Cardiovascular presentations during the COVID-19 pandemic: an interrupted time series analysis
Hari Prakash Sritharan1,2, Harrison Nguyen2, Usaid Khalil Allahwala1,2
1Faculty of Medicine and Health, University of Sydney, Science Road, Camperdown, Sydney, NSW 2050, Australia.
Insights
Cardiovascular hospitalizations significantly decreased during the initial COVID-19 lockdown. This trend reversed as restrictions eased, except for ongoing reductions in cardiomyopathy and heart failure cases.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The impact of the Coronavirus disease 2019 (COVID-19) pandemic on cardiovascular hospitalizations requires further investigation.
- Understanding these trends is crucial for healthcare planning and resource allocation.
Purpose of the Study:
- To analyze trends in cardiovascular presentations during the COVID-19 pandemic.
- To assess the impact of different pandemic phases on hospitalization rates.
Main Methods:
- A multicentre study analyzed cardiovascular presentations from March 2018 to February 2023.
- Interrupted time series analysis was employed to evaluate changes in weekly presentations across four distinct periods: pre-pandemic, first lockdown, easing of restrictions, and widespread vaccination.
- Data were sourced from administrative health records using ICD-10-AM diagnosis codes.
Main Results:
- A total of 116,518 patients were included from three Australian public hospitals.
- Cardiovascular presentations were significantly lower during the first lockdown (T1), with a mean decline of 13.1% (P=0.004).
- While most presentations returned to expected levels in later phases (T2 and T3), a significant reduction in cardiomyopathy and heart failure persisted in T3 (4.5% decline, P=0.007).
Conclusions:
- The initial COVID-19 lockdown led to a significant decrease in cardiovascular hospitalizations.
- These hospitalization trends largely normalized with the easing of restrictions and vaccination rollout.
- A notable exception was the persistent reduction in cardiomyopathy and heart failure presentations observed even after restrictions were lifted.
Background:
The broader implications of the Coronavirus disease 2019 pandemic on cardiovascular hospitalizations remain unclear. We aimed to assess trends in cardiovascular presentations during the Coronavirus disease 2019 pandemic.
Methods:
This multicentre study examined cardiovascular presentations from March 2018 to February 2023. Patients with cardiovascular presentations were identified through administrative health records using ICD-10-AM diagnosis codes. Four key study periods were analysed: T0-pre-pandemic, T1-first lockdown, T2-easing of restrictions and T3-release of restrictions and widespread vaccination. Interrupted time series analysis was used to predict weekly cardiovascular presentations, with the mean difference between actual and predicted numbers assessed for significance.
Results:
Overall, 116 518 patients were included across three major public hospitals in Australia. Cardiovascular presentations were significantly lower in T1 than predicted, with a mean decline of 13.1% (SD 16.2%; P = 0.004). There was a significant difference between the expected and actual number of most cardiovascular presentations in T2 and T3, apart from a significant reduction in cardiomyopathy and heart failure presentations during T3 (4.5% [SD 23.7%]; P = 0.007).
Conclusions:
Cardiovascular presentations were significantly lower during the initial lockdown phase of the COVID-19 pandemic; this attenuated with easing of social restrictions and widespread vaccination, except for persistent reduction in cardiomyopathy and heart failure presentations.
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