Short Term Outcomes and Treatment Intensity of Major Cardiovascular Emergencies During the COVID-19 Pandemic in...

Area of Science:

• Cardiology
• Vascular Medicine
• Health Services Research

Background:

• Hospital admission rates declined globally during the COVID-19 pandemic.
• Patient demographics and selection for acute conditions shifted during this period.
• Understanding the pandemic's impact on cardiovascular and cerebrovascular outcomes is crucial.

Purpose of the Study:

• To investigate changes in patient characteristics for acute conditions during the COVID-19 pandemic.
• To assess short-term mortality rates and the likelihood of invasive procedures.
• To examine potential sex disparities in outcomes before and during the pandemic.

Main Methods:

• Utilized claims data from Germany's BARMER insurance fund (2018-2021).
• Included patients with ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), acute limb ischemia (ALI), and stroke, excluding COVID-19 cases.
• Employed propensity score matching to balance confounders and compared outcomes between pre-pandemic (2018/2019) and pandemic (2020/2021) periods, analyzing sex-specific differences.

Main Results:

• A cohort of 122,340 patients (48.3% female) was analyzed, with 102,960 matched cases.
• The probability of receiving an invasive procedure increased for ALI, NSTEMI, and STEMI in both sexes.
• No statistically significant increase in in-hospital or 30-day mortality rates was observed post-pandemic onset.

Conclusions:

• The COVID-19 pandemic did not demonstrate a direct or indirect impact on major short-term hospital outcomes for these conditions.
• Despite an increased likelihood of invasive procedures for STEMI, NSTEMI, and ALI, overall short-term mortality rates remained stable for both sexes.