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Introduction The impact of the COVID-19 pandemic on hospitalization for cardiac infections is not well known. We aimed to evaluate the nationwide trends in-hospital stays for myocarditis and endocarditis cases before, during and after the nationwide lockdown for the COVID-19 pandemic in France. Objective We then aimed to describe the proportion of myocarditis and endocarditis patients with and without COVID-19 and their clinical characteristics. Method Hospitalized cases of cardiac infection were extracted from the French National Discharge database, which collects the medical records of all patients discharged from all public and private hospitals in France. Age, sex, and available cardiovascular risk factors were compared between stays with and without COVID-19 during the lockdown. Results The number of myocarditis cases was 11% higher in 2020, compared to the average of the three prior years. In 2020, 439 of 3727 cases of myocarditis were associated with COVID-19. For endocarditis, there was an increase in cases by 7% in 2020 versus prior years. For endocarditis, 3% (240 of 8128 cases) of patients with endocarditis had COVID-19. For myocarditis, older age, hypertension, diabetes, obesity, and atrial fibrillation were more frequent in patients with COVID-19 than in those without. For endocarditis, only hypertension was more frequent in patients with COVID-19 than in those without. Conclusion Our study reports an increase in hospitalizations for both myocarditis and endocarditis in 2020, possibly related to the COVID-19 pandemic. Interestingly, the trends differ according to the COVID-19 status. Knowledge of the factors associating myocarditis or endocarditis and COVID-19 may improve the quality and the type of monitoring for people with COVID-19, the identification of patients at risk of cardiac infections, and the treatment of COVID-19 patients.
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ABSTRACT
The Covid-19 pandemic has boosted telemedicine (TLM) for acute and chronic neurological disorders and it has demonstrated its cost/efficiency benefits. Before the Covid-19 pandemic, TLM was used mainly for the acute stroke management to deliver thrombolysis and select mechanical thrombectomy in rural and underserved areas. To the opposite, experiences for chronic neurological disorders were limited before the Covid-19 pandemic. Covid-19 pandemic suggests to re-think neurological practices. Therefore, it was observed that neurological diseases are compatible with tele-consultation, teleassistance and tele-expertise, because clinical symptoms are accessible to simple questionnaires, functional scales and expert visual observation. The new use of TLM has demonstrated its efficiency for stroke but also for chronic neurological diseases as Multiple Sclerosis, Epilepsy, Parkinson and Alzheimer diseases, Atrophic Lateral Sclerosis, Myasthenia gravis, neuromuscular diseases, post-traumatic lesions and psychiatric disorders. Moreover, TLM is safe, it allows treatments changes, it protects patient confidentially, it safeguards the privacy of participants. TLM improves quality of life, allowing to the patients to hold the tele-visit in familiar environment in a multidisciplinary approach, with a strong correlation compared with the equivalent face-to-face visit. This new medical practice provides multiple consequences: TLM training is necessary, and governments, health care systems and payers should be encouraged to continue to develop its generalization. Conclusion: TLM for acute and chronic neurological disorders presents 4 advantages: better access to care, greater convenience, enhanced patient comfort, better confidentiality. TLM must become a new normality rather than exception, while standard operating procedures and legal framework are essential.