University, Ghent 9000, Belgium
| | - Laura Van den Borre
- Department of Epidemiology and Public Health, Sciensano, Brussels 1050, Belgium
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent 9000, Belgium
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Gajewski P, Błaziak M, Urban S, Garus M, Braunschweig F, Caldeira D, Gawor A, Greenwood JP, Guzik M, Halfwerk FR, Iwanek G, Jarocki M, Jura M, Krzystek-Korpacka M, Lewandowski Ł, Lund LH, Matysiak M, Pinto F, Sleziak J, Wietrzyk W, Sokolski M, Biegus J, Ponikowski P, Zymliński R. Sex-stratified patterns of emergency cardiovascular admissions prior and during the COVID-19 pandemic. Sci Rep 2023; 13:17924. [PMID: 37864029 PMCID: PMC10589214 DOI: 10.1038/s41598-023-44400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/07/2023] [Indexed: 10/22/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact on global public health, with long-term consequences that are still largely unknown. This study aimed to assess the data regarding acute cardiovascular hospital admissions in five European centers before and during the pandemic. A multicenter, multinational observational registry was created, comparing admissions to the emergency departments during a 3-months period in 2020 (during the pandemic) with the corresponding period in 2019 (pre-pandemic). Data on patient demographics, COVID-19 test results, primary diagnosis, comorbidities, heart failure profile, medication use, and laboratory results were collected. A total of 8778 patients were included in the analysis, with 4447 patients in 2019 and 4331 patients in 2020. The results showed significant differences in the distribution of cardiovascular diseases between the two years. The frequency of pulmonary embolism (PE) increased in 2020 compared to 2019, while acute heart failure (AHF) and other cardiovascular diseases decreased. The odds of PE incidence among hospitalized patients in 2020 were 1.316-fold greater than in 2019. The incidence of AHF was 50.83% less likely to be observed in 2020, and the odds for other cardiovascular diseases increased by 17.42% between the 2 years. Regarding acute coronary syndrome (ACS), the distribution of its types differed between 2019 and 2020, with an increase in the odds of ST-segment elevation myocardial infarction (STEMI) in 2020. Stratification based on sex revealed further insights. Among men, the incidence of AHF decreased in 2020, while other cardiovascular diseases increased. In women, only the incidence of STEMI showed a significant increase. When analyzing the influence of SARS-CoV-2 infection, COVID-positive patients had a higher incidence of PE compared to COVID-negative patients. COVID-positive patients with ACS also exhibited symptoms of heart failure more frequently than COVID-negative patients. These findings provide valuable information on the impact of the COVID-19 pandemic on acute cardiovascular hospital admissions. The increased incidence of PE and changes in the distribution of other cardiovascular diseases highlight the importance of monitoring and managing cardiovascular health during and post pandemic period. The differences observed between sexes emphasize the need for further research to understand potential sex-specific effects of COVID-19 on cardiovascular outcomes.
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Affiliation(s)
- Piotr Gajewski
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland.
