Listen to Your Heart

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During the COVID-19 pandemic, fewer people are visiting the hospital for heart disease.
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A study led by Dr. Carolina Alba at the Toronto General Hospital found that ER admissions and hospitalizations for heart failure dropped by around 40% during the pandemic.

The COVID-19 pandemic has resulted in drastic changes to the health care system. “Our findings provide an early glimpse into the impacts of the pandemic on the care of those with heart failure,” says Dr. Alba, who is a Scientist at Toronto General Hospital Research Institute.

For the study, the research team looked at the number of patients presenting to hospital for worsening heart failure symptoms between March 1 and April 19. These dates capture the public lockdown in Ontario, which began on March 12. By comparing data before and after the pandemic, the team found an average decrease of 43.5% in emergency department visits and a decrease of 39% in hospitalizations for heart failure.

Despite the decrease, the study also revealed that rates of hospitalization or intensive care unit stays did not increase among patients presenting to the emergency department for heart failure during the pandemic.  

According to the authors of the study, these observations are likely the result of complex public health and social factors. For example, patients may be more cautious about going to hospitals for fear of contracting COVID-19. The effects could also be the result of ‘silver linings’ from the pandemic and physical distancing. For example, stay-at-home directives may have enabled patients to better manage their conditions, eat healthier and receive care virtually, leading to less hospital visits.

“While we are not sure of the underlying causes and effects, reduced hospital visits pose a serious threat. Over time, these reductions may lead to deteriorating health in those with chronic conditions and other individuals with complex health issues,” says Dr. Alba. This threat is supported by additional findings in the study, which suggest that early trends for in-hospital deaths are rising.

The results of this study add to the growing body of evidence from around the world—in particular from the United States—that show reduced hospitalization rates for these and other conditions, such as stroke.

“While it is still too early to predict whether the COVID-19 pandemic has caused collateral damage to the care received for chronic conditions, our findings are a call to action,” says Dr. Alba. “As the situation evolves, there is a strong need to closely monitor chronic disease management and care during the pandemic. As well, more education is necessary so that the public knows that emergency care is still available for those who need help.”

This work was supported by Toronto General & Western Hospital Foundation.

Frankfurter C, Buchan TA, Kobulnik J, Lee DS, Luk A, McDonald M, Ross HJ, Alba AC. Reduced Rate of Hospital Presentations for Heart Failure During the COVID-19 Pandemic in Toronto, Canada. Can J Cardiol. 2020 Jul 17:S0828-282X(20)30599-7. doi: 10.1016/j.cjca.2020.07.006.

Dr. Carolina Alba, lead author of the study and Scientist at the Toronto General Hospital Research Institute.