Background

The Coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic crisis in health care systems worldwide. These may have significant implications for the management of cardiometabolic diseases. We conducted a systematic review of published evidence to assess the indirect impact of the COVID-19 pandemic on hospitalisations for cardiovascular diseases and their management.

Methods

Studies that evaluated volume of hospitalisations for cardiometabolic conditions and their management with comparisons between the COVID-19 and pre-COVID periods were identified from MEDLINE, Embase and the reference list of relevant studies from January 2020 to 25 February 2021.

Results

We identified 103 observational studies, with most studies assessing hospitalisations for acute cardiovascular conditions such as acute coronary syndrome, ischemic strokes and heart failure. About 89% of studies reported a decline in hospitalisations during the pandemic compared to pre-pandemic times, with reductions ranging from 20.2 to 73%. Severe presentation, less utilization of cardiovascular procedures, and longer patient- and healthcare-related delays were common during the pandemic. Most studies reported shorter length of hospital stay during the pandemic than before the pandemic (1–8 vs 2–12 days) or no difference in length of stay. Most studies reported no change in in-hospital mortality among hospitalised patients.

Conclusion

Clinical care of patients for acute cardiovascular conditions, their management and outcomes have been adversely impacted by the COVID-19 pandemic. Patients should be educated via population-wide approaches on the need for timely medical contact and health systems should put strategies in place to provide timely care to patients at high risk.

Systematic review registration

PROSPERO 2021: CRD42021236102

中文翻译：

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COVID-19 大流行对心脏代谢疾病住院治疗及其管理的间接影响：系统评价

背景

2019 年冠状病毒病 (COVID-19) 大流行已导致全球卫生保健系统出现严重危机。这些可能对心脏代谢疾病的管理具有重要意义。我们对已发表的证据进行了系统审查，以评估 COVID-19 大流行对心血管疾病住院治疗及其管理的间接影响。

方法

从 MEDLINE、Embase 和 2020 年 1 月至 2021 年 2 月 25 日的相关研究参考清单中确定了评估心脏代谢疾病住院人数及其管理并比较 COVID-19 和 COVID-19 前时期的研究。

结果

我们确定了 103 项观察性研究，其中大多数研究评估了急性心血管疾病的住院治疗，例如急性冠状动脉综合征、缺血性中风和心力衰竭。大约 89% 的研究报告说，与大流行前相比，大流行期间的住院人数有所下降，下降幅度从 20.2% 到 73%。在大流行期间，严重的表现、心血管手术的使用较少以及与患者和医疗保健相关的延误时间较长是很常见的。大多数研究报告说，大流行期间的住院时间比大流行前短（1-8 天对 2-12 天）或住院时间没有差异。大多数研究报告住院患者的院内死亡率没有变化。

结论

COVID-19 大流行对急性心血管疾病患者的临床护理、管理和结果产生了不利影响。应通过全人群方法对患者进行及时医疗联系的必要性教育，卫生系统应制定策略，为高危患者提供及时护理。

系统审查登记

繁荣 2021：CRD42021236102