| | - Mikołaj Błaziak
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Szymon Urban
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Mateusz Garus
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Frieder Braunschweig
- Department of Medicine, Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel Caldeira
- Cardiovascular da Universidade de Lisboa - CCUL (CCUL@RISE), CEMBE, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Cardiology Department, Hospital Universitário de Santa Maria (CHLN), Centro Académico de Medicina de Lisboa (CAML), Lisbon, Portugal
| | - Antoni Gawor
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - John P Greenwood
- Leeds University and Leeds Teaching Hospitals NHS Trust, Leeds,, UK
| | - Mateusz Guzik
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Frank R Halfwerk
- Thorax Center Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Gracjan Iwanek
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Michał Jarocki
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Maksym Jura
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | | | - Łukasz Lewandowski
- Department of Medical Biochemistry, Wroclaw Medical University, Wrocław, Poland
| | - Lars H Lund
- Department of Medicine, Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Michał Matysiak
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Fausto Pinto
- Cardiovascular da Universidade de Lisboa - CCUL (CCUL@RISE), CEMBE, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Cardiology Department, Hospital Universitário de Santa Maria (CHLN), Centro Académico de Medicina de Lisboa (CAML), Lisbon, Portugal
| | - Jakub Sleziak
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Weronika Wietrzyk
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Mateusz Sokolski
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Jan Biegus
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Robert Zymliński
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
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5
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Hrycek E, Walawska-Hrycek A, Hamankiewicz M, Milewski K, Nowakowski P, Buszman P, Żurakowski A. The Influence of SARS-CoV-2 Infection on Acute Myocardial Infarction Outcomes. J Clin Med 2023; 12:5899. [PMID: 37762840 PMCID: PMC10532337 DOI: 10.3390/jcm12185899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/30/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This multicenter retrospective study with a control group was designed to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the outcomes of patients with myocardial infarction (MI). METHODS A total of 129 patients with COVID-19 who were treated for MI were included in this study. The control group comprised 129 comparable patients without SARS-CoV-2 infection. The in-hospital, out-of-hospital, and overall mortality were analyzed. RESULTS A total of thirty-one (24%) patients died in the study group, and two (1.6%) patients died in the control group (OR = 20.09; CI: 4.69-85.97; p < 0.001). Similar results were observed in all analyzed patient subgroups. Multivariable Cox regression analysis confirmed the significant influence of SARS-CoV-2 infection on in-hospital outcomes (HR: 8.48459; CI: 1.982-36.320; p = 0.004). Subanalysis of the groups with COVID-19 plus ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI) revealed comparable mortality rates: 14 (21.12%) patients in the NSTEMI group and 17 (26.98%) patients in the STEMI subgroup died (OR: 1.3; CI: 0.56-3.37; p = 0.45). During out-of-hospital observation, no differences in mortality were observed (OR: 0.77; CI: 0.11-4.07; p = 0.73). CONCLUSIONS SARS-CoV-2 infection affects the in-hospital outcomes of patients with both MI and COVID-19, regardless of MI type (STEMI vs. NSTEMI).
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Affiliation(s)
- Eugeniusz Hrycek
- American Heart of Poland, Topolowa 16, 32-500 Chrzanów, Poland
- Department of Cardiology, Faculty of Medical Sciences, Andrzej Frycz Modrzewski Kraków University, 30-705 Kraków, Poland
| | - Anna Walawska-Hrycek
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | | | - Krzysztof Milewski
- American Heart of Poland, Armii Krajowej 101, 43-316 Bielsko-Biała, Poland
| | - Przemysław Nowakowski
- American Heart of Poland, Topolowa 16, 32-500 Chrzanów, Poland
- Department of Vascular Surgery, Faculty of Medical Sciences, University of Technology, Rolna 43, 40-555 Katowice, Poland
| | - Piotr Buszman
- Department of Cardiology, Faculty of Medical Sciences, Andrzej Frycz Modrzewski Kraków University, 30-705 Kraków, Poland
- American Heart of Poland, Armii Krajowej 101, 43-316 Bielsko-Biała, Poland
| | - Aleksander Żurakowski
- American Heart of Poland, Topolowa 16, 32-500 Chrzanów, Poland
- Department of Cardiology, Faculty of Medical Sciences, Andrzej Frycz Modrzewski Kraków University, 30-705 Kraków, Poland
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6
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Chouairi F, Pinsker B, Miller PE, Fudim M. Effects of COVID-19 on heart failure admissions. Am Heart J 2023; 263:183-187. [PMID: 37156331 PMCID: PMC10163787 DOI: 10.1016/j.ahj.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/07/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
Despite significant investigation into the effects of COVID-19 on cardiovascular disease, there is a paucity of national data specifically examining its effects on heart failure (HF) hospitalizations. Previous cohort study data demonstrate worsened outcomes in HF patients with recent COVID-19 infection. To better understand this association, this study aimed to utilize a nationally representative database to examine demographics, outcomes, and health care utilization in hospitalizations for HF with a codiagnosis of COVID-19.
