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Incidence of New-Onset and Worsening Heart Failure Before and After the COVID-19 Epidemic Lockdown in Denmark: A Nationwide Cohort Study

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@article{b2dda2f9e3244e3a902fe026d89f94f4,
title = "Incidence of New-Onset and Worsening Heart Failure Before and After the COVID-19 Epidemic Lockdown in Denmark: A Nationwide Cohort Study",
abstract = "BACKGROUND: The Danish government ordered a public lockdown on March 12, 2020, because of the coronavirus disease 2019 (COVID-19) pandemic. We investigated the immediate consequences of such a lockdown for patients with heart failure (HF).METHODS: Using the Danish nationwide administrative databases, we investigated the incidence of new-onset HF and hospitalizations for worsening HF before and after the lockdown (January 1 to March 11 versus March 12 to March 31) in 2020 versus 2019. We also investigated the mortality for all patients with HF and in COVID-19-infected patients with HF.RESULTS: Rates of new-onset HF between January 1 and March 11 were comparable for 2020 and 2019 (1.83 versus 1.78 per 10 000 person-years; P=0.19), while hospitalizations for worsening HF were slightly higher in 2020 versus 2019 (1.04 versus 0.93 per 1000 person-years; P=0.02). In the lockdown period, rates of new-onset HF diagnoses (1.26 versus 2.25 per 1000 person-years) and of hospitalizations for worsening HF (0.63 versus 0.99 per 1000 person-years) were significantly lower in 2020 versus 2019 (P for both, <0.0001). Mortality was similar before and after the national lockdown for the population with HF. We observed 90 HF patients with diagnosed COVID-19 infection, of whom 37{\%} (95{\%} CI, 23{\%}-50{\%}) died within 15 days.CONCLUSIONS: The number of patients hospitalized with worsening HF or diagnosed with new-onset HF was markedly reduced after lockdown but has not yet impacted mortality in HF patients at a population-based level. However, these data raise concerns for a potential undertreatment of HF currently that may impact prognosis in the longer term.",
keywords = "Betacoronavirus, Cohort Studies, Coronavirus Infections/epidemiology, Denmark/epidemiology, Female, Heart Failure/diagnosis, Hospitalization/statistics & numerical data, Humans, Incidence, Male, Middle Aged, Pandemics, Pneumonia, Viral/epidemiology, Risk Factors",
author = "Charlotte Andersson and Thomas Gerds and Emil Fosb{\o}l and Matthew Phelps and Julie Andersen and Morten Lamberts and Anders Holt and Butt, {Jawad H} and Christian Madelaire and Gunnar Gislason and Christian Torp-Pedersen and Lars K{\o}ber and Morten Schou",
year = "2020",
month = "6",
doi = "10.1161/CIRCHEARTFAILURE.120.007274",
language = "English",
volume = "13",
pages = "e007274",
journal = "Circulation. Heart failure",
issn = "1941-3289",
publisher = "Lippincott Williams & Wilkins",
number = "6",

}

RIS

TY - JOUR

T1 - Incidence of New-Onset and Worsening Heart Failure Before and After the COVID-19 Epidemic Lockdown in Denmark

T2 - A Nationwide Cohort Study

AU - Andersson, Charlotte

AU - Gerds, Thomas

AU - Fosbøl, Emil

AU - Phelps, Matthew

AU - Andersen, Julie

AU - Lamberts, Morten

AU - Holt, Anders

AU - Butt, Jawad H

AU - Madelaire, Christian

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - Schou, Morten

PY - 2020/6

Y1 - 2020/6

N2 - BACKGROUND: The Danish government ordered a public lockdown on March 12, 2020, because of the coronavirus disease 2019 (COVID-19) pandemic. We investigated the immediate consequences of such a lockdown for patients with heart failure (HF).METHODS: Using the Danish nationwide administrative databases, we investigated the incidence of new-onset HF and hospitalizations for worsening HF before and after the lockdown (January 1 to March 11 versus March 12 to March 31) in 2020 versus 2019. We also investigated the mortality for all patients with HF and in COVID-19-infected patients with HF.RESULTS: Rates of new-onset HF between January 1 and March 11 were comparable for 2020 and 2019 (1.83 versus 1.78 per 10 000 person-years; P=0.19), while hospitalizations for worsening HF were slightly higher in 2020 versus 2019 (1.04 versus 0.93 per 1000 person-years; P=0.02). In the lockdown period, rates of new-onset HF diagnoses (1.26 versus 2.25 per 1000 person-years) and of hospitalizations for worsening HF (0.63 versus 0.99 per 1000 person-years) were significantly lower in 2020 versus 2019 (P for both, <0.0001). Mortality was similar before and after the national lockdown for the population with HF. We observed 90 HF patients with diagnosed COVID-19 infection, of whom 37% (95% CI, 23%-50%) died within 15 days.CONCLUSIONS: The number of patients hospitalized with worsening HF or diagnosed with new-onset HF was markedly reduced after lockdown but has not yet impacted mortality in HF patients at a population-based level. However, these data raise concerns for a potential undertreatment of HF currently that may impact prognosis in the longer term.

AB - BACKGROUND: The Danish government ordered a public lockdown on March 12, 2020, because of the coronavirus disease 2019 (COVID-19) pandemic. We investigated the immediate consequences of such a lockdown for patients with heart failure (HF).METHODS: Using the Danish nationwide administrative databases, we investigated the incidence of new-onset HF and hospitalizations for worsening HF before and after the lockdown (January 1 to March 11 versus March 12 to March 31) in 2020 versus 2019. We also investigated the mortality for all patients with HF and in COVID-19-infected patients with HF.RESULTS: Rates of new-onset HF between January 1 and March 11 were comparable for 2020 and 2019 (1.83 versus 1.78 per 10 000 person-years; P=0.19), while hospitalizations for worsening HF were slightly higher in 2020 versus 2019 (1.04 versus 0.93 per 1000 person-years; P=0.02). In the lockdown period, rates of new-onset HF diagnoses (1.26 versus 2.25 per 1000 person-years) and of hospitalizations for worsening HF (0.63 versus 0.99 per 1000 person-years) were significantly lower in 2020 versus 2019 (P for both, <0.0001). Mortality was similar before and after the national lockdown for the population with HF. We observed 90 HF patients with diagnosed COVID-19 infection, of whom 37% (95% CI, 23%-50%) died within 15 days.CONCLUSIONS: The number of patients hospitalized with worsening HF or diagnosed with new-onset HF was markedly reduced after lockdown but has not yet impacted mortality in HF patients at a population-based level. However, these data raise concerns for a potential undertreatment of HF currently that may impact prognosis in the longer term.

KW - Betacoronavirus

KW - Cohort Studies

KW - Coronavirus Infections/epidemiology

KW - Denmark/epidemiology

KW - Female

KW - Heart Failure/diagnosis

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Pandemics

KW - Pneumonia, Viral/epidemiology

KW - Risk Factors

U2 - 10.1161/CIRCHEARTFAILURE.120.007274

DO - 10.1161/CIRCHEARTFAILURE.120.007274

M3 - Journal article

VL - 13

SP - e007274

JO - Circulation. Heart failure

JF - Circulation. Heart failure

SN - 1941-3289

IS - 6

ER -

ID: 60232060