JACC Study: Significant Decline in CV-Related Hospitalizations as COVID-19 Pandemic Began

Journal of the American College of Cardiology

In the first month of the COVID-19 pandemic, a large health system in Massachusetts experienced a significant decrease in acute cardiovascular hospitalizations, compared with the same month in 2019, according to a study published May 22 in the Journal of the American College of Cardiology.

Ankeet S. Bhatt, MD, MBA, et al., retrospectively analyzed hospitalizations for acute cardiovascular conditions with discharge dates between Jan. 1, 2019, and March 31, 2020.

The researchers looked at hospitalization trends and compared demographics, length of stay and in-hospital mortality between patients admitted prior to March 2020, when the pandemic began, and those admitted in March 2020.

During the study period, there were 6,083 unique patients experiencing 7,187 hospitalizations for primary acute cardiovascular diagnoses. There were 43.4% fewer estimated daily hospitalizations in March 2020, compared with March 2019.

The daily hospitalization rate did not change throughout 2019 or in January 2020 and February 2020, but significantly declined in March 2020.

There were no significant demographic differences between patients admitted prior to March 2020 and those admitted in March 2020. The distribution of reasons for hospitalization was comparable, with heart failure the most common diagnosis in March 2019 (41.5%) and March 2020 (35.0%).

The average length of stay decreased from 6 days in March 2019 to 4.8 days in March 2020. In-hospital mortality was 4.4% in March 2019 vs. 6.2% in March 2020.

The study demonstrates a significant decline in cardiovascular hospitalizations corresponding with the first phase of the COVID-19 pandemic in Massachusetts, the researchers write.

According to the researchers, patients with acute cardiovascular illness likely are not seeking emergency treatment because of concerns regarding the virus. There is a need for increased education and guidance for high-risk patients on the need to seek emergency care when experiencing cardiovascular symptoms, they conclude.

"This study is quite consistent with another recent report from Italy where investigators documented a nearly 50% reduction in admissions for acute coronary syndromes during the COVID-19 surge compared with a similar time frame in 2019," commented Kim A. Eagle, MD, MACC, ACC.org editor-in-chief.

Clinical Topics: Acute Coronary Syndromes, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: COVID-19, Coronavirus, Coronavirus Infections, Pandemics, Patient Discharge, Hospital Mortality, Acute Coronary Syndrome, Length of Stay, severe acute respiratory syndrome coronavirus 2, Hospitalization, Heart Failure, Acute Disease, Emergency Treatment, Emergency Medical Services

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