Avoidance Of Medical Care Research Articles

Impact of state of emergency for coronavirus disease 2019 on hospital visits and disease exacerbation: the Japan COVID-19 and Society Internet Survey.

BackgroundStudies on the impact of coronavirus disease 2019 (COVID-19) on people’s routine medical care are limited, and understanding the factors associated with medical care avoidance can inform us about the ongoing pandemic.ObjectivesWe aimed to assess the impact of Japan’s state of emergency and stay-at-home policy for COVID-19 on hospital visits and disease exacerbation; we also identified related factors.MethodsThis cross-sectional study used data from the Japan COVID-19 and Society Internet Survey (JACSIS), which included randomly sampled research agency panellists in Japan. Among the 28,000 participants, we included 7,747 respondents who reported having any disease. We described baseline characteristics and avoidance-related hospital visit outcomes. We used multivariable logistic regression analyses to assess the association between chronic diseases and outcomes of hospital visit avoidance.ResultsAmong 7,747 participants, 17.7% of patients with chronic diseases avoided hospital visits, 2.1% of patients postponed hospitalization or surgery, 4.9% of patients ran out of drug, and 5.3% of patients experienced disease exacerbation during the COVID-19 pandemic in April and May 2020. Exacerbations occurred mostly in participants with mental diseases, chronic pain and headache, and diabetes (OR 3.33 [95% confidence interval (CI): 2.51–4.41], 2.83 [95% CI: 2.19–3.66], and 1.53 [95% CI: 1.10–2.13], respectively). Patients with cardiovascular disease or cancer did not experience exacerbation [OR 0.55 (95% CI: 0.31–0.97), 0.79 (95% CI: 0.43–1.45)].ConclusionsThe rates of hospital visit avoidance and exacerbation varied among patients with different diseases under the COVID-19 stay-at-home policy in April and May 2020, and disease-specific preparedness may be necessary for the pandemic.

Improving Health through Action on Economic Stability: Results of the Finances First Randomized Controlled Trial of Financial Education and Coaching in Single Mothers of Low-Income.

Evaluate the health impact of a novel financial education and coaching program in single mothers of low-income in Omaha, Nebraska. Employed, single mothers earning no more than 200% of the 2017 Federal Poverty Level (n = 345) enrolled in the study between April 2017 and August 2020 and were randomized to receive a novel financial education and coaching program, the Financial Success Program (FSP) or no intervention control. Demographics, biometrics, financial strain, health behaviors and healthcare utilization were assessed at baseline and the 12-month study visits. Participants who completed the FSP demonstrated significantly reduced financial strain, an increased rate of smoking cessation, and a reduction in avoidance of medical care due to cost compared to participants in the control group. The FSP represents an effective model in promoting economic stability in vulnerable individuals through a reduction in financial strain. Health behavior changes including an increased rate of smoking cessation were demonstrated within the first 12 months of intervention.

Lonely older adults are more likely to delay or avoid medical care during the coronavirus disease 2019 pandemic.

ObjectivesTo examine the relationship between loneliness and self‐reported delay or avoidance of medical care among community‐dwelling older adults during the coronavirus disease 2019 (COVID‐19) pandemic.MethodsAnalyses of data from a nationally representative survey administered in June of 2020, in COVID‐19 module of the Health and Retirement Study. Bivariate and multivariable analyses determined associations of loneliness with the likelihood of, reasons for, and types of care delay or avoidance.ResultsThe rate of care delay or avoidance since March of 2020 was 29.1% among all respondents (n = 1997), and 10.1% higher for lonely (n = 1,150%, 57.6%) versus non‐lonely respondents (33.5% vs. 23.4%; odds ratio = 1.59, p = 0.003 after covariate adjustment). The differences were considerably larger among several subgroups such as those with emotional/psychiatric problems. Lonely older adults were more likely to cite “Decided it could wait,” “Was afraid to go,” and “Couldn't afford it” as reasons for delayed or avoided care. Both groups reported dental care and doctor's visit as the two most common care delayed or avoided.ConclusionsLoneliness is associated with a higher likelihood of delaying or avoiding medical care among older adults during the pandemic.