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Affiliation(s)
- Fouad Chouairi
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Bret Pinsker
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - P Elliott Miller
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT
| | - Marat Fudim
- Division of Cardiology, Department of Internal Medicine, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC
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7
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Ilelaboye AI, Vardar U, Baskaran N, Shaka A, DeAngelo S, Shaka H. Effect of coronavirus disease 2019 pandemic on heart failure hospitalization rates and disparities: a National Inpatient Sample study. J Cardiovasc Med (Hagerstown) 2023; 24:689-690. [PMID: 37577921 DOI: 10.2459/jcm.0000000000001517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Affiliation(s)
- Ayodeji I Ilelaboye
- Department of Medicine, Ladoke Akintola University of Technology, Ogbomosho, Nigeria
| | - Ufuk Vardar
- Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois
| | - Naveen Baskaran
- Department of Medicine, University of Florida, Gainesville, Gainesville, Florida, USA
| | - Abdultawab Shaka
- Department of Medicine, Windsor University School of Medicine Cayon, Saint Kitts and Nevis
| | - Sean DeAngelo
- Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois
| | - Hafeez Shaka
- Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, Illinois
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8
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Costello RE, Tazare J, Piehlmaier D, Herrett E, Parker EP, Zheng B, Mansfield KE, Henderson AD, Carreira H, Bidulka P, Wong AY, Warren-Gash C, Hayes JF, Quint JK, MacKenna B, Mehrkar A, Eggo RM, Katikireddi SV, Tomlinson L, Langan SM, Mathur R. Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY platform. EClinicalMedicine 2023; 61:102077. [PMID: 37434746 PMCID: PMC10331810 DOI: 10.1016/j.eclinm.2023.102077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
Background The COVID-19 pandemic disrupted healthcare and may have impacted ethnic inequalities in healthcare. We aimed to describe the impact of pandemic-related disruption on ethnic differences in clinical monitoring and hospital admissions for non-COVID conditions in England. Methods In this population-based, observational cohort study we used primary care electronic health record data with linkage to hospital episode statistics data and mortality data within OpenSAFELY, a data analytics platform created, with approval of NHS England, to address urgent COVID-19 research questions. We included adults aged 18 years and over registered with a TPP practice between March 1, 2018, and April 30, 2022. We excluded those with missing age, sex, geographic region, or Index of Multiple Deprivation. We grouped ethnicity (exposure), into five categories: White, Asian, Black, Other, and Mixed. We used interrupted time-series regression to estimate ethnic differences in clinical monitoring frequency (blood pressure and Hba1c measurements, chronic obstructive pulmonary disease and asthma annual reviews) before and after March 23, 2020. We used multivariable Cox regression to quantify ethnic differences in hospitalisations related to diabetes, cardiovascular disease, respiratory disease, and mental health before and after March 23, 2020. Findings Of 33,510,937 registered with a GP as of 1st January 2020, 19,064,019 were adults, alive and registered for at least 3 months, 3,010,751 met the exclusion criteria and 1,122,912 were missing ethnicity. This resulted in 14,930,356 adults with known ethnicity (92% of sample): 86.6% were White, 7.3% Asian, 2.6% Black, 1.4% Mixed ethnicity, and 2.2% Other ethnicities. Clinical monitoring did not return to pre-pandemic levels for any ethnic group. Ethnic differences were apparent pre-pandemic, except for diabetes monitoring, and remained unchanged, except for blood pressure monitoring in those with mental health conditions where differences narrowed during the pandemic. For those of Black ethnicity, there were seven additional admissions for diabetic ketoacidosis per month during the pandemic, and relative ethnic differences narrowed during the pandemic compared to the White ethnic group (Pre-pandemic hazard ratio (HR): 0.50, 95% confidence interval (CI) 0.41, 0.60, Pandemic HR: 0.75, 95% CI: 0.65, 0.87). There was increased admissions for heart failure during the pandemic for all ethnic groups, though highest in those of White ethnicity (heart failure risk difference: 5.4). Relatively, ethnic differences narrowed for heart failure admission in those of Asian (Pre-pandemic HR 1.56, 95% CI 1.49, 1.64, Pandemic HR 1.24, 95% CI 1.19, 1.29) and Black ethnicity (Pre-pandemic HR 1.41, 95% CI: 1.30, 1.53, Pandemic HR: 1.16, 95% CI 1.09, 1.25) compared with White ethnicity. For other outcomes the pandemic had minimal impact on ethnic differences. Interpretation Our study suggests that ethnic differences in clinical monitoring and hospitalisations remained largely unchanged during the pandemic for most conditions. Key exceptions were hospitalisations for diabetic ketoacidosis and heart failure, which warrant further investigation to understand the causes. Funding LSHTM COVID-19 Response Grant (DONAT15912).
