Reduced hospital visits for urgent heart problems during the initial phase of the Covid-19 pandemic may have contributed to hundreds of avoidable deaths, new research has found.
In the wake of the coronavirus pandemic, a marked decline in inpatient visits to emergency departments (EDs) was observed in England and the US, including for people with heart problems.
In this study, published online in the journal Circulation: Cardiovascular Quality and Outcomes, researchers at University College London’s Institute of Health Informatics estimated the effect of reduced emergency department visits for suspected cardiac disease on non-Covid-19 related cardiac mortality in England.
The researchers estimated that the excess cardiac mortality due to non-attendance at Emergency Departments, during the initial phase of the pandemic, may have been as high as 232 deaths per week.
To quantify the number of excess deaths due to cardiac disease, the team used mortality counts from the Office of National Statistics (ONS) for England.
To quantify the change in daily ED visits, researchers used data from the Public Health England (PHE) Emergency Department Syndromic Surveillance System (EDSSS): a network of sentinel EDs across England.
To explore how the reduction in ED visits may have affected cardiac mortality, researchers implemented causal inference methodology.
“During the initial phase of the pandemic, between March 12 and April 15, 2020, there was an estimated fewer ED visits of 2,750 per week for suspected cardiac disease; this is around a 35 percent decrease compared to the pre-pandemic period this year,” said lead study author Michail Katsoulis.
“Our analysis suggested that one cardiac death might have been prevented or delayed for every additional 12 ED visits for suspected cardiac conditions.”
March 12 was the day the UK’s Chief Medical Officer raised the risk to the UK from moderate to high and the government advised that anyone with a new continuous cough or a fever should self-isolate for seven days.
“Our results suggest that the pandemic response may have led to the undertreatment of non-Covid-19 diseases, including heart conditions, with important impacts on the excess mortality observed during this period,” said senior study author Tom Lumbers.
“These results provide evidence of the stark indirect effects of the Covid-19 pandemic on mortality in England.”