Attitudes Toward Medical Care and Sexual Orientation Identity in Lesbian, Gay, and Bisexual Individuals

This study examined factors of lesbian, gay, and bisexual (LGB) identity in relation to general attitudes toward medical care and specific attitudes of medical care avoidance. Through an online questionnaire, 114 participants who self-identified as LGB completed measures of LGB identity and attitudes toward medical care. Out of eight domains of LGB identity, identity affirmation, acceptance concerns, and identity superiority significantly related to overall attitudes toward medical care. In other words, an affirming experience with one's LGB identity significantly related to positive attitudes. Conversely, concerns about judgement for being LGB and beliefs that LGB identity is superior to heterosexual identity related to negative attitudes. Furthermore, stronger overall negative LGB identity significantly related to stronger attitudes of medical care avoidance. These findings suggest that both positive and negative aspects of LGB identity relate to attitudes toward seeking medical care. We discuss the implications of our findings for clinical work with LGB individuals and their loved ones.

Vision Difficulty and Engagement in Care Among Aging Men Living With HIV

For aging adults living with HIV (AALH) who have complex medical care needs, vision impairment may be an added burden that may lead individuals to disengage from their own medical care. We examined the relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (> 2 questions at a medical visit). A modified version of the National Eye Institute vision function questionnaire was administered at three semi-annual visits (from October 2017 to April 2018) to assess difficulty performing vision-dependent tasks (no, a little, moderate to extreme difficulty). We included 1063 AALH participants (median age 60 years, 24% Black). Data were analyzed using repeated measures logistic regression with generalized estimating equations adjusted for fixed race, and at visit values for age, education level, depressive symptoms, alcohol use, and smoking status. Compared to no vision difficulty, those reporting moderate to extreme vision difficulty on at least one task (18%) had 1.95 times higher odds (95% CI: 1.36, 2.79) of having less than optimal ART adherence and 1.92 times higher odds [95% CI: 1.06, 3.47]) of avoiding necessary medical care, but 1.6 times higher odds [95%CI: 0.93, 2.72] of asking more questions. These findings suggest that vision impairment plays a role in medical care engagement among older adults living with HIV, and may contribute to poorer management of HIV and chronic comorbidities.

Factors Associated with Healthcare Avoidance among US Adults: Analyses of the 2019 Healthy Information National Trends Survey

Background: Healthcare avoidance represents a significant impediment to health and well-being of individuals and society. Avoidance undermines positive healthcare-seeking and carries significant health and economic consequences including increased morbidity and mortality as well as loss of job or economic productivity. Objective: The current study analyzed factors associated with healthcare avoidance. Methods: Using the 2019 Healthy Information National Trends Survey, we conducted multiple logistic regression to identify factors associated with avoiding doctor’s visit even when deemed necessary. Factors included sociodemographic, economic, access to health care, health care practices and trust to better understand medical care avoidance. Results: Notably, 30.3% of Americans reported healthcare avoidance, and 29% reported “no/little/some trust” in medical information from the doctor. Greater likelihood of healthcare avoidance was observed among those who had less trust in medical information from their doctor, younger, and male. Significant health behavior predictors of healthcare avoidance included current smokers, those who had infrequent visits to health professionals, and those with better self-reported health. Conclusions: By identifying multiple factors that may be associated with healthcare avoidance we can identify individuals at risk for avoidant behaviors and encourage positive health behavior.

Stigma and Human Rights: Transgender Discrimination and Its Influence on Patient Health.

Transgender patients encounter barriers to accessing medical treatment. Although the medical field has made strides to improve transgender patients' health care experiences, programs that provide support in navigating existing obstacles are lacking. As integrated care becomes more prevalent, primary care settings have the potential to become medical havens for vulnerable patient populations. Enlisting support of professional case managers to connect transgender patients to services to meet their physical and behavioral health needs could increase health care utilization and decrease disparities. Because of their gender identities, transgender individuals experience high rates of discrimination within health care settings. There are also inequities that limit their access to quality treatment. These, combined with the fear of discrimination, contribute to an avoidance of medical care that negatively impacts the physical and mental health of transgender patients. Transgender discrimination in health care settings is pervasive and has detrimental effects on patients' well-being. Future research should foster collaboration between health care administrators, professional case managers, primary care providers, behavioral health consultants, and transgender patients to remove existing barriers and increase access to care. Until these changes occur, programs need to be designed for case managers to assist transgender patients in navigating the health care system and connecting to affirming providers. Health care systems and integrated primary care settings.

