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One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic

Identifieur interne : 000434 ( Hal/Corpus ); précédent : 000433; suivant : 000435

One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic

Auteurs : Fabien Huet ; Cyril Prieur ; Guillaume Schurtz ; Édouard Gerbaud ; Stéphane Manzo-Silberman ; Gérald Vanzetto ; Meyer Elbaz ; Victoria Tea ; Grégoire Mercier ; Benoit Lattuca ; Claire Duflos ; François Roubille

Source :

RBID : Hal:hal-02563201

Descripteurs français

English descriptors

Abstract

Coronavirus disease 2019 (COVID-19) is likely to have significant implications for the cardiovascular care of patients. In most countries, containment has already started (on 17 March 2020 in France), and self-quarantine and social distancing are reducing viral contamination and saving lives. However, these considerations may only be the tip of the iceberg; most resources are dedicated to the struggle against COVID-19, and this unprecedented situation may compromise the management of patients admitted with cardiovascular conditions.AIM:We aimed to assess the effect of COVID-19 containment measures on cardiovascular admissions in France.METHODS:We asked nine major cardiology centres to give us an overview of admissions to their nine intensive cardiac care units for acute myocardial infarction or acute heart failure, before and after containment measures.RESULTS:Before containment (02-16 March 2020), the nine participating intensive cardiac care units admitted 4.8±1.6 patients per day, versus 2.6±1.5 after containment (17-22 March 2020) (rank-sum test P=0.0006).CONCLUSIONS:We confirm here, for the first time, a dramatic drop in the number of cardiovascular admissions after the establishment of containment. Many hypotheses might explain this phenomenon, but we feel it is time raise the alarm about the risk for patients presenting with acute cardiovascular disease, who may suffer from lack of attention, leading to severe consequences (an increase in the number of ambulatory myocardial infarctions, mechanical complications of myocardial infarction leading to an increase in the number of cardiac arrests, unexplained deaths, heart failure, etc.). Similar consequences can be feared for all acute situations, beyond the cardiovascular disease setting.


