Study highlights drop in aortic dissection cases in New York during COVID-19 pandemic

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In a recently-published study, researchers found a significant drop in acute aortic dissection cases in New York City since the beginning of the COVID-19 pandemic.

The study—”The COVID-19 pandemic and acute aortic dissections in New York: A matter of public health”—has been published in the Journal of the American College of Cardiology by Ismail El-Hamamsy, director of Aortic Surgery for the Mount Sinai Health System in New York, USA.

The study was designed to investigate the impact of COVID-19 on the incidence of acute aortic dissection cases in New York City hospitals.

According to a Mount Sinai press release, the researchers found that aortic dissection repairs dropped by 76% during March and April, at the height of the COVID-19 pandemic.

While similar drops have been observed with different life-threatening conditions including heart attacks, this represents the first study to systematically examine the decline in aortic dissection cases.

El-Hamamsy et al have come up with a number of hypotheses to potentially explain why. There has been an eight- to ten-fold increase in at-home deaths across New York City since the last week in March, meaning it is possible some aortic dissection patients did not call for help, fearful of contracting COVID-19 in the emergency room. Additionally, overstretched first responders may have caused delays, or overburdened emergency departments may have missed the diagnosis.

The investigators compiled data from all 11 hospitals providing cardiac surgery in New York City from 1 January 2018 to 15 April 15 2020. All centres reported monthly volumes of surgically treated aortic dissection cases, with no change in management of care during the COVID-19 pandemic. They noticed a 76.5% decrease in volume, a statistically significant decline. Analysis further confirmed unusually low volumes during/after COVID-19.

“This study highlights the potential unintended toll of the pandemic. This goes far beyond aortic dissections; it is an important public health message that applies to all medical conditions,” explains El-Hamamsy.

He adds: “While self-isolation and social distancing are key to flattening the curve, it is equally important to consult one’s physician or head to the emergency room to receive urgent care. In other words, there is a larger risk in trying to avoid the risk of going to the hospital.”


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