Indirect Impact of the COVID-19 Pandemic on Activity and Outcomes of Transcatheter and Surgical Treatment of Severe Aortic Stenosis in England
Indirect Impact of the COVID-19 Pandemic on Activity and Outcomes of Transcatheter and Surgical Treatment of Severe Aortic Stenosis in England
Abstract BackgroundAortic stenosis requires timely treatment with either surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). This study aimed to investigate the indirect impact of COVID-19 on national SAVR and TAVR activity and outcomes. MethodsThe UK TAVR Registry and the National Adult Cardiac Surgery Audit were used to identify all TAVR and SAVR procedures in England, between January 2017 and June 2020. The number of isolated AVR, AVR+coronary artery bypass graft (CABG) surgery, AVR+other surgery and TAVR procedures per month was calculated. Separate negative binomial regression models were fit to monthly procedural counts, with functions of time as covariates, to estimate the expected change in activity during COVID-19. ResultsWe included 13376 TAVR cases, 12328 isolated AVR cases, 7829 AVR+CABG cases, and 6014 AVR+Other cases. Prior to March 2020 (UK lockdown), monthly TAVR activity was rising, with a slight decrease in SAVR activity during 2019. We observed a rapid and significant drop in TAVR and SAVR activity during the COVID-19 pandemic, especially for elective cases. Cumulatively, over the period March to June 2020, we estimated an expected 2294 (95% CI 1872, 2716) cases of severe aortic stenosis who have not received treatment. ConclusionThis study has demonstrated a significant decrease in TAVR and SAVR activity in England following the COVID-19 outbreak. This situation should be monitored closely, to ensure that monthly activity rapidly returns to expected levels. There is potential for significant backlog in the near-to-medium term, and potential for increased mortality in this population.
Wu Jianhua、Gale Chris、de Belder Mark A、Ludman Peter、Martin Glen P.、Curzen Nick、Goodwin Andrew T.、Nolan James、Kontopantelis Evangelos、Mamas Mamas A.、Balacumaraswami Lognathen
Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsNational Institute for Cardiovascular Outcomes Research, Barts Health NHS TrustInstitute of Cardiovascular Sciences, University of BirminghamDivision of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science CentreWessex Cardiothoracic Unit, Southampton University Hospital Southampton & Faculty of Medicine, University of SouthamptonSouth Tees Hospital NHS Foundation Trust||National Institute for Cardiovascular Outcomes Research, Barts Health NHS TrustRoyal Stoke Hospital, Stoke on Trent and Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele UniversityDivision of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science CentreRoyal Stoke Hospital, Stoke on Trent and Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University||Thomas Jefferson UniversityRoyal Stoke Hospital, Stoke on Trent and Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University
临床医学内科学医学研究方法
aortic valve replacementaortic stenosisCOVID-19outcomessurvival
Wu Jianhua,Gale Chris,de Belder Mark A,Ludman Peter,Martin Glen P.,Curzen Nick,Goodwin Andrew T.,Nolan James,Kontopantelis Evangelos,Mamas Mamas A.,Balacumaraswami Lognathen.Indirect Impact of the COVID-19 Pandemic on Activity and Outcomes of Transcatheter and Surgical Treatment of Severe Aortic Stenosis in England[EB/OL].(2025-03-28)[2025-08-07].https://www.medrxiv.org/content/10.1101/2020.08.05.20168922.点此复制
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