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Impact of COVID-19 on Emergency Management of Acute Type A Aortic Dissection: A Single-Center Historic Control Study

Rui Zhao1, Wei Xu2, Zhao Wang3

  • 1Department of Cardiovascular Surgery, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed

Insights

The COVID-19 pandemic reduced emergency acute type A aortic dissection (ATAAD) cases and surgeries, but in-hospital mortality remained stable. Surgical timing and emergency department stays varied during the pandemic.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Public Health

Background:

  • The COVID-19 pandemic significantly impacted healthcare systems globally.
  • Understanding its effect on emergency management of critical conditions like acute type A aortic dissection (ATAAD) is crucial.

Purpose of the Study:

  • To assess the impact of the 2020 COVID-19 pandemic on the emergency management of acute type A aortic dissection (ATAAD).
  • To compare patient demographics, treatment strategies, and outcomes during the pandemic versus a historical control period.

Main Methods:

  • A retrospective study comparing 337 ATAAD patients from January to June 2020 (pandemic) with 189 patients from the same period in 2019 (control).
  • Primary outcome: in-hospital death. Secondary outcomes included automatic discharge and changes in treatment patterns.
  • Analysis of factors influencing outcomes across different epidemic stages.

Main Results:

  • No significant difference in in-hospital mortality between 2020 (20.5%) and 2019 (17.4%).
  • A significant decrease in the proportion of patients receiving surgical treatment in 2020 (50.0%) compared to 2019 (68.25%).
  • Shorter surgery times for ATAAD patients in 2020 (6.46 hours) versus 2019 (7.33 hours); length of stay in the emergency department varied by epidemic stage.

Conclusions:

  • The COVID-19 outbreak led to fewer ATAAD patients and reduced surgical interventions, without increasing overall mortality.
  • Surgical strategies adapted, with initial trends toward longer pre-operative intervals, normalizing later in the epidemic.
  • Effective epidemic prevention measures are vital to protect non-infected patients and maintain essential medical services.
Abstract

Keywords:
COVID-19aortic dissectionemergenciesepidemics

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