Abstract | Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on the implantation rates and types of Cardiac Implantable Electronic Devices (CIEDs) in the elderly population in Coburg. Compared was the year before the SARS-CoV-2 outbreak with the first COVID-19 pandemic year. Moreover, we will compare various variables of CIED patients before and during the COVID-19 pandemic to deduce further consequences of the ongoing pandemic.
Materials and methods: A retrospective observational study was conducted at the department of cardiology of the hospital Coburg, Germany. Included were patients being 70 years of age or older with de novo implantation of a CIED and divided into 2 groups according to two time spans. A total of 328 patients were included. The control group A contains collected data from 170 patients of the pre COVID-19 year March 1st 2019 – February 28th 2020 whereas the experimental group B includes 158 implantations during the first corona pandemic year from March 1st 2020 until February 28th 2021. Following variables were included and compared between the groups: age, gender, type of CIED, Body-Mass-Index (BMI), length of hospital stay and laboratory parameters Troponin T, n-terminal prohormone of brain natriuretic peptide (NT-proBNP) and C- reactive protein (CRP).
Results: A reduction of 7.1% in total CIED implantations could be observed between the year before the SARS-CoV-2 outbreak and the first pandemic year. Reduced Cardiac Resynchronization Therapy (CRT) (-33.33%), Implantable Cardioverter-Defibrillator (ICD) (-23.08%) and Loop recorder (-19.05%) implantations were performed whereas more pacemaker implantations (+1.74%) were performed during the first pandemic year. However, no statistically significant difference between the cardiac device implantations could be detected (P=0.616). The median age in group A was 79 years (IQR=76, 83) and 81 years (IQR=75, 84) in group B. No statistical difference could be deducted using the Mann-Whitney U test (P=0.208). There was no significant difference in recording parameters Troponin T, NT-proBNP and CRP (P=0.401, P=0.633, P=0.611 respectively) between the two groups at hospital admission. The median hospital stays were 8 (IQR=5, 13) and 9 (IQR=6, 13) days for group A and B respectively and did not reach statistical significance (P=0.845). No significant change in BMI (P=0.956) could be detected between the groups (A:28.1 kg/m2 vs. B:28.3 kg/m2).
Conclusion: The ongoing COVID-19 pandemic had no statistically significant effect on CIED implantations in the elderly population in Coburg during the first year. |
Abstract (croatian) | Ciljevi: Cilj ove studije bio je utvrditi utjecaj pandemije COVID-19 na stope implantacije i vrste cardiac implantable electronic devices (CIEDs) u Coburgu. U usporedbi s godinom prije izbijanja SARS-CoV-2 s prvom godinom pandemije COVID-19. Štoviše, usporedit ćemo različite varijable pacijenata s CIED-om prije i tijekom pandemije COVID-19 kako bismo zaključili daljnje posljedice pandemije koja je u tijeku.
Materijali i metode: Retrospektivna opservacijska studija provedena je na kardiološkom odjelu bolnice u Coburgu u Njemačkoj. Uključeni su pacijenti u dobi od 70 godina ili stariji s de novo implantacijom CIED-a i podijeljeni u 2 skupine prema dva vremenska raspona. Uključeno je ukupno 328 bolesnika. Kontrolna skupina A sadrži prikupljene podatke od 170 pacijenata iz godine prije COVID-19 1. ožujka 2019 – 28. veljače 2020, dok eksperimentalna skupina B uključuje 158 implantacija tijekom prve godine pandemije korone od 1. ožujka 2020 do 28. veljače 2021. Sljedeće varijable bile su uključeni i uspoređeni između skupina: dob, spol, tip CIED-a, Body-Mass-Index (BMI), duljina boravka u bolnici i laboratorijski parametri Troponin T, n-terminal prohormone of brain natriuretic peptide (NT-proBNP) i C-reactive protein (CRP).
Rezultati: Smanjenje od 7,1% ukupnih implantacija CIED-a moglo se primijetiti između godine prije izbijanja SARS-CoV-2 i prve godine pandemije. Smanjena Cardiac Resynchronization Therapy (CRT) (-33,33%), Implantable Cardioverter-Defibrillator (ICD) (-23,08%) and Loop recorder (-19,05%) ugradnje su učinjene dok je u prvoj godini pandemije učinjeno više ugradnji pacemakera (+1,74%). Međutim, nije se mogla otkriti nikakva statistički značajna razlika između implantata srčanog uređaja (P=0,616). Medijan dobi u skupini A bio je 79 godina (IQR=76, 83) i 81 godina (IQR=75, 84) u skupini B. Pomoću Mann-Whitneyevog U testa (P=0,208) nije se mogla odbiti statistička razlika. Nije bilo značajne razlike u bilježenju parametara Troponin T, NT-proBNP i CRP (P=0,401, P=0,633, P=0,611 respektivno) između dvije skupine pri prijemu u bolnicu. Medijan boravka u bolnici iznosio je 8 (IQR=5, 13) odnosno 9 (IQR=6, 13) dana za skupinu A i B i nije postigao statističku značajnost (P=0,845). Nije bilo značajne promjene u BMI (P=0,956) između skupina (A:28,1 kg/m2 u odnosu na B:28,3 kg/m2).
Zaključci: Pandemija COVID-19 koja je u tijeku nije imala statistički značajan učinak na implantacije CIED-a kod starije populacije u Coburgu tijekom prve godine. |