Mohamed, MO, Banerjee, A, Clarke, S, de Belder, M, Patwala, A, Goodwin, A, Kwok, CS, Rashid, M, Gale, C, Curzen, N and Mamas, M (2020) Impact of COVID-19 on cardiac procedure activity in England and associated 30-day mortality. European Heart Journal - Quality of Care and Clinical Outcomes, 7 (3). pp. 247-256. ISSN 2058-1742 (In Press)

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Background: Limited data exists 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 1st January and 31st 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 catheterisation and device implantations were the most affected in terms of numbers (n=19,637 and n=10,453) whereas surgical procedures such as MVR, other valve replacement/repair, ASD/VSD repair and CABG were the most affected as a relative percentage difference () to previous years’ averages. TAVR was the least affected (-10.6%). No difference in 30-day mortality was observed between pre-COVID and COVID time-periods for all cardiac procedures except cardiac catheterisation (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 45000 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 longterm morbidity and mortality.

Item Type: Article
Additional Information: Covid-19, cardiac procedure
Uncontrolled Keywords: COVID-19, Procedures, Cardiac, England, Mortality
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 05 Oct 2020 12:50
Last Modified: 02 Oct 2021 01:30

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