Michalis Katsoulis PhD Immediate PostDoctoral BHF fellow Institute of Health Informatics Senior Research Fellow, UCL

COVID-19: Fewer Emergency Room Visits, More Cardiac Deaths

MedicalResearch.com Interview with:

Michalis Katsoulis PhD Immediate PostDoctoral BHF fellow Institute of Health Informatics Senior Research Fellow, UCL

Dr. Katsoulis

Michalis Katsoulis PhD
Immediate PostDoctoral BHF fellow
Institute of Health Informatics
Senior Research Fellow, UCL

MedicalResearch.com: What is the background for this study?

Response: In the early stage of the pandemic, we observed a decline in patient visits to Emergency Departments (ED), including those for cardiac diseases. This decline may have been due to fear of coronavirus infection when attending hospital, public reluctance to overload National Health Service facilities, or difficulty accessing care.

In our study, we tried to estimate the impact of reduced ED visits on cardiac mortality in England. We used data from ED visits from the Public Health England Emergency Department Syndromic Surveillance System (EDSSS). For cardiovascular disease outcomes, we obtained mortality counts for cardiac disease from the Office of National Statistics (ONS) for England.

MedicalResearch.com: What are the main findings? 

Response: During the initial COVID-19 pandemic period (3/12/20-4/15/20), we observed a decline of 2750 ED visits per week for suspected cardiac disease (~35% decrease compared to the average weekly admission before the pandemic this year). When assuming a lag period of 18 days between non-presentation and the associated mortality, we estimated that for every 12 people with symptoms of heart disease, who didn’t visit the emergency departments, one of them died. We estimated that up to 232 cardiac deaths per week could have been prevented or delayed, had patients with heart disease symptoms attended hospital.

However, there is some uncertainty regarding these estimates, due to the nature of the data and the method’s assumptions.  

MedicalResearch.com: What should readers take away from your report?

Response: The key message from our research is that patients who suffer with symptoms of heart disease, including sudden onset chest pain or tightness, should seek urgent medical attention in the usual way.    

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In many countries, we observed a decline in ED visits, especially for cardiovascular diseases; in some of them (like England) only in the early stage of the pandemic, while in others for a more prolonged period. More studies should be conducted to better understand the ways in which the pandemic affected hospital attendance and to estimate the effect of reduced attendance to EDs on overall, as well as cause-specific mortality.   

MedicalResearch.com: Is there anything else you would like to add?

Response: These findings should alert policymakers to the importance of ensuring that any measures introduced to control COVID19 infection do not adversely affect the management of heart disease and other non-COVID illnesses.


Estimating the effect of reduced attendance at emergency departments for suspected cardiac conditions on cardiac mortality during the COVID-19 pandemic

irculation: Cardiovascular Quality and Outcomes. ;0
Michail Katsoulis et al

Video discussing this work: https://www.youtube.com/watch?v=sN___9SIB2Q

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Last Updated on December 22, 2020 by Marie Benz MD FAAD