Dynamics of Emergency Cardiovascular Hospital Admissions and In-Hospital Mortality During the COVID-19 Pandemic : Time Series Analysis and Impact of Socioeconomic Factors
Álvarez-Martín, Claudia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ribera, A (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Marsal, Josep Ramon (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ariza-Solé, Albert (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Pérez-Hoyos, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Oristrell, Gerard (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Soriano-Colomé, Toni (Hospital Universitari Vall d'Hebron)
Romaguera, Rafael (Institut d'Investigació Biomèdica de Bellvitge)
Pijoan, Jose Ignacio (Instituto de Investigación Sanitaria Biocruces Bizkaia)
Lidón, Rosa M. (Hospital Universitari Vall d'Hebron)
Mauri, Josepa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferreira-Gonzalez, Ignacio (Hospital Universitari Vall d'Hebron)

Data:	2022
Resum:	This study aimed to evaluate the decline in urgent cardiovascular hospital admissions and in-hospital mortality during the COVID pandemic in two successive waves, and to evaluate differences by sex, age, and deprivation index subgroups. We obtained acute cardiovascular hospital episodes during the years 2019-2020 from region-wide data on public healthcare usage for the population of Catalonia (North-East Spain). We fitted time models to estimate the incidence rate ratios (IRRs) of the acute coronary syndrome (ACS) and acute heart failure (HF) admissions during the first pandemic wave, the between-waves period, and the second wave compared with the corresponding pre-COVID-19 periods and to test for the interaction with sex, age, and area-based socioeconomic level. We evaluated the effect of COVID-19 period on in-hospital mortality. ACS (n = 8,636) and HF (n = 27,566) episodes were defined using primary diagnostic ICD-10 codes. ACS and HF admissions decreased during the first wave (IRR = 0. 66, 95%CI: 0. 58-0. 76 and IRR = 0. 61, 95% CI: 0. 55-0. 68, respectively) and during the second wave (IRR = 0. 80, 95%CI: 0. 72-0. 88 and IRR = 0. 76, 95%CI: 0. 69-0. 84, respectively); acute HF admissions also decreased in the period between waves (IRR: 0. 81, 95%CI: 0. 74-0. 89). The impact was similar in all sex and socioeconomic subgroups and was higher in older patients with ACS. In-hospital mortality was higher than expected only during the first wave. During the first wave of the COVID-19 pandemic, there was a marked decline in urgent cardiovascular hospital admissions that were attenuated during the second wave. Both the decline and the attenuation of the effect have been similar in all subgroups regardless of age, sex, or socioeconomic status. In-hospital mortality for ACS and HF episodes increased during the first wave, but not during the second wave.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; Acute coronary syndrome ; Myocardial infarction ; Heart failure ; Time-series
Publicat a:	Frontiers in Cardiovascular Medicine, Vol. 9 (april 2022) , ISSN 2297-055X

DOI: 10.3389/fcvm.2022.827212
DOI: 10.3389/fcvm.2022.935850
PMID: 35557541
PMID: 35757335

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