The Association of Delayed Care With Depression Among US Middle-Aged and Older Adults During the COVID-19 Pandemic: Cross-sectional Analysis.

BackgroundDuring the COVID-19 pandemic, the depression level among US adults has significantly increased. Age disparity in depression during the pandemic has been reported in recent studies. Delay or avoidance of medical care is one of the collateral damages associated with the COVID-19 pandemic, and it can lead to increased morbidity and mortality.ObjectiveThis study aimed to assess the prevalence of depression and delayed care among US middle-aged adults and older adults during the pandemic, as well as investigate the association of delayed care with depression among those 2 age groups.MethodsThis cross-sectional study used data from the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0). Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years were included. Depression was measured by the Composite International Diagnostic Interview-Short Form (CIDI-SF). Delayed care was measured by the following 4 items: delayed surgery, delayed seeing a doctor, delayed dental care, and other delayed care.ResultsA total of 3246 participants were identified. More than half of the participants were older than 65 years (n=1890, 58.2%), and 274 (8.8%) participants had depression during the pandemic. Delayed dental care was positively associated with depression among both middle-aged adults (OR 2.05, 95% CI 1.04-4.03; P=.04) and older adults (OR 3.08, 95% CI 1.07-8.87; P=.04). Delayed surgery was positively associated with depression among older adults (OR 3.69, 95% CI 1.06-12.90; P=.04). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education levels (some college or above) or worse self-reported health had a higher likelihood of having depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults.ConclusionsThis study found that depression was prevalent among middle-aged and older adults during the pandemic. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the association of delayed surgery and dental care with depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients’ concerns on delayed surgery and dental care. Moreover, the implementation of telemental health services is needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive measurements for delayed care is needed to decipher the path through which delayed care is associated with depression.

Effect of COVID-19-Related Lockdown οn Hospital Admissions for Asthma and COPD Exacerbations: Associations with Air Pollution and Patient Characteristics.

We conducted a retrospective observational study to assess the hospitalization rates for acute exacerbations of asthma and COPD (chronic obstructive pulmonary disease) during the first imposed lockdown in Athens, Greece. Patient characteristics and the concentration of eight air pollutants [namely, NO (nitrogen monoxide), NO2 (nitrogen dioxide), CO (carbon monoxide), PM2.5 (particulate matter 2.5), PM10 (particulate matter 10), O3 (ozone), SO2 (sulfur dioxide) and benzene] were considered. A total of 153 consecutive hospital admissions were studied. Reduced admissions occurred in the Lockdown period compared to the Pre-lockdown 2020 (p < 0.001) or the Control 2019 (p = 0.007) period. Furthermore, the concentration of 6/8 air pollutants positively correlated with weekly hospital admissions in 2020 and significantly decreased during the lockdown. Finally, admitted patients for asthma exacerbation during the lockdown were younger (p = 0.046) and less frequently presented respiratory failure (p = 0.038), whereas patients with COPD presented higher blood eosinophil percentage (p = 0.017) and count (p = 0.012). Overall, admissions for asthma and COPD exacerbations decreased during the lockdown. This might be partially explained by reduction of air pollution during this period while medical care avoidance behavior, especially among elderly patients cannot be excluded. Our findings aid in understanding the untold impact of the pandemic on diseases beyond COVID-19, focusing on patients with obstructive diseases.

