Covid lockdowns ‘increased collateral damage to those with cardiac disease’

Covid lockdowns increased collateral damage to those with cardiovascular diseases, according to a consultant cardiologist at Royal Brompton and Harefield Hospitals who contributed to a new review.

According to Professor Thomas F. Lüscher, a consultant cardiologist and director of research, education and development at Royal Brompton and Harefield Hospitals, the review demonstrated that the COVID-19 pandemic witnessed a substantial global decline in hospitalisations with acute cardiovascular disease, fewer diagnostic and interventional procedures and fewer outpatient and community consultations.” Thomas Luscher portrait

"There is no free lunch. Any measure against the Covid-19 pandemic has unexpected and unwanted effects. We reduced infection rates with the lockdowns but increased collateral damage to those with cardiac disease; people suffering untreated heart attacks dying at home, fatal arrhythmias being untreated and heart failure without proper management.”

In the University of Leeds-led review, the researchers analysed data from 189 separate research papers looking at the impact of Covid-19 on cardiovascular services from 49 countries on six continents and covering a two-year period from December 2019.      

‘The collateral damage of COVID-19 to cardiovascular services: a meta-analysis’, published today in the European Heart Journal, found that there was a disparity in the severity of collateral cardiovascular damage across geographic and economic boundaries.

Across low and middle-income countries and countries outside of Europe and North America, they observed a more severe decline in hospitalisations and revascularisation for heart attacks with no or insufficient treatment and elevated in-hospital mortality for patients with heart attacks and those with heart failure. 

“The lessons from this review are that healthcare systems have to be prepared for surprising increases in acutely ill patients, which occur during a pandemic, to avoid future collateral damage to those suffering from other acute and chronic conditions. Members of the public must be aware that staying at home with chest pain or acute breathlessness increases the risk of death and is not a good idea, even during a pandemic and lockdowns,” Professor Lüscher added.

Dr Ramesh Nadarajah, a British Heart Foundation Clinical Research Fellow at the University of Leeds and lead author of the paper, said: “Heart disease is the number one killer in most countries – and the analysis shows that during the pandemic, people across the world did not receive the cardiac care they should have received.  

“The longer people wait for treatment for a heart attack, the greater the damage to their heart muscle, causing complications that can be fatal or cause chronic ill health. Health systems need to be reinforced so they can support and treat people whose heart conditions will inevitably be worse because of the pandemic.”

Dr Sonya Babu-Narayan, Associate Medical Director of the British Heart Foundation said the study provides evidence that delays to cardiovascular care are costing lives and causing avoidable heart damage.