Url:
DOI: 10.1016/j.acvd.2020.04.002

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Hal:hal-02563201

Le document en format XML

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<idno type="DOI">10.1016/j.acvd.2020.04.002</idno>
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<title level="j">Archives of cardiovascular diseases</title>
<idno type="ISSN">1875-2136</idno>
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<date type="datePub">2020-04-28</date>
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<keywords scheme="mix" xml:lang="en">
<term>Acute cardiac care</term>
<term>Acute coronary syndrome</term>
<term>COVID-19</term>
<term>Heart failure</term>
<term>Intensive care unit</term>
</keywords>
<keywords scheme="mix" xml:lang="fr">
<term>Insuffisance cardiaque</term>
<term>Soins cardiaques aigus</term>
<term>Syndrome coronarien aigu</term>
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<p>Coronavirus disease 2019 (COVID-19) is likely to have significant implications for the cardiovascular care of patients. In most countries, containment has already started (on 17 March 2020 in France), and self-quarantine and social distancing are reducing viral contamination and saving lives. However, these considerations may only be the tip of the iceberg; most resources are dedicated to the struggle against COVID-19, and this unprecedented situation may compromise the management of patients admitted with cardiovascular conditions.AIM:We aimed to assess the effect of COVID-19 containment measures on cardiovascular admissions in France.METHODS:We asked nine major cardiology centres to give us an overview of admissions to their nine intensive cardiac care units for acute myocardial infarction or acute heart failure, before and after containment measures.RESULTS:Before containment (02-16 March 2020), the nine participating intensive cardiac care units admitted 4.8±1.6 patients per day, versus 2.6±1.5 after containment (17-22 March 2020) (rank-sum test P=0.0006).CONCLUSIONS:We confirm here, for the first time, a dramatic drop in the number of cardiovascular admissions after the establishment of containment. Many hypotheses might explain this phenomenon, but we feel it is time raise the alarm about the risk for patients presenting with acute cardiovascular disease, who may suffer from lack of attention, leading to severe consequences (an increase in the number of ambulatory myocardial infarctions, mechanical complications of myocardial infarction leading to an increase in the number of cardiac arrests, unexplained deaths, heart failure, etc.). Similar consequences can be feared for all acute situations, beyond the cardiovascular disease setting.</p>
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<hal api="V3">
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<title xml:lang="en">One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic</title>
<title xml:lang="fr">Un train peut en cacher un autre: les urgences cardiovasculaires pourraient être négligées en raison de la pandémie à COVID-19</title>
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<persName>
<forename type="first">Fabien</forename>
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<forename type="first">Guillaume</forename>
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<forename type="first">Benoit</forename>
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<forename type="first">François</forename>
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<forename>Dominique</forename>
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<date type="whenModified">2020-05-15 12:22:09</date>
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<date type="whenProduced">2020-04-28</date>
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<idno type="stamp" n="UNIV-GRENOBLE1" corresp="UGA">Université Joseph Fourier - Grenoble I</idno>
<idno type="stamp" n="UNIV-TLSE3">Université Paul Sabatier - Toulouse III</idno>
<idno type="stamp" n="HCL">Hospices Civils de Lyon</idno>
<idno type="stamp" n="APHP" corresp="INSERM">AP-HP</idno>
<idno type="stamp" n="DSP">Droit et Science Politique</idno>
<idno type="stamp" n="UNIV-MONTPELLIER">Université de Montpellier</idno>
<idno type="stamp" n="CEPEL">Centre d'Etudes Politiques de l'Europe Latine</idno>
<idno type="stamp" n="CHU-UNIV-PARIS5">Les centres hospitaliers de Paris Descartes</idno>
<idno type="stamp" n="UGA">HAL Grenoble Alpes</idno>
<idno type="stamp" n="CNRS">CNRS - Centre national de la recherche scientifique</idno>
<idno type="stamp" n="BS">Biologie-Santé</idno>
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<title xml:lang="en">One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic</title>
<title xml:lang="fr">Un train peut en cacher un autre: les urgences cardiovasculaires pourraient être négligées en raison de la pandémie à COVID-19</title>
<author role="aut">
<persName>
<forename type="first">Fabien</forename>
<surname>Huet</surname>
</persName>
<idno type="halauthorid">11198089</idno>
<affiliation ref="#struct-258773"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Cyril</forename>
<surname>Prieur</surname>
</persName>
<idno type="halauthorid">11231806</idno>
<affiliation ref="#struct-301764"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Guillaume</forename>
<surname>Schurtz</surname>
</persName>
<idno type="halauthorid">11238314</idno>
<affiliation ref="#struct-569210"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Édouard</forename>
<surname>Gerbaud</surname>
</persName>
<idno type="halauthorid">475752</idno>
<affiliation ref="#struct-301071"></affiliation>
<affiliation ref="#struct-139744"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Stéphane</forename>
<surname>Manzo-Silberman</surname>
</persName>
<idno type="halauthorid">11171989</idno>
<affiliation ref="#struct-300128"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Gérald</forename>
<surname>Vanzetto</surname>
</persName>
<idno type="halauthorid">554661</idno>
<affiliation ref="#struct-51369"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Meyer</forename>
<surname>Elbaz</surname>
</persName>
<idno type="halauthorid">425186</idno>
<affiliation ref="#struct-101902"></affiliation>
<affiliation ref="#struct-300791"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Victoria</forename>
<surname>Tea</surname>
</persName>
<idno type="halauthorid">11816256</idno>
