The collateral damage of COVID-19 to cardiovascular services: a meta-analysis

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The impact of the COVID-19 pandemic on non-COVID-19 cardiovascular diseases (CV) remains unclear.
• Assessing pandemic-related changes in CV disease care and outcomes is crucial for global health planning.

Purpose of the Study:

• To systematically review and meta-analyze the effect of the COVID-19 pandemic on cardiovascular disease care and outcomes.
• To investigate variations in these effects by CV disease type, geographic region, country income, and pandemic timeline.

Main Methods:

• Systematic review and meta-analysis of observational studies (January 2019-December 2021) from Medline and Embase.
• Synthesis of data on CV disease hospitalizations, procedures, consultations, and mortality using incidence rate ratios and risk ratios.
• Meta-regression to explore variations by country income classification and pandemic waves.

Main Results:

• A significant global reduction in cardiovascular disease hospitalizations, procedures, and consultations was observed during the pandemic.
• Low-middle income countries (LMICs) experienced more severe declines in ST-segment elevation myocardial infarction (STEMI) hospitalizations and revascularization compared to high-income countries (HICs).
• In-hospital mortality for STEMI and heart failure increased in LMICs but not in HICs.

Conclusions:

• The COVID-19 pandemic resulted in substantial global collateral damage to cardiovascular disease care.
• Disparities in the severity of this damage were evident based on country income classification, with LMICs bearing a disproportionately higher burden.