Abstract
The COVID-19 pandemic affected regular health care for patients with chronic diseases. However, the impact of the pandemic on primary care for patients with coronary artery disease (CAD) who are enrolled in a structured disease management program (DMP) in Germany is not clear. We investigated whether the pandemic affected primary care and health outcomes of DMP-CAD patients (n = 750) by using a questionnaire assessing patients' utilization of medical care, CAD symptoms, as well as health behavior and mental health since March 2020. We found that out of concern about getting infected with COVID-19, 9.1% of the patients did not consult a medical practitioner despite having CAD symptoms. Perceived own influence on infection risk was lower and anxiety was higher in these patients compared to symptomatic CAD patients who consulted a physician. Among the patients who reported chest pain lasting longer than 30 min, one third did not consult a medical practitioner subsequently. These patients were generally more worried about COVID-19. Patients with at least one worsening CAD symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since the pandemic showed more depressive symptoms, higher anxiety scores, and were less likely to consult a doctor despite having CAD symptoms out of fear of infection. Our results provide evidence that the majority of patients received sufficient medical care during the COVID-19 pandemic in Germany. However, one in ten patients could be considered particularly at risk for medical undersupply and adverse health outcomes. The perceived infection risk with COVID-19 might have facilitated the decision not to consult a medical doctor.
Highlights
The coronavirus-19 disease (COVID-19) has been causing a global pandemic and developed into a burden for health care systems worldwide [1]
Our results provide evidence that the COVID-19 pandemic influenced the willingness of some coronary artery disease (CAD) patients to seek medical care and those patients who are more concerned about COVID-19 and exhibited higher anxiety are especially vulnerable
We further found that a decrease in family visits and a lower frequency of leaving homes since the pandemic were associated with decreased general practitioner (GP) consultations, worsening of CAD symptoms, more anxiety and depressive symptoms, as well as a higher individual risk perception
Summary
The coronavirus-19 disease (COVID-19) has been causing a global pandemic and developed into a burden for health care systems worldwide [1]. The pandemic affected patients who suffered from the new disease, but potentially left all patients needing regular treatment or preventive consultations in any medical sectors undersupplied due to insufficient capacities of the health care system. To deal with COVID-19 patients and to reduce infection risks, many planned procedures and preventive consultations concerning all medical services had to be canceled or postponed, affecting in particular patients with chronic diseases [2,3,4]. Patients with chronic coronary artery disease (CAD) are especially vulnerable to an undersupply of medical care as the pathophysiological process of CAD leads to a higher risk for acute myocardial infarctions (AMI) [5]. A comparable development of AMI cases has been reported in other countries [10,11,12,13,14,15,16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