<affiliation ref="#struct-300119"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Grégoire</forename>
<surname>Mercier</surname>
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<email type="md5">26731ad3a5efcf9fc0074b2b6436f526</email>
<email type="domain">telecom-bretagne.eu</email>
<ptr type="url" target="http://perso.telecom-bretagne.eu/~mercierg"></ptr>
<idno type="halauthorid">729456</idno>
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<author role="aut">
<persName>
<forename type="first">Benoit</forename>
<surname>Lattuca</surname>
</persName>
<idno type="halauthorid">1499354</idno>
<affiliation ref="#struct-258773"></affiliation>
</author>
<author role="aut">
<persName>
<forename type="first">Claire</forename>
<surname>Duflos</surname>
</persName>
<idno type="halauthorid">11207527</idno>
<affiliation ref="#struct-193568"></affiliation>
</author>
<author role="crp">
<persName>
<forename type="first">François</forename>
<surname>Roubille</surname>
</persName>
<email type="md5">b0111e27ff9f7b03fbcadd7348af26ff</email>
<email type="domain">gmail.com</email>
<idno type="idhal" notation="string">francois-roubille</idno>
<idno type="idhal" notation="numeric">183497</idno>
<idno type="halauthorid">348957</idno>
<idno type="ORCID">https://orcid.org/0000-0002-5288-9687</idno>
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<affiliation ref="#struct-258773"></affiliation>
</author>
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<monogr>
<idno type="halJournalId" status="VALID">60015</idno>
<idno type="issn">1875-2136</idno>
<title level="j">Archives of cardiovascular diseases</title>
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<publisher>Elsevier/French Society of Cardiology</publisher>
<biblScope unit="pp">S1875-2136(20)30099-1</biblScope>
<date type="datePub">2020-04-28</date>
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</monogr>
<idno type="doi">10.1016/j.acvd.2020.04.002</idno>
<idno type="pubmed">32362433</idno>
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<language ident="en">English</language>
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<keywords scheme="author">
<term xml:lang="en">Acute cardiac care</term>
<term xml:lang="en">Acute coronary syndrome</term>
<term xml:lang="en">COVID-19</term>
<term xml:lang="en">Heart failure</term>
<term xml:lang="en">Intensive care unit</term>
<term xml:lang="fr">Insuffisance cardiaque</term>
<term xml:lang="fr">Soins cardiaques aigus</term>
<term xml:lang="fr">Unité de soins intensifs</term>
<term xml:lang="fr">Syndrome coronarien aigu</term>
</keywords>
<classCode scheme="halDomain" n="sdv">Life Sciences [q-bio]</classCode>
<classCode scheme="halTypology" n="ART">Journal articles</classCode>
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<abstract xml:lang="en">
<p>Coronavirus disease 2019 (COVID-19) is likely to have significant implications for the cardiovascular care of patients. In most countries, containment has already started (on 17 March 2020 in France), and self-quarantine and social distancing are reducing viral contamination and saving lives. However, these considerations may only be the tip of the iceberg; most resources are dedicated to the struggle against COVID-19, and this unprecedented situation may compromise the management of patients admitted with cardiovascular conditions.AIM:We aimed to assess the effect of COVID-19 containment measures on cardiovascular admissions in France.METHODS:We asked nine major cardiology centres to give us an overview of admissions to their nine intensive cardiac care units for acute myocardial infarction or acute heart failure, before and after containment measures.RESULTS:Before containment (02-16 March 2020), the nine participating intensive cardiac care units admitted 4.8±1.6 patients per day, versus 2.6±1.5 after containment (17-22 March 2020) (rank-sum test P=0.0006).CONCLUSIONS:We confirm here, for the first time, a dramatic drop in the number of cardiovascular admissions after the establishment of containment. Many hypotheses might explain this phenomenon, but we feel it is time raise the alarm about the risk for patients presenting with acute cardiovascular disease, who may suffer from lack of attention, leading to severe consequences (an increase in the number of ambulatory myocardial infarctions, mechanical complications of myocardial infarction leading to an increase in the number of cardiac arrests, unexplained deaths, heart failure, etc.). Similar consequences can be feared for all acute situations, beyond the cardiovascular disease setting.</p>
</abstract>
<abstract xml:lang="fr">
<p>ContexteLa maladie du coronavirus 2019 (COVID-19) a des implications importantes concernant la prise en charge des problèmes cardiovasculaires. Dans la plupart des pays, le confinement a déjà commencé (en France le 17 mars) et l’isolement, la distanciation sociale, réduisent la contamination virale et sauvent des vies. Ces considérations ne pourraient être cependant que la partie émergée de l’iceberg. Parce que la plupart des ressources sont consacrées à la lutte contre le COVID-19, cette situation sans précédent pourrait compromettre la prise en charge des patients admis pour des problèmes cardiovasculaires.ObjectifNotre objectif était d’évaluer l’impact des mesures de confinement du COVID-19 sur les admissions cardiovasculaires en France.MéthodesNous avons demandé à plusieurs grands centres de cardiologie de nous donner un aperçu de leurs admissions en USIC pour infarctus aigu du myocarde ou insuffisance cardiaque aiguë.RésultatsAvant le confinement (du 02 au 16 mars), les neuf USIC participantes ont admis 4,6 ± 1,6 patients par jour, contre 2,6 ± 1,5 après le confinement (du 17 au 22 mars) (P = 0,0006).ConclusionsNous confirmons ici pour la première fois une baisse spectaculaire du nombre d’admissions après la mise en place du confinement. De nombreuses hypothèses pourraient expliquer ce phénomène, mais nous pensons qu’il est temps d’alerter sur le risque pour les patients présentant une maladie cardiovasculaire aiguë, de souffrir du manque d’attention, entraînant des conséquences graves (augmentation du nombre d’infarctus du myocarde ambulatoires, conduisant à une augmentation du nombre d’arrêts cardiaques, décès inexpliqués, insuffisance cardiaque, etc.). Des conséquences similaires pourraient être craintes pour toutes les situations aiguës en dehors des maladies cardiovasculaires.</p>
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