Factors associated with increased financial toxicity after the completion of radiation treatment for gynecologic cancer

<h3>Objectives:</h3> Financial toxicity is estimated to impact up to 50% of patients with gynecologic malignancies, but little is known about the factors that may predispose patients receiving radiation treatment for gynecologic cancer to increased financial distress. <h3>Methods:</h3> Patients from an urban academic gynecologic radiation oncology practice completed a financial toxicity survey at their 1-month follow-up visit after completion of radiation treatment from August 2019-March 2020. The survey was modified from our prior study and included basic demographic questions, the Comprehensive Score for Financial Toxicity (COST) tool and the EQ-5D to measure quality of life. Consistent with our prior work, high financial toxicity was defined as COST score ≤23. We assessed correlation of COST scores with QOL. Demographic and disease characteristics between high and low financial toxicity groups were compared using Chi-square or Fisher's exact test for categorical variables and Wilcoxon rank sum test for continuous variables. We used log-binomial regression to examine associations between high financial toxicity and cost-coping strategies. <h3>Results:</h3> The response rate was 88%. Of the 49 patients surveyed, 71% were White, 14% Black and 10% Asian. The majority of patients had uterine cancer (65%), followed by cervical (23%) and vaginal (8%) cancer. Two-thirds (63%) received external beam radiation with or without brachytherapy; the remaining (37%) received brachytherapy alone. Median COST score was 13 (IQR 5-19) in the high financial toxicity group (n=18) and 32 (IQR 27-36) in the low toxicity group (n=31). Greater financial toxicity was significantly correlated with worse QOL (R=-0.36, P=0.02). No demographic, disease or treatment characteristics were associated with high financial toxicity aside from employment status (p=0.03), though income was borderline significant (p=0.053). Compared with the low financial toxicity group, patients with high financial toxicity were more likely to move from full-time to part-time employment since diagnosis (22% vs 0%, p=0.01) and reported that difficulty paying for transportation or parking was a consideration in making medical decisions (33.3 vs 3.2%, p=0.01). Patients with high financial toxicity were more likely to report delaying or avoiding medical care (22% vs 0%, P=0.01), 13.8 (95% CI 1.9-101.4, P<0.001) times more likely to borrow money, and 10.3 (95% CI 1.3-79.1, p=0.01) times more likely to report reduced spending on basic goods. <h3>Conclusions:</h3> Financial toxicity correlated with worse quality of life in patients who received radiation for their gynecologic cancer diagnosis and was associated with delays or avoidance of medical care and use of economic cost-coping strategies. A larger survey cohort may improve our ability to meaningfully detect other associations with high financial toxicity. Moreover, transportation and parking costs should be considered in the design of any future intervention study in this population.

Older adults report cancellation or avoidance of medical care during the COVID-19 pandemic: results from the Longitudinal Aging Study Amsterdam

Key summary pointsAimTo investigate the extent to which Dutch older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic.FindingsOne third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions.MessageDelay of routine care during the pandemic may impact morbidity and related adverse outcomes in the long term, which should be monitored in future research.

Abstract 045: Declines In Acute Myocardial Infarction And Stroke Emergency Department Visits Observed During Covid-19 Restrictions In North Carolina

Introduction: Efforts to control the COVID-19 pandemic brought sweeping social change, with stay-at-home orders and physical distancing mandates in 43 of 50 states by April 2020. Early on, isolated studies around the world described reduced hospital admissions. Reports from some US hospitals also described declines in catheterization laboratory activations, and acute myocardial infarction (AMI) and stroke admissions. However, there have been few population-based analyses of emergency department (ED) visits to verify these initial reports and describe longer term impacts of the pandemic on care seeking behavior. Hypothesis: We hypothesized that AMI and stroke ED visits in North Carolina (NC) would decrease substantially after a statewide stay-at-home order was announced on March 27, 2020. Methods: We analyzed all ED visits from January 5 to August 28, 2020 using data collected by the NC Disease Event Tracking and Epidemiologic Collection Tool, a syndromic surveillance system that automatically gathers ED data in near-real time for all EDs in NC. Counts of AMI and stroke/transient ischemic attack (TIA) were ascertained using ICD-10-CM diagnosis codes. We compared weekly 2020 ED visit data before and after NC’s stay-at-home order, and to 2019 ED visit data. Results: Overall ED volume declined by 44% in the weeks before and after the stay-at-home order ( Figure ) while the prior year’s ED volume stayed steady at ~100,000 visits per week. From January 5 to March 28, there were 593 AMI and 791 stroke/TIA visits per week on average. By April 11, ED visits reached a nadir at 426 AMI and 543 stroke/TIA visits per week, representing a 28% and 31% decrease, respectively. Since June, AMI and stroke/TIA ED visits have rebounded slightly but have yet to reach pre-pandemic levels. Conclusions: We observed swift declines in AMI and stroke/TIA ED visits following NC’s stay-at-home order. These findings potentially reflect the avoidance of medical care due to fears of COVID-19 exposure and may eventually result in higher associated case fatality.

