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Carolina Alba
Dr. Carolina Alba, a scientist at the Toronto General Hospital Research Institute and a cardiologist at the Peter Munk Cardiac Centre, says, “while it is still too early to predict whether the COVID-19 pandemic has caused collateral damage to the care received for chronic conditions, our findings are a call to action.” (Photo: Toronto General & Western Hospital Foundation)

A study led by Dr. Carolina Alba at the Toronto General Hospital found Emergency Department (ED) admissions and hospitalizations for heart failure have dropped by about 40 per cent during the pandemic.

The COVID-19 pandemic has resulted in drastic changes to the healthcare system.

"Our findings provide an early glimpse into the impacts of the pandemic on the care of those with heart failure," says Dr. Alba, a scientist at Toronto General Hospital Research Institute and a cardiologist at the Peter Munk Cardiac Centre.

For the study, the research team looked at the number of patients presenting to hospital for worsening heart failure symptoms between March 1 and April 19. These dates capture the public lockdown in Ontario, which began on March 12.

By comparing data before and after the lockdown began, the team found an average decrease of 43.5 per cent in ED visits and a decrease of 39 per cent in hospitalizations for heart failure.

Despite the decrease, the study also revealed that rates of hospitalization or intensive care unit stays did not increase among patients presenting to the ED for heart failure during the pandemic.

According to the authors of the study, these observations are likely the result of complex public health and social factors. For example, patients may be more cautious about going to hospitals for fear of contracting COVID-19.

The effects could also be the result of "silver linings" from the pandemic and physical distancing. For example, stay-at-home directives may have enabled patients to better manage their conditions, eat healthier and receive care virtually, leading to less hospital visits.

"While we are not sure of the underlying causes and effects, reduced hospital visits pose a serious threat," Dr. Alba says. "Over time, these reductions may lead to deteriorating health in those with chronic conditions and other individuals with complex health issues."

This threat is supported by additional findings in the study, which suggest that early trends for in-hospital deaths are rising.

The results of this study add to the growing body of evidence from around the world – in particular from the United States – that show reduced hospitalization rates for these and other conditions, such as stroke.

"While it is still too early to predict whether the COVID-19 pandemic has caused collateral damage to the care received for chronic conditions, our findings are a call to action," says Dr. Alba. "As the situation evolves, there is a strong need to closely monitor chronic disease management and care during the pandemic.

"As well, more education is necessary so that the public knows that emergency care is still available for those who need help."

This work was supported by Toronto General & Western Hospital Foundation.

Read more about the study.

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