Comparison of the number of cardiovascular admissions before and after covid-19: Experience from Turkey

ABSTRACT

Background: The frequency of cardiovascular problems in patients with COVID-19 could be interpreted to suggest an increase in the number of cardiovascular admissions in the COVID-19 era. However, almost all countries announced social restrictions and distancing measures which could unintentionally lead to a decline in admissions to the hospital for acute disorders other than those associated with pneumonia. This study aimed to compare cardiovascular admissions before and after COVID-19 at the emergency department of secondary and tertiary centers in Turkey. Methods: We analyzed emergency department referrals to secondary and tertiary centers in Ordu province, Turkey for subjects with acute chest pain, shortness of breath, palpitation, leg swelling, and acute limb ischemia from March 10, 2020 to April 30, 2020. Also, we recorded the number of diagnostic coronary angiographies, peripheral endovascular interventions, and cardiac surgeries performed at our institute. The difference in the frequency of emergency department referrals due to acute cardiovascular disorders before and after COVID-19 was the primary outcome measure of this study. Results: Our findings show that, following the establishment of social restrictions 1918 patients were admitted to the emergency department with acute chest pain, shortness of breath, palpitation, leg swelling, and acute limb ischemia. Compared to the last five years (2105-2019) there was a decline in numbers of the patients admitted to the emergency department with acute coronary syndromes, and acute heart failure. There was also a dramatic decline in number of diagnostic coronary angiographies, peripheral interventions and cardiac surgeries. Finally, the number of lower extremity amputations from peripheral artery disease was increased. Conclusion: Our findings show that, compared to the same intervals in the last five years, a critical decline has occurred in the number of patients admitted to our emergency department with cardiovascular symptoms, acute heart failure, acute coronary syndrome, STEMI, while the number of diagnostic angiographies, peripheral endovascular interventions and cardiac surgeries were also decreased. The state of alarm declared by many countries may have caused a higher threshold for hospital application in patients with cardiovascular problems, possibly due to social distancing measures and concerns of contracting COVID-19 in the hospital.