{"id":"0c86e68657aa","type":"article","url":"https://hartvaat.nl/2022/09/01/collaterale-schade-van-covid-19-aan-cardiovasculaire-zorg-meta-analyse/","title":"Collaterale schade van COVID-19 aan cardiovasculaire zorg: meta-analyse","title_en":"The collateral damage of COVID-19 to cardiovascular services: a meta-analysis.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":["covid-hart"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehac227","source_url":"https://doi.org/10.1093/eurheartj/ehac227","authors":["Ramesh Nadarajah","Jianhua Wu","Ben Hurdus","Samira Asma","Deepak L Bhatt","Giuseppe Biondi-Zoccai","Laxmi S Mehta","C Venkata S Ram","Antonio Luiz P Ribeiro","Harriette G C Van Spall","John E Deanfield","Thomas F Lüscher","Mamas Mamas","Chris P Gale"],"significance":7,"published":"2022-09-01","source_date":"2022-09-01","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/insulineresistentie-mechanisme/"],"congress":"","summary_en":"This meta-analysis quantified the collateral damage of COVID-19 on cardiovascular services, showing significant reductions in ACS hospitalizations, prolonged door-to-balloon times, and increased cardiovascular mortality during pandemic waves.","created":"2026-07-03T10:29:55Z","updated":"2026-07-03T13:29:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse kwantificeerde de impact van COVID-19 op cardiovasculaire zorg: 20% minder hospitalisaties voor ACS, 30% langere door-to-balloon-tijden en hogere mortaliteit. De pandemie veroorzaakte significante collaterale schade aan de cardiologische zorgketen.","abstract_original":"AIMS: The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic. METHODS AND RESULTS: From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66-0.94) and revascularisation (RR 0.73, 95% CI 0.62-0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10-1.37) and heart failure (RR 1.08, 95% CI 1.04-1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave. CONCLUSIONS: There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification."}