Impact of covid19 crisis on the emergency management of cardiovascular diseases

Background/Introduction The Covid19 epidemic has a considerable impact on healthcare systems in France. Firstly by a flooding of hospital resuscitation services, as well as of the call platforms for emergency services. The strict lockdown of the French population decreed on March 17, 2020 has also completely changed the conditions for seeking healthcare. Purpose The aim of our study was to give a first estimation of the impact of lockdown during the Covid19 crisis on the use of hospital emergency departments for the management of three groups of acute cardiovascular diseases: ischemic heart disease (IHD), stroke and pulmonary embolism (PE) Methods The French hospital emergency departments OSCOUR network daily collects 93 % of national ED visits, which are transmitted each day to the French public health agency. The weekly number of visits and the proportion of hospitalization following these visits between January 1, 2019 and April 12, 2020 were compared with the same weeks of 2019. Results During the first month of lockdown, the number of visits and hospitalizations after visits decreased by 35 % for IHD, 27 % for stroke, and 28 % (visits) and 18 % (hospitalizations) for PE compared to the same period in 2019. The decrease was even higher during the first three weeks of lockdown. The proportion of hospitalizations after visits was high and increased slightly for IHD (+3 %) and for stroke (+2 %), and markedly for PE (+8 %). Conclusion These preliminary data show a major impact of Covid19 lockdown on the management of acute cardiovascular diseases with a likely delay for treatment. This could lead to an increase in cardiovascular sequelae and mortality in the following months. Data on hospitalization and healthcare expenditure should complete this first analysis to have a more precise estimation of the loss of chance caused by this crisis for patients not affected by covid19.