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Affiliation(s)
| | - John Tazare
- London School of Hygiene and Tropical Medicine, London, UK
| | - Dominik Piehlmaier
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- University of Sussex Business School, Jubilee Building, Brighton, UK
| | - Emily Herrett
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Bang Zheng
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | | | - Joseph F. Hayes
- Division of Psychiatry, University College London, London, UK
| | - Jennifer K. Quint
- Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Brian MacKenna
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | | | | | - Rohini Mathur
- London School of Hygiene and Tropical Medicine, London, UK
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary, University of London, London, UK
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9
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Manemann SM, Weston SA, Jiang R, Larson NB, Roger VL, Takahashi PY, Chamberlain AM, Singh M, St Sauver JL, Bielinski SJ. Health Care Utilization and Death in Patients With Heart Failure During the COVID-19 Pandemic. Mayo Clin Proc Innov Qual Outcomes 2023; 7:194-202. [PMID: 37229286 PMCID: PMC10099179 DOI: 10.1016/j.mayocpiqo.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/27/2023] Open
Abstract
Objective To compare the 1-year health care utilization and mortality in persons living with heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic. Patients and Methods Residents of a 9-county area in southeastern Minnesota aged 18 years or older with a HF diagnosis on January 1, 2019; January 1, 2020; and January 1, 2021, were identified and followed up for 1-year for vital status, emergency department (ED) visits, and hospitalizations. Results We identified 5631 patients with HF (mean age, 76 years; 53% men) on January 1, 2019, 5996 patients (mean age, 76 years; 52% men) on January 1, 2020, and 6162 patients (mean age, 75 years; 54% men) on January 1, 2021. After adjustment for comorbidities and risk factors, patients with HF in 2020 and patients with HF in 2021 experienced similar risks of mortality compared with those in 2019. After adjustment, patients with HF in 2020 and 2021 were less likely to experience all-cause hospitalizations (2020: rate ratio [RR], 0.88; 95% CI, 0.81-0.95; 2021: RR, 0.90; 95% CI, 0.83-0.97) compared with patients in 2019. Patients with HF in 2020 were also less likely to experience ED visits (RR, 0.85; 95% CI, 0.80-0.92). Conclusion In this large population-based study in southeastern Minnesota, we observed an approximately 10% decrease in hospitalizations among patients with HF in 2020 and 2021 and a 15% decrease in ED visits in 2020 compared with those in 2019. Despite the change in health care utilization, we found no difference in the 1-year mortality between patients with HF in 2020 and those in 2021 compared with those in 2019. It is unknown whether any longer-term consequences will be observed.
