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Management of acute and chronic aortic disease during the COVID-19 pandemic-Results from a web-based ad hoc platform
Martin Czerny1,2, Jos van den Berg3, Roberto Chiesa4
1Department of Cardiovascular Surgery, University Heart Center Freiburg, Bad Krozingen, Germany.
Insights
The COVID-19 pandemic decreased acute aortic syndrome referrals, with patient reluctance to seek care being a key factor. While some aortic ruptures occurred in postponed elective cases, their incidence remained low.
Area of Science:
- Cardiology
- Vascular Surgery
- Infectious Diseases
Background:
- The COVID-19 pandemic significantly impacted healthcare delivery, including the management of acute and chronic aortic diseases.
- Expert consensus and experience sharing are crucial for navigating complex medical challenges during global health crises.
Purpose of the Study:
- To present findings from a web-based expert panel on managing aortic diseases amidst the COVID-19 pandemic.
- To assess the preparedness and experiences of healthcare settings in treating aortic conditions during the pandemic.
Main Methods:
- An online expert panel discussion was conducted on April 18, 2020, involving eight specialists in aortic medicine.
- Discussions covered various aspects of aortic disease management during the pandemic, followed by audience Q&A and immediate result evaluation.
Main Results:
- Nearly 70% of participants reported a decrease in acute aortic syndrome referrals since the pandemic's onset.
- While most hospitals were prepared, some reported significant percentages of infected healthcare professionals (10-20%).
- Pulmonary embolism was noted in 30% of COVID-19 patients, and a small percentage of postponed elective patients experienced aortic rupture.
Conclusions:
- The pandemic led to reduced referrals for acute aortic syndromes, primarily driven by patient hesitancy to seek medical attention.
- The incidence of aortic rupture in patients with postponed elective procedures was low.
- Further research is essential to fully understand the pandemic's long-term effects on aortic disease treatment and outcomes.
Background:
To share the results of a web-based expert panel discussion focusing on the management of acute and chronic aortic disease during the coronavirus (COVID-19) pandemic.
Methods:
A web-based expert panel discussion on April 18, 2020, where eight experts were invited to share their experience with COVID-19 disease touching several aspects of aortic medicine. After each talk, specific questions were asked by the online audience, and results were immediately evaluated and shared with faculty and participants.
Results:
As of April 18, 73.3% answered that more than 200 patients have been treated at their respective settings. Sixty-four percent were reported that their hospital was well prepared for the pandemic. In 57.7%, the percentage of infected healthcare professionals was below 5% whereas 19.2% reported the percentage to be between 10% and 20%. Sixty-seven percent reported the application of extracorporeal membrane oxygenation in less than 2% of COVID-19 patients whereas 11.8% reported application in 5%-10% of COVID-19 patients. Thirty percent of participants reported the occurrence of pulmonary embolism in COVID-19 patients. Three percent reported to have seen aortic ruptures in primarily elective patients having been postponed because of the anticipated need to provide sufficient ICU capacity because of the pandemic. Nearly 70% reported a decrease in acute aortic syndrome referrals since the start of the pandemic.
Conclusion:
The current COVID-19 pandemic has-besides the stoppage of elective referrals-also led to a decrease of referrals of acute aortic syndromes in many settings. The reluctance of patients seeking medical help seems to be a major driver. The number of patients, who have been postponed due to the provisioning of ICU resources but having experienced aortic rupture in the waiting period, is still low. Further, studies are needed to learn more about the influence that the COVID-19 pandemic has on the treatment of patients with acute and chronic aortic disease.
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