Risk Perception, Preventive Behavior, and Medical Care Avoidance among American Older Adults During the COVID-19 Pandemic.

Objectives: This study investigated the predictors of risk perception and its effect on older adults' preventive behavior and/or medical care avoidance during the COVID-19 pandemic. Methods: Older respondents (age >50 years) from the MIT COVID-19 Preventive Health Survey reported their social distancing, hand washing, mask wearing, and medical care avoidance between July and October 2020 (n = 4395). Structural equation models were used. Results: Significant predictors of higher risk perception were female gender, older age, poorer health, city residency, personally knowing someone who had COVID-19, and correct knowledge of vaccine/treatment. Higher risk perception was subsequently associated with higher frequency/probability of practicing preventive behavior and/or avoiding medical care. Knowledge had the strongest path coefficient with risk perception. Discussion: Disseminating correct information to older adults could help them evaluate infection risk accurately. Educational programs on the precautions implemented at clinical settings to ensure patient safety may encourage older adults to seek timely medical care.

Pediatric asthma exacerbations during the COVID-19 pandemic: Absence of the typical fall seasonal spike in Washington, DC

Pediatric asthma exacerbations during the COVID-19 pandemic: Absence of the typical fall seasonal spike in Washington, DC

Patient perspective: Wearable and digital health tools to support managing our health during the COVID-19 pandemic and beyond

Patient perspective: Wearable and digital health tools to support managing our health during the COVID-19 pandemic and beyond

COVID-19 impact on ST-elevation myocardial infarction incidence rate in a Italian STEMI network: a U-shaped curve phenomenon.

Public health emergencies such as the COVID-19 outbreak may impact on the incidence rate of ST-elevation myocardial infarction (STEMI) in severely affected areas. However, this phenomenon demands attention also in areas where media and patients were focused on the COVID-19 pandemic, but the healthcare system was not overwhelmed by the huge number of COVID-19 patients. In this observational study, we compared the incidence rate of all consecutive STEMI patients admitted at the University Hospital of Trieste, Italy, during March and April 2020 with the same 2 months of the previous 5 years (2015-2019). Patient characteristics were compared between 2020 and 2019.The incidence rate of STEMI admission in March-April 2020 was lower than those in March-April 2015-2019, 36 vs. 56 cases per 100 000 inhabitants/year [relative risk (RR) 0.65, 95% confidence interval (95% CI) 0.42-0.96, P = 0.045]. Considering that the incidence rates were constant in the past years (P = 0.24), the turnaround in 2020 is most likely due to the COVID-19 outbreak. Interestingly, this reduction was a dynamic phenomenon with a U-shaped curve during the 2-month period. System-of-care times were similar between 2020 and 2019; however in 2020, patients presented more frequently signs of heart failure compared to 2019 (Killip class ≥2 in 68% vs. 29%, P = 0.003). During the COVID-19 outbreak, we observed a marked reduction in the STEMI incidence rate. This U-shaped phenomenon demands attention because a potential cause for the decrease in STEMI incidence may include the avoidance of medical care. Public campaigns aiming to increase awareness of ischemic symptoms may be needed during community outbreak.

Tendency of Patients to Delay Emergency Department Visits and Avoid Medical Care During the Viral COVID-19 Pandemic: A Cross-Sectional Survey Study in Saudi Arabia