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Affiliation(s)
- Sheila M Manemann
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Susan A Weston
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Ruoxiang Jiang
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Nicholas B Larson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Véronique L Roger
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
- National Institutes of Health, Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Paul Y Takahashi
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Alanna M Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Mandeep Singh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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10
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Fraser M, Nzemenoh B, Jackson S, Chaikijurajai T, Halmosi R, Toth K, Khan WJ, Alexy T. Substance Use-Associated Mortality among Heart Donors after the COVID-19 National Emergency Increased but Did Not Affect Peri-Transplant Outcomes. J Cardiovasc Dev Dis 2023; 10:jcdd10050222. [PMID: 37233189 DOI: 10.3390/jcdd10050222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/07/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic and consequent social isolation prompted a surge in mental health disorders and substance use in the general population and, therefore, in potential organ donors. We aimed to evaluate if this led to a change in donor characteristics, including the mechanism and circumstance of death, and how this may have affected clinical outcomes following heart transplantation. METHODS We identified all heart donors from the SRTR database between 18 October 2018 and 31 December 2021, excluding those who donated immediately after the US national emergency declaration. Donors were stratified into pre-COVID-19 (Pre-Cov; through 12 March 2020) and post-COVID-19 national emergency declaration cohorts (Post-Cov; 1 August 2020 through 31 December 2021) based on the heart procurement date. Relevant demographics, cause of death, and substance use history were collected in addition to graft cold ischemic time, the incidence of primary graft dysfunction (PGD), and recipient survival at 30 days post-transplant. RESULTS A total of 10,314 heart donors were identified; 4941 were stratified into the Pre-Cov and 5373 into the Post-Cov cohorts. There was no difference in demographics, but illicit drug use was significantly higher in the Post-Cov group, leading to an increased incidence of death from drug intoxication. Fatal gunshot wounds were also more common. Despite these changes, the incidence of PGD remained similar (p = 0.371), and there was no difference in 30 days recipient survival (p = 0.545). CONCLUSION Our findings confirm that COVID-19 had a major impact on mental health and psychosocial life with an associated increase in illicit substance use and fatal intoxication rates in heart transplant donors. These changes did not alter peri-operative mortality following heart transplantation. Future studies are needed to ensure that long-term outcomes remain unaffected.
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Affiliation(s)
- Meg Fraser
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bellony Nzemenoh
- Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Scott Jackson
- Analytics Consulting Services, MHealth Fairview, Minneapolis, MN 55455, USA
| | | | - Robert Halmosi
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624 Pecs, Hungary
| | - Kalman Toth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624 Pecs, Hungary
| | - Wahab J Khan
- Department of Medicine, Avera Health, Sioux Falls, SD 57105, USA
| | - Tamas Alexy
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN 55455, USA
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11
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Glowniak A, Wojewoda K, Tarkowski A. COVID-19 and long-COVID-19 syndrome related myocarditis: The heart rhythm matters. Cardiol J 2023; 30:165-166. [PMID: 36790044 PMCID: PMC9987533 DOI: 10.5603/cj.a2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/09/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023] Open
Affiliation(s)
- Andrzej Glowniak
- Department of Cardiology, Medical University of Lublin, Poland. .,Clinical Department of Electrocardiology, SPSK-4 University Hospital, Lublin, Poland.
| | - Katarzyna Wojewoda
- Clinical Department of Electrocardiology, SPSK-4 University Hospital, Lublin, Poland.,Doctoral School, Medical University of Lublin, Poland
| | - Adam Tarkowski
- Clinical Department of Electrocardiology, SPSK-4 University Hospital, Lublin, Poland
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12
