Direct and indirect effect of the COVID-19 pandemic on patients with cardiomyopathy

Daniel J Hammersley; Rachel J Buchan; Amrit S Lota; Lukas Mach; Richard E Jones; Brian P Halliday; Upasana Tayal; Devendra Meena; Abbas Dehghan; Ioanna Tzoulaki; A John Baksi; Antonis Pantazis; Angharad M Roberts; Sanjay K Prasad; James S Ware

doi:10.1136/openhrt-2021-001918

journal article Open Access Jan 01, 2022

Direct and indirect effect of the COVID-19 pandemic on patients with cardiomyopathy

Daniel J Hammersley

Rachel J Buchan Amrit S Lota Lukas Mach

Richard E Jones Brian P Halliday

Upasana Tayal Devendra Meena Abbas Dehghan

Ioanna Tzoulaki

A John Baksi Antonis Pantazis

Angharad M Roberts Sanjay K Prasad

James S Ware

Open Heart Vol. 9 No. 1 pp. e001918 · BMJ

View at Publisher Save 10.1136/openhrt-2021-001918

Abstract

Objectives
(1) To evaluate the prevalence and hospitalisation rate of COVID-19 infections among patients with dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) in the Royal Brompton and Harefield Hospital Cardiovascular Research Centre (RBHH CRC) Biobank. (2) To evaluate the indirect impact of the pandemic on patients with cardiomyopathy through the Heart Hive COVID-19 study. (3) To assess the impact of the pandemic on national cardiomyopathy-related hospital admissions.

Methods
(1) 1236 patients (703 DCM, 533 HCM) in the RBHH CRC Biobank were assessed for COVID-19 infections and hospitalisations; (2) 207 subjects (131 cardiomyopathy, 76 without heart disease) in the Heart Hive COVID-19 study completed online surveys evaluating physical health, psychological well-being, and behavioural adaptations during the pandemic and (3) 11 447 cardiomyopathy-related hospital admissions across National Health Service (NHS) England were studied from NHS Digital Hospital Episode Statistics over 2019–2020.

Results
A comparable proportion of patients with cardiomyopathy in the RBHH CRC Biobank had tested positive for COVID-19 compared with the UK population (1.1% vs 1.6%, p=0.14), but a higher proportion of those infected were hospitalised (53.8% vs 16.5%, p=0.002). In the Heart Hive COVID-19 study, more patients with cardiomyopathy felt their physical health had deteriorated due to the pandemic than subjects without heart disease (32.3% vs 13.2%, p=0.004) despite only 4.6% of the cardiomyopathy cohort reporting COVID-19 symptoms. A 17.9% year-on-year reduction in national cardiomyopathy-related hospital admissions was observed in 2020.

Conclusion
Patients with cardiomyopathy had similar reported rates of testing positive for COVID-19 to the background population, but those with test-proven infection were hospitalised more frequently. Deterioration in physical health amongst patients could not be explained by COVID-19 symptoms, inferring a significant contribution of the indirect consequences of the pandemic.

Trial registration number

NCT04468256

Topics

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Citations

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References

Details

Published: Jan 01, 2022
Vol/Issue: 9(1)
Pages: e001918
License: View

Authors

D

Daniel J Hammersley

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

R

Rachel J Buchan

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; MRC London Institute of Medical Sciences, Imperial College, London, UK

A

Amrit S Lota

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

L

Lukas Mach

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

R

Richard E Jones

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

B

Brian P Halliday

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

U

Upasana Tayal

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

D

Devendra Meena

Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK

A

Abbas Dehghan

Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK

I

Ioanna Tzoulaki

Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK; British Heart Foundation Centre of Excellence, Imperial College London, London, UK; Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece

A

A John Baksi

Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

A

Antonis Pantazis

Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

A

Angharad M Roberts

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

S

Sanjay K Prasad

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

J

James S Ware

National Heart and Lung Institute, Imperial College London, London, UK; Cardiovascular Research Centre, Royal Brompton and Harefield Clinical Group, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; MRC London Institute of Medical Sciences, Imperial College, London, UK

Funding

National Institute for Health Research

Wellcome Award: 107469/Z/15/Z

Medical Research Council (UK), British Heart Foundation Award: RE/18/4/34215

Cardiomyopathy UK

Sam’s Rainbow Foundation

Royal Brompton & Harefield Cardiovascular Biomedical Research Unit

Cite This Article

Daniel J Hammersley, Rachel J Buchan, Amrit S Lota, et al. (2022). Direct and indirect effect of the COVID-19 pandemic on patients with cardiomyopathy. Open Heart, 9(1), e001918. https://doi.org/10.1136/openhrt-2021-001918

Direct and indirect effect of the COVID-19 pandemic on patients with cardiomyopathy

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