Background: Patients' avoidance of medical care and visiting emergency departments (EDs) during the viral coronavirus disease-2019 (COVID-19) pandemic has been reported in many countries; however, similar studies are almost absent in Saudi Arabia. We aimed to (1) study the tendency to avoid or delay medical care during the COVID-19 pandemic, (2) identify factors that affect patients' decision to visit an ED when required, and (3) examine the medical consequences and possible complications in terms of a patient's health due to avoiding medical care during the COVID-19 pandemic. Methods: This was a cross-sectional study conducted using a descriptive and analytical survey to explore the prevalence of patient avoidance of medical care. The survey was distributed through social media websites to the population of Saudi Arabia. Results: Of the 1,275 participants in this study, 51% were male and the majority (77.8%) were aged between 21 and 49 years. Forty-four percent (n = 561) of the participants had delayed or avoided medical care due to concerns about contracting COVID-19. A variety of significant factors were associated with delaying or avoiding medical care during the COVID-19 pandemic, including age, marital status, paying when seeking care, presence of comorbidities, and the level of anxiousness about visiting an ED during the pandemic. The multinomial logistic regression model highlighted that being very anxious significantly predicted avoidance of medical care. Conclusions: Avoiding medical care during the pandemic is not uncommon. Many factors contribute to overall patients' avoidance and the consequences can be fatal. Patient education and efforts to decrease patients' anxiousness are the keys to decreasing avoidance and complications due to the late presentation.

Activity of a catheterization laboratory in Tunisia: A comparative study before and during confinement (COVID-19)

IntroductionThe COVID-19 pandemic has significantly impacted the Tunisian healthcare system. To reduce the risk of contracting or transmitting COVID-19, the Centers for Disease Control and Prevention recommended deferral of elective cardiac procedures, including coronary angiography (CA) and percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD).PurposeHowever anecdotal reports suggest also a decline in the number of patients consulting for an unstable CAD and therefore in the activity of the catheterization laboratory.MethodsTo confirm this finding, we conducted a study comparing the number of patients who consulted for an unstable CAD and who benefited from a CA associated or not with a PCI during the confinement period (CP) (from March 15, 2020 to April 30, 2020) and just 6 weeks before (from February 1, 2020 to March 15, 2020) in Mongi Slim La Marsa University Hospital Center.ResultsOur analysis showed that out of 183 patients with unstable CAD, 127 (69,4%) and 56 (30.6%) consulted and were urgently treated in our catheterization laboratory respectively before and during the confinement period thus an estimated 40% reduction in our daily activity (Fig. 1).ConclusionPotential etiologies for the decrease in unstable patients with CAD may be related to the avoidance of medical care due to social distancing or concerns of contracting COVID-19 in the hospital and ST-Segment elevation myocardial infarction misdiagnosis. As long as the pandemic continues, we highly recommend to follow this signal and investigate its causes.

Greater decline of acute stroke admissions compared with acute coronary syndromes during COVID‐19 outbreak in Greece: Cerebro/cardiovascular implications amidst a second wave surge

A remarkable decline in admissions for acute stroke and acute coronary syndrome (ACS) has been reported in countries severely hit by the COVID-19 pandemic. However, limited data are available from countries with less COVID-19 burden focusing on concurrent stroke and ACS hospitalisation rates from the same population. The study was conducted in three geographically and demographically representative COVID-19 referral university hospitals in Greece. We recorded the rate of stroke and ACS hospital admissions during a 6-week period of the COVID-19 outbreak in 2020 and compared them with the rates of the corresponding period in 2019. We found a greater relative reduction of stroke admissions (51% [35 vs. 71]; incidence rate ratio [IRR]: 0.49, p=0.001) compared with ACS admissions (27% [123 vs. 168]; IRR: 0.73, p=0.009) during the COVID-19 outbreak (p=0.097). Fewer older (>65years) patients (stroke: 34.3% vs. 45.1%, odds ratio [OR]: 0.64, p=0.291; ACS: 39.8% vs. 54.2%, OR: 0.56, p=0.016) were admitted during the COVID-19 compared with the control period. Hospitalisation rates both for stroke and ACS were reduced during the COVID-19 outbreak in a country with strict social distancing measures, low COVID-19 incidence and low population mortality. Lack of triggers for stroke and ACS during social distancing/quarantining may explain these observations. However, medical care avoidance attitudes among cerebro/cardiovascular patients should be dissipated amidst the rising second COVID-19 wave.

Heartbeat: an increase in preventable cardiovascular deaths during the COVID-19 pandemic due to avoidance of medical care

Patients with cardiovascular disease (CVD) have an increased mortality risk with COVID-19 infection yet several studies have shown fewer hospital-based CVD diagnoses and procedures during the COVID-19 pandemic. In this...