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Vidal-Perez R, Brandão M, Pazdernik M, Kresoja KP, Carpenito M, Maeda S, Casado-Arroyo R, Muscoli S, Pöss J, Fontes-Carvalho R, Vazquez-Rodriguez JM. Cardiovascular disease and COVID-19, a deadly combination: A review about direct and indirect impact of a pandemic. World J Clin Cases 2022; 10:9556-9572. [PMID: 36186196 PMCID: PMC9516905 DOI: 10.12998/wjcc.v10.i27.9556] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is known to present with respiratory symptoms, which can lead to severe pneumonia and respiratory failure. However, it can have multisystem complications such as cardiovascular manifestations. The cardiovascular manifestations reported comprise myocarditis, cardiogenic shock, arrhythmias, pulmonary embolism, deep vein embolism, acute heart failure, and myocardial infarction. There is also an indirect impact of the pandemic on the management of cardiovascular care that has been shown clearly in multiple publications. In this review, we summarize the deadly relation of COVID-19 with cardiovascular events and the wider impact on several cardiovascular care areas by the pandemic situation
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Affiliation(s)
- Rafael Vidal-Perez
- Servicio de Cardiología, Unidad de Imagen y Función Cardíaca, Complexo Hospitalario Universitario A Coruña Centro de Investigación Biomédica en Red-Instituto de Salud Carlos III, A Coruña 15006, Spain
| | - Mariana Brandão
- Department of Cardiology, Centro Hospitalar de Gaia, Gaia 4400-020, Portugal
| | - Michal Pazdernik
- Intensive Care Unit, Department of Cardiology, Institute for Clinical and Experimental Medicine Prague, Prague 14021, Czech Republic
| | | | - Myriam Carpenito
- Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome 00128, Italy
| | - Shingo Maeda
- Arrhythmia Advanced Therapy Center, AOI Universal Hospital, Kawasaki 210-0822, Japan
| | - Rubén Casado-Arroyo
- Department of Cardiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels 1070, Belgium
| | - Saverio Muscoli
- Unit of Cardiology, Policlinico Tor Vergata, Rome 00133, Italy
| | - Janine Pöss
- Heart Center Leipzig, University of Leipzig, Leipzig 04289, Germany
| | - Ricardo Fontes-Carvalho
- Department of Cardiology, Centro Hospitalar de Gaia, Gaia 4400-020, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto 4200-319, Portugal
| | - Jose Manuel Vazquez-Rodriguez
- Servicio de Cardiología, Unidad de Imagen y Función Cardíaca, Complexo Hospitalario Universitario A Coruña Centro de Investigación Biomédica en Red-Instituto de Salud Carlos III, A Coruña 15006, Spain
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13
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Dahiya G, Bensimhon D, Goodwin MM, Mohr JF, Alexy T. From Oral to Subcutaneous Furosemide: The Road to Novel Opportunities to Manage Congestion. STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2022; 6:100076. [PMID: 37288336 PMCID: PMC10242578 DOI: 10.1016/j.shj.2022.100076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 06/09/2023]
Abstract
The steadily rising prevalence of heart failure (HF) and the associated increase in health care expenditures represent a significant burden for patients, caregivers, and society. Ambulatory management of worsening congestion is a complex undertaking that requires diuretic escalation, yet clinical success is often hindered by the progressively declining bioavailability of oral agents. Once beyond a threshold, patients with acute on chronic HF often require hospital admission for intravenous diuresis. A novel, pH neutral formulation of furosemide that is administered by a biphasic drug delivery profile (80 mg total over 5 hours) via an automated, on-body infusor was designed to overcome these limitations. Early studies have shown that it has equivalent bioavailability with comparable diuresis and natriuresis to the intravenous formulation, leads to significant decongestion, and improvement in quality of life. It was shown to be safe and is well tolerated by patients. Although there is one ongoing clinical trial, available data have demonstrated the potential to shift hospital-administered, intravenous diuresis to the outpatient setting. Reduction in the need for recurrent hospital admissions would be highly desirable by most patients with chronic HF and would lead to a significant reduction in health care expenditures. In this article, we describe the rationale and evolution of this novel PH neutral formulation of furosemide administered subcutaneously, summarize its pharmacokinetic and pharmacodynamic profiles, and review emerging clinical trials demonstrating its clinical safety, efficacy, and potential to reduce health care expenditures.
