Fewer Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic
Open accessAbstract
Background Although patients with cardiovascular disease face excess risks of severe illness with coronavirus disease-2019 (COVID-19), there may be indirect consequences of the pandemic on this high-risk patient segment. Objectives This study sought to examine longitudinal trends in hospitalizations for acute cardiovascular conditions across a tertiary care health system. Methods Acute cardiovascular hospitalizations were tracked between January 1, 2019, and March 31, 2020. Daily hospitalization rates were estimated using negative binomial models. Temporal trends in hospitalization rates were compared across the first 3 months of 2020, with the first 3 months of 2019 as a reference. Results From January 1, 2019, to March 31, 2020, 6,083 patients experienced 7,187 hospitalizations for primary acute cardiovascular reasons. There were 43.4% (95% confidence interval [CI]: 27.4% to 56.0%) fewer estimated daily hospitalizations in March 2020 compared with March 2019 (p < 0.001). The daily rate of hospitalizations did not change throughout 2019 (-0.01% per day [95% CI: -0.04% to +0.02%]; p = 0.50), January 2020 (-0.5% per day [95% CI: -1.6% to +0.5%]; p = 0.31), or February 2020 (+0.7% per day [95% CI: -0.6% to +2.0%]; p = 0.27). There was significant daily decline in hospitalizations in March 2020 (-5.9% per day [95% CI: -7.6% to -4.3%]; p < 0.001). Length of stay was shorter (4.8 days [25th to 75th percentiles: 2.4 to 8.3 days] vs. 6.0 days [25th to 75th percentiles: 3.1 to 9.6 days]; p = 0.003) and in-hospital mortality was not significantly different (6.2% vs. 4.4%; p = 0.30) in March 2020 compared with March 2019. Conclusions During the first phase of the COVID-19 pandemic, there was a marked decline in acute cardiovascular hospitalizations, and patients who were admitted had shorter lengths of stay. These data substantiate concerns that acute care of cardiovascular conditions may be delayed, deferred, or abbreviated during the COVID-19 pandemic.
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Previous studies have reported significant reductions in hospital admissions for myocardial infarction and stroke during the COVID-19 pandemic.
“Previous studies have also reported significant reductions in hospital admissions for MI and stroke during the COVID-19 pandemic (2–7).”
From Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020 (2020) · cites this paper as [4]
The Results (Hospitalization rates for acute cardiovascular conditions; page unavailable) report statistically significant daily declines in admissions for stroke and the combined chest pain/acute coronary syndrome category in March 2020. They do not report a statistically significant decline for myocardial infarction admissions specifically; the discussion of earlier STEMI findings concerns catheterization-laboratory activations rather than admissions. (LLM, conf=0.83)
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Myocarditis mortality with and without COVID-19: insights from a national registry
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- Authors
- Bhatt, A. S., Moscone, A., McElrath, E. E., Varshney, A. S., Claggett, B. L., Bhatt, D. L., Januzzi, J. L., Butler, J., Adler, D. S., Solomon, S. D., & Vaduganathan, M.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Vaduganathan, Muthiah
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 76
- Issue
- 3
- Pages
- 280-288
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC7250561
- OpenAlex
- W3028265325
- Cited by
- 357
- References
- 2
- Citations by year
- 2026: 18 · 2025: 31 · 2024: 39 · 2023: 60 · 2022: 82 · 2021: 78 · 2020: 48 · 2012: 1
- FWCI
- 24.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Sanofi
- Gilead Sciences
- Cleveland Clinic
- CSL Behring
- Boston VA Research Institute
- Regado Biosciences
- Belvoir Media Group
- Daiichi-Sankyo
- National Institutes of Health
- St. Jude Medical
- Sanofi Pasteur
- Duke Clinical Research Institute
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- COVID-19 pandemic, hospitalization trends, length of hospital stay, in-hospital mortality, cardiovascular disease, tertiary care hospital, SARS-CoV-2 transmission risk, health system preparedness, remote patient monitoring, telemedicine
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Hospitalization, Humans, Male, Middle Aged, Pneumonia, Viral, Retrospective Studies, Hospital Mortality, Coronavirus Infections, Pandemics, Tertiary Care Centers
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