The Impact of the COVID-19 Pandemic on Hospital Services for Patients with Cardiac Diseases: A Scoping Review

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Abstract

This study aims to assess the impact of the COVID-19 pandemic on hospital cardiac care, as assessed by performance indicators. Scoping review methodology: performance indicators were extracted to inform on changes in care during January–June 2020. Database searches yielded 6277 articles, of which 838 met the inclusion criteria. After full-text screening, 94 articles were included and 1637 indicators were retrieved. Most of the indicators that provided information on changes in the number of admissions (n = 118, 88%) signaled a decrease in admissions; 88% (n = 15) of the indicators showed patients’ delayed presentation and 40% (n = 54) showed patients in a worse clinical condition. A reduction in diagnostic and treatment procedures was signaled by 95% (n = 18) and 81% (n = 64) of the indicators, respectively. Length of stay decreased in 58% (n = 21) of the indicators, acute coronary syndromes treatment times increased in 61% (n = 65) of the indicators, and outpatient activity decreased in 94% (n = 17) of the indicators related to outpatient care. Telehealth utilization increased in 100% (n = 6). Outcomes worsened in 40% (n = 35) of the indicators, and mortality rates increased in 52% (n = 31). All phases of the pathway were affected. This information could support the planning of care during the ongoing pandemic and in future events.

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  1. SciScore for 10.1101/2021.12.01.21267100: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variableThe following exclusion criteria were set: 1) non-primary studies (such as editorials and commentaries); 2) prediction models; 3) clinical case reports; and 4) diseases management or health services organization guidelines; 5) studies about the impact on healthcare workers, patients diagnosed with COVID-19, children, or pregnant women; 6) studies primarily performed in non-OECD countries; 7) articles from which only an abstract was available.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The full search strategy for Embase and MEDLINE can be found in Supplementary material S2.
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    MEDLINE
    suggested: (MEDLINE, RRID:SCR_002185)
    Duplicates were removed using EndNote software.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    The data underlying this article are available in Zenodo.org, at https://dx.doi.org/10.5281/zenodo.5745755.
    Zenodo
    suggested: (ZENODO, RRID:SCR_004129)

    Results from OddPub: Thank you for sharing your data.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, a scoping review has its limitations. Ideally a systematic review with meta-analyses would be performed. For the articles included in this paper this would be extremely difficult, given their different methodologies, indicators, indicators’ definitions, and comparison periods. In fact, the heterogeneity in study characteristics and indicators make it hard to compare data in a reliable way. In July 2020, the International Training Network for Healthcare Performance Intelligence Professionals (HealthPros) (129) suggested that to compare, manage and improve health systems responsiveness to the pandemic, commonly agreed-upon standardized data and indicators are necessary (130). We recommend devising a uniformly accepted set of indicators with clear definitions to use in future pandemics. Another limitation is that only articles reporting on OECD countries were included in this scoping review. The global repercussions of the COVID-19 pandemic on hospital services for cardiac care will therefore likely be larger than reported in this paper, given the smaller capacity to handle changes in hospital care in low-income countries. On the other hand, publication bias may have played a role in portraying a more severe impact of the pandemic. Physicians might publish sooner when effects of the pandemic are being clearly noticed in their hospital. It could also be the case that the overload with clinical tasks did not allow physicians to find the time to do scientific work, which m...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.