Cardiovascular Surgical Emergencies in France, before, during and after the First Lockdown for COVID-19 in 2020: A Comparative Nationwide Retrospective Cohort Study.

Anna Baudry,Eric Steinmetz,Yannick Bejot,Eric Benzenine,Olivier Bouchot,Catherine Quantin,Maurice Giroud,Chloé Bernard,Anne-Sophie Mariet,Marie-Catherine Morgant,Valentin Crespy

doi:10.3390/life11111245

Abstract

Background: There are still gaps regarding the impact of the nationwide lockdown on non-COVID-19 emergency hospitalizations. This study aims to describe the trends in hospitalizations for cardiovascular surgical emergencies in France, before, during and after the first lockdown. Materials and Methods: All adults admitted for mechanical complications of myocardial infarction (MI), aortic dissection, aortic aneurysm rupture, acute and critical limb ischemia, circulatory assistance, heart transplantation and major amputation were included. This retrospective cohort study used the French National Hospital Discharge database. The numbers of hospitalizations per month in 2020 were compared to the previous three years. Results: From January to September 2020, 94,408 cases of the studied conditions were reported versus 103,126 in the same period in 2019 (−8.5%). There was a deep drop in most conditions during the lockdown, except for circulatory assistance, which increased. After the lockdown, mechanical complications of MI and aortic aneurysm rupture increased, and cardiac transplantations declined compared with previous years. Conclusion: We confirmed a deep drop in most cardiovascular surgical emergencies during the lockdown. The post-lockdown period was characterized by a small over-recovery for mechanical complications of MI and aortic aneurysm rupture, suggesting that many patients were able to access surgery after the lockdown.

Highlights

From a public health policy point of view, we have a good understanding of the impact of the first nationwide lockdown for coronavirus disease (COVID-19) on hospital admissions for non-COVID-19 medical emergencies [1]
There was no change in the number of mechanical complications of myocardial infarction (MI) during lockdown in 2020, but there was an increase of 171.4% (19 vs. 7 patients) right after the end of the lockdown (Table 1 and Table S1) (Figure 1A)
For aortic and peripheral vascular diseases, there was a significant drop in the number of hospitalizations that started before the lockdown and gradually returned to

Summary

Introduction

From a public health policy point of view, we have a good understanding of the impact of the first nationwide lockdown for coronavirus disease (COVID-19) on hospital admissions for non-COVID-19 medical emergencies [1]. Any delay in the management of cardiovascular surgical emergencies, such as ventricular septal rupture or papillary muscle rupture, which are some of the consequences of acute myocardial infarction (MI) [4], critical limb ischemia and secondary amputation [5] and aortic aneurysm ruptures and aortic dissection (AD) [6], can have devastating consequences on survival or functional outcomes. Materials and Methods: All adults admitted for mechanical complications of myocardial infarction (MI), aortic dissection, aortic aneurysm rupture, acute and critical limb ischemia, circulatory assistance, heart transplantation and major amputation were included. This retrospective cohort study used the French National Hospital Discharge database. Mechanical complications of MI and aortic aneurysm rupture increased, and cardiac transplantations declined compared with previous years. The post-lockdown period was characterized by a small over-recovery for mechanical complications of MI and aortic aneurysm rupture, suggesting that many patients were able to access surgery after the lockdown

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