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Affiliation(s)
- Garima Dahiya
- Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Daniel Bensimhon
- Division of Cardiovascular Medicine, Cone Health, Greensboro, North Carolina, USA
| | - Matthew M. Goodwin
- Clinical Development and Medical Affairs, scPharmaceuticals, Burlington, Massachusetts, USA
| | - John F. Mohr
- Clinical Development and Medical Affairs, scPharmaceuticals, Burlington, Massachusetts, USA
| | - Tamas Alexy
- Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
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14
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Ratajczak J, Szczerbiński S, Kubica A. Occurrence and Temporal Variability of Out-of-Hospital Cardiac Arrest during COVID-19 Pandemic in Comparison to the Pre-Pandemic Period in Poland-Observational Analysis of OSCAR-POL Registry. J Clin Med 2022; 11:jcm11144143. [PMID: 35887907 PMCID: PMC9316491 DOI: 10.3390/jcm11144143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023] Open
Abstract
An investigation of the chronobiology of out-of-hospital cardiac arrest (OHCA) during the coronavirus disease 2019 (COVID-19) pandemic and the differences in comparison to the 6-year pre-pandemic period. A retrospective analysis of the dispatch cards from the Emergency Medical Service between January 2014 and December 2020 was performed within the OSCAR-POL registry. The circadian, weekly, monthly, and seasonal variabilities of OHCA were investigated. A comparison of OHCA occurrence between the year 2020 and the 6-year pre-pandemic period was made. A total of 416 OHCAs were reported in 2020 and the median of OHCAs during the pre-pandemic period was 379 (interquartile range 337−407) cases per year. Nighttime was associated with a decreased number of OHCAs (16.6%) in comparison to afternoon (31.5%, p < 0.001) and morning (30.0%, p < 0.001). A higher occurrence at night was observed in 2020 compared to 2014−2019 (16.6% vs. 11.7%, p = 0.001). Monthly and seasonal variabilities were observed in 2020. The months with the highest OHCA occurrence in 2020 were November (13.2%) and October (11.1%) and were significantly higher compared to the same months during the pre-pandemic period (9.1%, p = 0.002 and 7.9%, p = 0.009, respectively). Autumn was the season with the highest rate of OHCA, which was also higher compared to the pre-pandemic period (30.5% vs. 25.1%, p = 0.003). The COVID-19 pandemic was related to a higher occurrence of OHCA. The circadian, monthly, and seasonal variabilities of OHCA occurrence were confirmed. In 2020, the highest occurrence of OHCA was observed in October and November, which coincided with the highest occurrence of COVID-19 infections in Poland.
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Affiliation(s)
- Jakub Ratajczak
- Department of Health Promotion, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland;
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
- Correspondence: ; Tel.: +48-52-585-40-23; Fax: +48-52-585-40-24
| | | | - Aldona Kubica
- Department of Health Promotion, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland;
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15
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Clinical Support through Telemedicine in Heart Failure Outpatients during the COVID-19 Pandemic Period: Results of a 12-Months Follow Up. J Clin Med 2022; 11:jcm11102790. [PMID: 35628916 PMCID: PMC9147859 DOI: 10.3390/jcm11102790] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/02/2023] Open
Abstract
Background: Heart failure (HF) patients are predisposed to recurrences and disease destabilizations, especially during the COVID-19 outbreak period. In this scenario, telemedicine could be a proper way to ensure continuous care. The purpose of the study was to compare two modalities of HF outpatients’ follow up, the traditional in-person visits and telephone consultations, during the COVID-19 pandemic period in Italy. Methods: We conducted an observational study on consecutive HF outpatients. The follow up period was 12 months, starting from the beginning of the COVID-19 Italy lockdown. According to the follow up modality, and after the propensity matching score, patients were divided into two groups: those in G1 (n = 92) were managed with traditional in-person visits and those in G2 (n = 92) were managed with telephone consultation. Major adverse cardiovascular events (MACE) were the primary endpoints. Secondary endpoints were overall mortality, cardiovascular death, cardiovascular hospitalization, and hospitalization due to HF. Results: No significant differences between G1 and G2 have been observed regarding MACE (p = 0.65), cardiovascular death (p = 0.39), overall mortality (p = 0.85), hospitalization due to acute HF (p = 0.07), and cardiovascular hospitalization (p = 0.4). Survival analysis performed by the Kaplan–Meier method also did not show significant differences between G1 and G2. Conclusions: Telephone consultations represented a valid option to manage HF outpatients during COVID-19 pandemic, comparable to traditional in-person visits.
