ABSTRACT
Introduction: Among all western countries, Italy was the first to be strongly affected by COVID-19 pandemic, and one of the first to apply the “hard” lockdown. In order to limit the in-hospital infections and to re-distribute the healthcare professionals, all healthcare elective activities were reduced or cancelled, and among them, cardiac percutaneous interventions in Pediatric and Adult Congenital Heart Disease (ACHD) patients were limited to urgent or emergent ones. The aim of this paper is to describe the impact of COVID-19 pandemic on Pediatric and ACHD cath lab activity during the so called “hard lockdown” in Italy. Methods: On behalf of the interventional working group of the Italian Society of Pediatric Cardiology, 11 out of 12 Italian Institutions with a dedicated Invasive Cardiology Unit in Congenital Heart Disease actively participated to the survey. The institutions were distributed over all the national territory, 5 in the northern regions, 3 in the central and 3 in the southern ones. The data from each center were collected using a self-completion questionnaire containing 41 multiple choices questions. Results: Most of the hospitals were affected by the COVID-19 pandemic, either actively, with direct management of infected patients, or passively due to decrease of routinely clinical activities. The majority of institutions stated a change in the cath lab usual workflow plan and accessibility. Most of the centers had to cease at least temporarily the Cath lab practice, and the overall reduction of procedures number ranged between 50% and 75%. This reduction was more pronounced for teenagers and ACHD compared to neonates and children. Interestingly, there was an evident discrepancy in the management of the lock-down, irrespective of the number of COVID-19 positive cases registered, with higher reduction in Southern Italy compared to the most affected Regions Conclusions: COVID-19 pandemic has significantly affected the activity of 11 different pediatric cardiology and ACHD units all over Italy. Cath lab services were deeply impacted due to decline in outpatient clinic consultations and referrals from local hospitals. ACHD cath lab procedures suffered the biggest drop. However, overall activity reduction was not consistent with the severity of outbreak in the different Italian regions.
ABSTRACT
COVID-19 pandemic continues to strike across the world with increasing number of infected patients, severe morbidity and mortality, social life and economy disruption. Universal access to vaccine prophylaxis will be pivotal in controlling this infection and providing individual level protection. However, mismatch between vaccine request and vaccine availability, as well as constraints in logistics of vaccine campaign is creating a transition phase of progressive but still incomplete inclusion of group of individuals in the vaccination process. Selected patients living with chronic and multisystemic disease may present increased propensity of adverse outcome, should Sars-Cov-2 infection develop. In these patients, expedite access to COVID-19 vaccination may be considered. The Italian Society of Pediatric Cardiology National Board is providing a viewpoint to inform policy makers and public authorities during vaccine allocation strategies development, to consider higher priority and expedite access for selected groups of patients living with congenital heart disease. © 2021, Tech Science Press. All rights reserved.