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Repercussions of the COVID-19 Pandemic on the Care Practices of a Tertiary Hospital
André Luiz Cerqueira Almeida1,2, Thyago Monteiro do Espírito Santo1,2, Maurício Silva Santana Mello1,2
1Santa Casa de Misericórdia de Feira de Santana, Feira de Santana, BA - Brasil.
Insights
The COVID-19 pandemic significantly reduced medical care in Brazil, with sharp declines in cardiology and oncology services. This decrease in essential treatments raises concerns about patient outcomes for non-COVID-19 conditions.
Area of Science:
- Cardiology
- Oncology
- Public Health
Background:
- The impact of the COVID-19 pandemic on healthcare services in Brazil remains largely unquantified.
- Tertiary hospitals are crucial for specialized care, particularly in cardiology and oncology.
Purpose of the Study:
- To assess the repercussions of the COVID-19 pandemic on the routine medical care at a tertiary hospital.
- To analyze changes in cardiology and oncology services during the initial phase of the pandemic in Brazil.
Main Methods:
- A cross-sectional cohort study compared medical visits from March 23 to April 23, 2020, with the same period in 2019.
- Data included consultations, diagnostic tests, surgical procedures, and hospital admissions.
Main Results:
- Significant decreases were observed in cardiology consultations (90%) and diagnostic tests (up to 94%).
- Cardiac surgeries and catheterizations dropped by 48% and 60%, respectively, while chemotherapy (45%) and radiotherapy (19%) also decreased.
- Admissions to the ICU (20%), cardiac emergency room (45%), and cardiology ward (36%) declined, alongside a 30% reduction in oncology consultations.
Conclusions:
- The COVID-19 pandemic caused a substantial reduction in outpatient consultations and procedures for cardiology and oncology.
- Decreases in critical care services like cardiac surgery, chemotherapy, and radiotherapy raise concerns about patient prognosis.
- Reduced emergency room visits and hospital admissions suggest potential delays in care for non-COVID-19 conditions during the pandemic.
Background:
We still do not have information regarding the impact of the COVID-19 pandemic on medical care activity in Brazil.
Objective:
To describe the repercussions of the COVID-19 pandemic on the care routine of a tertiary hospital, which is a regional reference in cardiology and oncology.
Methods:
Cross-sectional cohort study. We conducted a survey of medical visits from March 23, 2020 (when local commerce was closed) to April 23, 2020 (P20), in comparison with the same period in 2019 (P19).
Results:
We found decreases in the number of cardiology consultations, exercise tests, Holter, ambulatory blood pressure monitoring, electrocardiogram, and echocardiogram (90%, 84%, 94%, 92%, 94%, and 81%, respectively). In relation to cardiac surgery and cardiac catheterization, there were 48% and 60% decreases, respectively. There was an increase in the number of percutaneous transluminal coronary angioplasties (33%) and definitive pacemaker implantations (29%). There were 97 admissions to the ICU during P19, in contrast with 78 during P20, a 20% decrease. Visits to the cardiac emergency room (45%) and admissions to the cardiology ward (36%) also decreased. The decrease in oncology consultations was 30%. Chemotherapy sessions decreased from 1,944 to 1,066 (45%), and radiotherapy sessions decreased by 19%.
Conclusion:
COVID-19 has led to a considerable decrease in the number of consultations in outpatient clinics for cardiology, oncology, and other specialties. There was a concerning decrease in the number of cardiac surgeries, chemotherapy sessions, and radiotherapy sessions during the initial weeks of the pandemic. The number of people seeking care in the cardiac emergency room and the number of admissions to the cardiology ward and ICU also decreased, generating concern regarding the evolution and prognosis of these patients with pathologies other than COVID-19 during this pandemic time. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
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