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16
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Sokolski M, Reszka K, Suchocki T, Adamik B, Doroszko A, Drobnik J, Gorka-Dynysiewicz J, Jedrzejczyk M, Kaliszewski K, Kilis-Pstrusinska K, Konopska B, Kopec A, Larysz A, Lis W, Matera-Witkiewicz A, Pawlik-Sobecka L, Rosiek-Biegus M, Sokolska JM, Sokolowski J, Zapolska-Tomasiewicz A, Protasiewicz M, Madziarska K, Jankowska EA. History of Heart Failure in Patients Hospitalized Due to COVID-19: Relevant Factor of In-Hospital Complications and All-Cause Mortality up to Six Months. J Clin Med 2022; 11:jcm11010241. [PMID: 35011982 PMCID: PMC8746048 DOI: 10.3390/jcm11010241] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 02/04/2023] Open
Abstract
Background: Patients with heart failure (HF) are at high risk of unfavorable courses of COVID-19. The aim of this study was to evaluate characteristics and outcomes of COVID-19 patients with HF. Methods: Data of patients hospitalized in a tertiary hospital in Poland between March 2020 and May 2021 with laboratory-confirmed COVID-19 were analyzed. The study population was divided into a HF group (patients with a history of HF) and a non-HF group. Results: Out of 2184 patients (65 ± 13 years old, 50% male), 12% had a history of HF. Patients from the HF group were older, more often males, had more comorbidities, more often dyspnea, pulmonary and peripheral congestion, inflammation, and end-organ damage biomarkers. HF patients had longer and more complicated hospital stay, with more frequent acute HF development as compared with non-HF. They had significantly higher mortality assessed in hospital (35% vs. 12%) at three (53% vs. 22%) and six months (72% vs. 47%). Of 76 (4%) patients who developed acute HF, 71% died during hospitalization, 79% at three, and 87% at six months. Conclusions: The history of HF identifies patients with COVID-19 who are at high risk of in-hospital complications and mortality up to six months of follow-up.
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Affiliation(s)
- Mateusz Sokolski
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (J.M.S.); (A.Z.-T.); (M.P.); (E.A.J.)
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
- Correspondence: ; Tel.: +48-717331112
| | - Konrad Reszka
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
| | - Tomasz Suchocki
- Biostatistics Group, Department of Genetics, Wroclaw University of Environmental and Life Sciences, 51-631 Wroclaw, Poland;
| | - Barbara Adamik
- Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Adrian Doroszko
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Jarosław Drobnik
- Gerontology Unit, Public Health Department, Wroclaw Medical University, 51-618 Wroclaw, Poland;
| | - Joanna Gorka-Dynysiewicz
- Department of Pharmaceutical Biochemistry, Division of Pharmaceutical Biochemistry, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Maria Jedrzejczyk
- Department of Nursing and Obstetrics, Division of Internal Medicine Nursing, Wroclaw Medical University, 51-618 Wroclaw, Poland;
| | - Krzysztof Kaliszewski
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | | | - Bogusława Konopska
- Department of Pharmaceutical Biochemistry, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Agnieszka Kopec
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland; (A.K.); (M.R.-B.)
| | - Anna Larysz
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
- Clinical Department of Heart Transplantation and Mechanical Circulatory Support, Institute of Heart Disease, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Weronika Lis
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
| | | | - Lilla Pawlik-Sobecka
- Division of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Marta Rosiek-Biegus
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland; (A.K.); (M.R.-B.)
| | - Justyna M. Sokolska
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (J.M.S.); (A.Z.-T.); (M.P.); (E.A.J.)
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
| | - Janusz Sokolowski
- Clinical Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Anna Zapolska-Tomasiewicz
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (J.M.S.); (A.Z.-T.); (M.P.); (E.A.J.)
| | - Marcin Protasiewicz
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (J.M.S.); (A.Z.-T.); (M.P.); (E.A.J.)
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
| | - Katarzyna Madziarska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Ewa A. Jankowska
- Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (J.M.S.); (A.Z.-T.); (M.P.); (E.A.J.)
- Institute of Heart Diseases, University Hospital, 50-556 Wroclaw, Poland; (K.R.); (A.L.); (W.L.)
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