Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions
Authors: Czerny Martin , Gottardi Roman , Puiu Paul , Bernecker Oliver Y , Citro Rodolfo , Della Corte Alessandro , di Marco Luca , Fink Martina , Gosslau Yvonne , Haldenwang Peter Lukas , Heijmen Robin H , Hugas-Mallorqui Maria , Iesu Severino , Jacobsen Oyvind , Jassar Arminder S , Juraszek Andrzej , Kolowca Maciej , Lepidi Sandro , Marrocco-Trischitta Massimiliano M , Matsuda Hitoshi , Meisenbacher Katrin , Micari Antonio , Minatoya Kenji , Park Kay-Hyun , Peterss Sven , Petrich Michael , Piffaretti Gabriele , Probst Chris , Reutersberg Benedikt , Rosati Fabrizio , Schachner Bruno , Schachner Thomas , Sorokin Vitaly A , Szeberin Zoltan , Szopinski Piotr , Di Tommaso Luigi , Trimarchi Santi , Verhoeven Eric L G , Vogt Ferdinand , Voetsch Andreas , Walter Tim , Weiss Gabriel , Yuan Xun , Benedetto Filippo , De Bellis Antonio , D´ Oria Mario , Discher Philipp , Zierer Andreas , Rylski Bartosz , van den Berg Jos C , Wyss Thomas R , Bossone Eduardo , Schmidli Jürg , Nienaber Christoph ,   Collaborators:, Accarino Giulio , Baldascino Francesco , Böckler Dittmar , Corazzari Claudio , D´ Alessio Ilenia , de Beaufort Hector , De Troia Christopher , Dumfarth Julia , Galbiati Denise , Gorgatti Filippo , Hagl Christian , Hamiko Marwan , Huber Florian , Hyhlik-Duerr Alexander , Ianelli Gabriele , Iesu Ivana , Jung Joon-Chui , Kainz Frieda-Maria , Katsargyris Athanasios , Koter Stephan , Kusmierczyk Mariusz , Kolsut Piotr , Lengyel Balazs , Lomazzi Chiara , Muneretto Claudio , Nava Giovanni , Nolte Thomas , Pacini Davide , Pleban Eliza , Rychla Miriam , Sakamoto Kazuhisa , Shijo Takayuki , Yokawa Koki , Siepe Matthias , Sirch Joachim , Strauch Justus , Sule Jai Ajitchandra , Tobler Eva-Luca , Walter Corinna , Weigang Ernst 
Published: November 2020

Abstract

OBJECTIVES
To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute and elective thoracic and abdominal aortic procedures.

METHODS
Forty departments shared their data on acute and elective thoracic and abdominal aortic procedures between January and May 2020 and January and May 2019 in Europe, Asia and the USA. Admission rates as well as delay from onset of symptoms to referral were compared.

RESULTS
No differences in the number of acute thoracic and abdominal aortic procedures were observed between 2020 and the reference period in 2019 [incidence rates ratio (IRR): 0.96, confidence interval (CI) 0.89–1.04; P = 0.39]. Also, no difference in the time interval from acute onset of symptoms to referral was recorded (&lt;12 h 32% vs &gt; 12 h 68% in 2020, &lt; 12 h 34% vs &gt; 12 h 66% in 2019 P = 0.29). Conversely, a decline of 35% in elective procedures was seen (IRR: 0.81, CI 0.76–0.87; P &lt; 0.001) with substantial differences between countries and the most pronounced decline in Italy (−40%, P &lt; 0.001). Interestingly, in Switzerland, an increase in the number of elective cases was observed (+35%, P = 0.02).

CONCLUSIONS
There was no change in the number of acute thoracic and abdominal aortic cases and procedures during the initial wave of the COVID-19 pandemic, whereas the case load of elective operations and procedures decreased significantly. Patients with acute aortic syndromes presented despite COVID-19 and were managed according to current guidelines. Further analysis is required to prove that deferral of elective cases had no impact on premature mortality.