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Multicenter Study
. 2023;30(3):344-352.
doi: 10.5603/CJ.a2023.0002. Epub 2023 Jan 18.

Comparison of reorganized versus unaltered cardiology departments during the COVID-19 era: A subanalysis of the COV-HF-SIRIO 6 study

Małgorzata Ostrowska  1 , Michał Kasprzak  2 , Wioleta Stolarek  2 , Klaudyna Grzelakowska  2 , Jacek Kryś  2 , Aldona Kubica  2 , Piotr Adamski  2 , Przemysław Podhajski  2 , Eliano Pio Navarese  2 , Edyta Anielska-Michalak  3 , Oliwia Matuszewska-Brycht  4 , Andrzej Curzytek  5 , Aneta Dudek  6 , Leszek Gromadziński  7 , Paweł Grzelakowski  8 , Leszek Kamiński  9 , Andrzej Kleinrok  10 , Marcin Kostkiewicz  11 , Marek Koziński  12 , Paweł Król  13 , Tomasz Kulawik  14 , Gleb Minczew  15 , Marcin Mindykowski  16 , Agnieszka Pawlak  17   18 , Janusz Prokopczuk  19 , Grzegorz Skonieczny  20 , Bożena Sobkowicz  21 , Sergiusz Sowiński  22 , Sebastian Stankala  23 , Paweł Szymański  24 , Andrzej Wester  25   26 , Przemysław Wilczewski  27 , Stanisław Bartuś  28 , Andrzej Budaj  29 , Robert Gajda  30   31 , Mariusz Gąsior  32 , Marcin Gruchała  33 , Jarosław Drożdż  4 , Miłosz Jaguszewski  33 , Piotr Jankowski  34 , Jacek Legutko  35 , Maciej Lesiak  36 , Przemysław Leszek  37 , Przemysław Mitkowski  36 , Jadwiga Nessler  38 , Anna Tomaszuk-Kazberuk  21 , Agnieszka Tycińska  21 , Tomasz Zdrojewski  39 , Jarosław Kaźmierczak  40 , Jacek Kubica  2
Affiliations
Multicenter Study

Comparison of reorganized versus unaltered cardiology departments during the COVID-19 era: A subanalysis of the COV-HF-SIRIO 6 study

Małgorzata Ostrowska et al. Cardiol J. 2023.

Abstract

Background: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, numerous cardiology departments were reorganized to provide care for COVID-19 patients. We aimed to compare the impact of the COVID-19 pandemic on hospital admissions and in-hospital mortality in reorganized vs. unaltered cardiology departments.

Methods: The present research is a subanalysis of a multicenter retrospective COV-HF-SIRIO 6 study that includes all patients (n = 101,433) hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, with a focus on patients with acute heart failure (AHF).

Results: Reduction of all-cause hospitalizations was 50.6% vs. 21.3% for reorganized vs. unaltered cardiology departments in 2020 vs. 2019, respectively (p < 0.0001). Considering AHF alone respective reductions by 46.5% and 15.2% were registered (p < 0.0001). A higher percentage of patients was brought in by ambulance to reorganized vs. unaltered cardiology departments (51.7% vs. 34.6%; p < 0.0001) alongside with a lower rate of self-referrals (45.7% vs. 58.4%; p < 0.0001). The rate of all-cause in-hospital mortality in AHF patients was higher in reorganized than unaltered cardiology departments (10.9% vs. 6.4%; p < 0.0001). After the exclusion of patients with concomitant COVID-19, the mortality rates did not differ significantly (6.9% vs. 6.4%; p = 0.55).

Conclusions: A greater reduction in hospital admissions in 2020 vs. 2019, higher rates of patients brought by ambulance together with lower rates of self-referrals and higher all-cause in-hospital mortality for AHF due to COVID-19 related deaths were observed in cardiology departments reorganized to provide care for COVID-19 patients vs. unaltered ones.

Keywords: COVID-19; acute heart failure; hospital admission; in-hospital mortality.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Reduction of all-cause hospitalizations during the COVID-19 pandemic in 2020 vs. 2019; *p < 0.05 for the comparison 2020 vs. 2019 in reorganized cardiology departments; #p < 0.05 for the comparison 2020 vs. 2019 in unaltered cardiology departments; &p < 0.05 for the comparison reorganized vs. unaltered cardiology departments in 2020.
Figure 2
Figure 2
Reduction of acute heart failure hospitalizations during the COVID-19 pandemic in 2020 vs. 2019; *p < 0.05 for the comparison 2020 vs. 2019 in reorganized cardiology departments; #p < 0.05 for the comparison 2020 vs. 2019 in unaltered cardiology departments; &p < 0.05 for the comparison reorganized vs. unaltered cardiology departments in 2020.
Figure 3
Figure 3
Modes of hospital admissions in reorganized vs. unaltered cardiology departments during the COVID-19 pandemic; *p < 0.05 for the comparison of self-referred patients in reorganized vs. unaltered cardiology departments; #p < 0.05 for the comparison of patients brought in by ambulance in reorganized vs. unaltered cardiology departments.
See this image and copyright information in PMC

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