Skip to main content

Research Repository

Advanced Search

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

Wright, F Lucy; Cheema, Kate; Goldacre, Raph; Hall, Nick; Herz, Naomi; Islam, Nazrul; Karim, Zainab; Moreno-Martos, David; Morales, Daniel R; O'Connell, Daniel; Spata, Enti; Akbari, Ashley; Ashworth, Mark; Barber, Mark; Briffa, Norman; Canoy, Dexter; Denaxas, Spiros; Khunti, Kamlesh; Kurdi, Amanj; Mamas, Mamas; Priedon, Rouven; Sudlow, Cathie; Morris, Eva J A; Lacey, Ben; Banerjee, Amitava

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


Authors

F Lucy Wright

Kate Cheema

Raph Goldacre

Nick Hall

Naomi Herz

Nazrul Islam

Zainab Karim

David Moreno-Martos

Daniel R Morales

Daniel O'Connell

Enti Spata

Ashley Akbari

Mark Ashworth

Mark Barber

Norman Briffa

Dexter Canoy

Spiros Denaxas

Kamlesh Khunti

Amanj Kurdi

Rouven Priedon

Cathie Sudlow

Eva J A Morris

Ben Lacey

Amitava Banerjee



Abstract

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: Analyses used national administrative electronic hospital records in England, Scotland and Wales for 2016-2021. Admissions and procedures during the pandemic (2020-2021) related to six major cardiovascular conditions (acute coronary syndrome, heart failure, stroke/transient ischaemic attack, peripheral arterial disease, aortic aneurysm, and venous thromboembolism) were compared to the annual average in the pre-pandemic period (2016-2019). Differences were assessed by time period and urgency of care. RESULTS: In 2020, there were 31 064 (-6%) fewer hospital admissions (14 506 [-4%] fewer emergencies, 16 560 [-23%] fewer elective admissions) compared to 2016-2019 for the six major cardiovascular diseases 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 heart failure and stroke in England, and for venous thromboembolism in all three countries. Analyses for procedures showed similar temporal variations to admissions. CONCLUSION: This 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.

Journal Article Type Article
Acceptance Date Nov 14, 2022
Online Publication Date Nov 16, 2022
Publication Date 2023-06
Publicly Available Date Mar 28, 2024
Journal European Heart Journal - Quality of Care and Clinical Outcomes
Print ISSN 2058-5225
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 9
Issue 4
DOI https://doi.org/10.1093/ehjqcco/qcac077
Keywords Cardiology and Cardiovascular Medicine, Health Policy
Publisher URL https://academic.oup.com/ehjqcco/advance-article/doi/10.1093/ehjqcco/qcac077/6831631