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. 2021 Jul-Sep;14(3):260-268.
doi: 10.4103/apc.apc_133_21. Epub 2021 Aug 26.

Impact of COVID-19 pandemic on pediatric cardiac services in India

Mrigank Choubey  1 , Sivasubramanian Ramakrishnan  1 , Sakshi Sachdeva  1 , Kalaivani Mani  2 , Debasree Gangopadhyay  3 , Kothandam Sivakumar  4 , Mahesh Kappanayil  5 , Mahimarangaiah Jayranganath  6 , Nageswara Rao Koneti  7 , Neeraj Awasthy  8 , Prashant Bobhate  9 , Saurabh Kumar Gupta  1 , Sushil Azad  10 , Bhargavi Dhulipudi  7 , Bhushan Sonawane  4 , Biswajit Bandopadhyay  3 , Chinnaswamy Sivaprakasam Muthukumaran  11 , Debasis Das  12 , Devaprasath Sivalingam  13 , Harpanahalli Ravi Ramamurthy  14 , Hemant Kumar Nayak  15 , Jayashree Mishra  16 , Kalyanasundaram Muthusamy  17 , Manisha Chakrabarti  18 , Nurul Islam  19 , Prashant Mahawar  20 , Prashant Shah  21 , Saileela Rajan  22 , Kavasseri Subramaniaiyer Remadevi  23 , Shaad Abqari  24 , Shiv Kumar Chaudhary  25 , Soumya Kasturi  6 , Raghavannair Suresh Kumar  26 , Anita Saxena  1 , Krishna Subramony Iyer  27 , Rajesh Sharma  28 , Raman Krishna Kumar  5 , Sitaraman Radhakrishnan  10 , Shyam Sunder Kothari  1 , Snehal Kulkarni  9 , Suresh G Rao  29 ; PCSI-COVID-19 study group
Affiliations

Impact of COVID-19 pandemic on pediatric cardiac services in India

Mrigank Choubey et al. Ann Pediatr Cardiol. 2021 Jul-Sep.

Abstract

Background: COVID-19 pandemic has disrupted pediatric cardiac services across the globe. Limited data are available on the impact of COVID.19 on pediatric cardiac care in India.

Aims: The aims are to study the impact of COVID-19 pandemic on the care of children with heart disease in India in terms of number of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries.

Settings and design: This is a retrospective, multicentric, observational study.

Methods: We collected monthly data on the number and characteristics of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries and major hospital statistics, over a period of 5 months (April to August 2020), which coincided with the first wave of COVID-19 pandemic in India and compared it with data from the corresponding months in 2019.

Results: The outpatient visits across the 24 participating pediatric cardiac centers decreased by 74.5% in 2020 (n = 13,878) as compared to the corresponding period in 2019 (n = 54,213). The reduction in the number of hospitalizations, cardiac surgeries, and catheterization procedures was 66.8%, 73.0%, and 74.3%, respectively. The reduction in hospitalization was relatively less pronounced among neonates as compared to infants/children (47.6% vs. 70.1% reduction) and for emergency surgeries as compared to elective indications (27.8% vs. 79.2%). The overall in-hospital mortality was higher in 2020 (8.1%) as compared to 2019 (4.8%), with a higher postoperative mortality (9.1% vs. 4.3%).

Conclusions: The current COVID-19 pandemic significantly impacted the delivery of pediatric cardiac care across India with two-third reduction in hospitalizations and cardiac surgeries. In an already resource-constrained environment, the impact of such a massive reduction in the number of surgeries could be significant over the coming years. These findings may prove useful in formulating strategy to manage subsequent waves of ongoing COVID-19 pandemic.

Keywords: Congenital heart disease; grown up with congenital heart disease; low- and middle-income countries; severe acute respiratory syndrome and cardiac surgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Location of participating pediatric cardiac centres across India
Figure 2
Figure 2
(a) Changes in outpatient numbers in 2020 as compared to 2019 (b) Changes in various parameters in 2020 as compared to 2019
Figure 3
Figure 3
(a) Monthly trends in total hospitalizations compared to new COVID-19 cases in India (b) Monthly trends in cardiac surgeries compared to cumulative COVID-19 cases in India (c) Monthly trends in outpatient visits compared to stringency of lockdown index in India
Figure 4
Figure 4
Decrease in hospitalizations in 2020 over the study period across various parts of India
See this image and copyright information in PMC

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