To the Editor,
The coronavirus disease 2019 (COVID-19) pandemic is having a considerable impact on patients with various co-morbidities, including cardiovascular disease [1]. Huet et al. [2] found that the number of patients admitted to intensive cardiac care units decreased considerably following the initiation of “containment”; their finding is straightforward, despite the lack of detailed supportive data to explain the causality.
Although there may be various hypotheses to explain this finding, one possible reason might be that patients hesitated to seek medical help until haemodynamic deterioration, given the COVID-19 pandemic. For the next surveillance, I would like to propose collecting additional data associated with in-hospital mortality and disease severity (e.g. B-type natriuretic peptide for heart failure and maximum creatinine kinase for myocardial infarction), both of which might be worsened.
Many patients with fatal cardiovascular disease might be unable to be admitted to hospital, and consequently die elsewhere. The number of out-of-hospital deaths is another valuable piece of data that could be collected; this number may be raised as a result of cardiovascular disease-related deaths.
Disclosure of interest
The author declares that he has no competing interest.
References
- 1.Driggin E., Madhavan M.V., Bikdeli B., et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic. J Am Coll Cardiol. 2020 doi: 10.1016/j.jacc.2020.03.031. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Huet F., Prieur C., Schurtz G., et al. One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic. Arch Cardiovasc Dis. 2020 doi: 10.1016/j.acvd.2020.04.002. [DOI] [PMC free article] [PubMed] [Google Scholar]