European Heart Journal | 2021
The ongoing impact of COVID-19 on cardiovascular care
Abstract
By the Spring of 2020, COVID-19 had gripped the planet leading to lockdowns, millions of cases and mounting deaths. The cardiology community was seriously concerned; heart patients were staying away from hospitals in fear of catching COVID-19, not seeking timely help for severe conditions, and funding for research into cardiovascular disease was under threat with resources diverted to tackling the pandemic. Now, while vaccinations are being rolled out, many of those concerns have proven true and the impact on cardiology and on cardiovascular disease is becoming clearer. While patients are returning, numerous appointments have been missed, waiting lists have grown, and there is the unknown long-term legacy of COVID-19 on heart patients. While China reported a return to near normal cardiovascular services, large parts of Europe remained in lockdown with cardiac surgery and interventions delayed with waiting lists growing. The European Association for Cardio-Thoracic Surgery unveiled plans to assess the scale of that in Europe following findings for the United States presented at the 57th Annual Meeting of the Society of Thoracic Surgeons showing that COVID-19 resulted in a 53% decrease nationwide in all adult cardiac surgery. In addition, a systematic review of 27 studies worldwide, published in the European Heart Journal in January, evaluated the impact of the pandemic on the care for patients with acute cardiovascular disease, showing hospital admissions down by 40–50% for acute coronary syndrome emergencies. Figures from the British Heart Foundation found that cardiac surgeries or interventions were down by 27%; and in the USA, evidence emerged of a deterioration in cardiovascular risk factor control, along with ‘a marked disruption’ of cardiovascular trials. Currently, the World Heart Federation (WHF)—the umbrella organization of >200 cardiac societies and foundations—is working on a large global registry on COVID and cardiovascular disease (WHF COVID-19 Global Cardiovascular Disease Study), to better understand COVID-19 and plan for future pandemics. Against this backdrop as we head towards the middle of 2021, four eminent cardiologists from Africa, America, Asia, and Europe offer their updated thoughts on the challenges of the COVID-19 crisis and their longer-term concerns on the fight against cardiovascular disease.