COVID-19 大流行期间的心血管症状:间断时间序列分析。

Hari Prakash Sritharan, Harrison Nguyen, Usaid Khalil Allahwala, Ravinay Bhindi
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摘要

背景:2019年冠状病毒病大流行对心血管住院治疗的广泛影响仍不清楚。我们旨在评估冠状病毒病 2019 年大流行期间心血管疾病的发病趋势:这项多中心研究调查了 2018 年 3 月至 2023 年 2 月期间的心血管病例。通过使用 ICD-10-AM 诊断代码的行政健康记录确定心血管疾病患者。对四个关键研究时段进行了分析:T0-大流行前、T1-首次封锁、T2-放松限制、T3-放开限制并广泛接种疫苗。采用间断时间序列分析预测每周心血管病发病情况,并评估实际发病人数与预测人数之间的平均差异是否显著:澳大利亚三家大型公立医院共纳入了 116 518 名患者。T1的心血管病发病率明显低于预测值,平均下降了13.1%(标准差为16.2%;P = 0.004)。除了心肌病和心力衰竭的发病率在 T3 期显著下降(4.5% [SD 23.7%];P = 0.007)外,大多数心血管疾病的发病率在 T2 期和 T3 期的预期和实际发病率之间存在显著差异:结论:在COVID-19大流行的最初封锁阶段,心血管病发病率明显降低;随着社会限制的放松和疫苗接种的普及,心血管病发病率有所下降,但心肌病和心力衰竭发病率持续下降。
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Cardiovascular presentations during the COVID-19 pandemic: an interrupted time series analysis.

Background: The broader implications of the Coronavirus disease 2019 pandemic on cardiovascular hospitalizations remain unclear. We aimed to assess trends in cardiovascular presentations during the Coronavirus disease 2019 pandemic.

Methods: This multicentre study examined cardiovascular presentations from March 2018 to February 2023. Patients with cardiovascular presentations were identified through administrative health records using ICD-10-AM diagnosis codes. Four key study periods were analysed: T0-pre-pandemic, T1-first lockdown, T2-easing of restrictions and T3-release of restrictions and widespread vaccination. Interrupted time series analysis was used to predict weekly cardiovascular presentations, with the mean difference between actual and predicted numbers assessed for significance.

Results: Overall, 116 518 patients were included across three major public hospitals in Australia. Cardiovascular presentations were significantly lower in T1 than predicted, with a mean decline of 13.1% (SD 16.2%; P = 0.004). There was a significant difference between the expected and actual number of most cardiovascular presentations in T2 and T3, apart from a significant reduction in cardiomyopathy and heart failure presentations during T3 (4.5% [SD 23.7%]; P = 0.007).

Conclusions: Cardiovascular presentations were significantly lower during the initial lockdown phase of the COVID-19 pandemic; this attenuated with easing of social restrictions and widespread vaccination, except for persistent reduction in cardiomyopathy and heart failure presentations.

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