Key result
COVID-19 pandemic linked to ~23% fewer ASCVD events but higher inpatient MACE mortality.
Why the study?
The COVID-19 pandemic altered usual care for ambulatory and acute cardiac patients, creating a need to evaluate ASCVD-related clinical outcomes and healthcare resource utilization patterns compared to preceding years.
Did the COVID-19 pandemic alter ASCVD-related clinical outcomes and healthcare resource utilization in Alberta, Canada?
Cross-Sectional
Did the COVID-19 pandemic alter ASCVD-related clinical outcomes and healthcare resource utilization in Alberta, Canada?
Effect estimate: 23% decline
The COVID-19 pandemic led to a transient 23% decline in ASCVD-related healthcare utilization but an increase in in-patient MACE mortality in Alberta, Canada.
Pandemic drop in ASCVD events with higher MACE mortality cautions against assuming lower burden; leaves open mechanisms in this cross-sectional analysis.
Background: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in Canada. The COVID-19 pandemic altered the usual care of ambulatory and acute cardiac patients. This study aimed to describe ASCVD-related clinical outcomes and healthcare resource utilization (HCRU) patterns during the coronavirus disease 2019 (COVID-19) pandemic in Alberta, Canada, relative to the three preceding years. Methods: A repeated cross-sectional study design was conducted over three-month periods using administrative health data between March 15, 2017, and March 14, 2021. ASCVD-related clinical outcomes included major adverse cardiovascular events (MACE) endpoints. HCRU was assessed through general practitioner and other healthcare professional visits (including telehealth claims) for ASCVD events, emergency department visits, ASCVD diagnostic imaging tests, laboratory tests, and hospital length of stay. Results: Relative to the control year period (March to June 2019) ASCVD-related events (i.e., hospitalizations, emergency department (ED) visits and physician office visits) declined by 23% during the three-months COVID-19 period (March to June 2020). Acute declines were not sustained following June 2020. In contrast, in-patient mortality rates involving a primary MACE endpoint increased from March to June 2020 COVID-19 period. Conclusions: This study demonstrates the COVID-19 pandemic and corresponding public health restrictions impacted ASCVD-related care. While many clinical outcomes returned to pre-pandemic levels at the end of the observation period, our results suggest that patients' HCRU declined, which could lead to further CV events and mortality. Understanding the impact of COVID-19 restrictions on ASCVD-related care may help improve healthcare resiliency.
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Mackinnon et al. (2023) conducted a cross-sectional in Atherosclerotic cardiovascular disease (ASCVD). COVID-19 pandemic vs. Pre-pandemic period (March to June 2019) was evaluated on ASCVD-related events (hospitalizations, emergency department visits, and physician office visits) (23% decline). The COVID-19 pandemic (March to June 2020) was associated with a 23% decline in ASCVD-related events compared to 2019, alongside an increase in in-patient mortality for primary MACE.
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