The impact of the COVID-19 pandemic on delayed care of CVD in Europe: a systematic review

AIM: Cardiovascular diseases are the leading cause of death worldwide and the COVID-19 pandemic has disrupted healthcare systems, causing delays in essential medical services, including cardiovascular (CV) care. This study aims to estimate the impact of the COVID-19 pandemic on delayed cardiovascular (CV) care in Europe by providing a systematic overview of the available evidence. METHODS AND RESULTS: PubMed, Embase, and Web of Science were searched until mid-September 2022. This review included 132 studies. Outcomes of interest were changes in hospital admission, mortality, delays in seeking medical help, delays in treatment initiation, and changes in the number of treatment procedures. Results were presented in five disease groups: Ischemic Heart Disease (IHD), cerebrovascular diseases, Cardiac Arrests (CA), Heart Failure (HF), and others. There was a significant decrease in hospital admissions for IHD, cerebrovascular diseases, and HF, and a significant increase in CA. Mortality rates were higher for IHD and cerebrovascular diseases. Urgent and elective cardiac procedures’ rates also decreased during the pandemic. CONCLUSIONS: The review's limitations include its exclusive focus on European countries, which may not generalize to other regions due to differences in containment and tracing measures. The reviewed studies did not always report consistent outcomes and were primarily conducted during or just after the first wave of the pandemic, limiting our understanding of the long-term impact. Policymakers and healthcare systems should allocate adequate resources, provide clear guidelines for accessing medical care, reduce delays in seeking medical attention, and promote healthy lifestyles to prepare for future pandemics. Future reviews should consider the longer-term impact of pandemics on delayed CV care and evaluate the long-term health and health-economic impact of the COVID-19 pandemic on delayed CV care. KEY MESSAGES: • The pandemic has reduced hospital admissions and caused delays in seeking medical attention, while increasing mortality rates for some cardiovascular diseases in Europe. • Prepare for pandemics: allocate resources, set guidelines for care, reduce delays, promote health, and evaluate impacts on cardiovascular care.