Cardiac operations and interventions during the COVID-19 pandemic: a nationwide perspective

Leyva, Francisco; Zegard, Abbasin; Okafor, Osita; Stegemann, Berthold; Ludman, Peter; Qiu, Tian

AIMS : The COVID-19 pandemic has led to a decline in hospitalizations for non-COVID-19-related conditions. We explored the impact of the COVID-19 pandemic on cardiac operations and interventions undertaken in England. METHODS AND RESULTS : An administrative database covering hospital activity for England, the Health Episodes Statistics, was used to assess a total of 286 697 hospitalizations for cardiac operations and interventions, as well as 227 257 hospitalizations for myocardial infarction (MI) and 453 799 for heart failure (HF) from 7 January 2019 to 26 July 2020. Over the 3 months of ‘lockdown’, total numbers and mean reductions in weekly rates [n (−%)], compared with the same time period in 2019, were: coronary artery bypass grafting [−2507 (−64%)]; percutaneous coronary intervention [−5245 (−28%)]; surgical [−1324 (−41%)] and transcatheter [−284 (−21%)] aortic valve replacement; mitral valve replacement; implantation of pacemakers [−6450 (−44%)], cardiac resynchronization therapy with [−356 (−42%)] or without [−491 (−46%)] defibrillation devices, and implantable cardioverter-defibrillators [−501 (−45%)]; atrial fibrillation ablation [−1902 (−83%)], and other ablations [−1712 (−64%)] (all P < 0.001). Over this period, there were 21 038 fewer procedures than in the reference period in 2019 (P < 0.001). These changes paralleled reductions in hospitalizations for MI [−10 794 (−27%)] and HF [−63 058 (−28%)] (both P < 0.001). CONCLUSIONS : The COVID-19 pandemic has led to substantial reductions in the number of cardiac operations and interventions undertaken. An alternative strategy for healthcare delivery to patients with cardiac conditions during the COVID-19 pandemic is urgently needed.