Brief Report

The Impact of the COVID-19 Pandemic on Hospitalization Rates due to Prosthetic Valve Thrombosis

Abstract

Backgrounds: Studies have shown a decline in the admission rates of various diseases during the COVID-19 pandemic. Prosthetic valve thrombosis (PVT) is a rare condition followed by surgical or transcatheter valvular interventions. Considering the lack of data on hospitalization rates due to PVT during the pandemic, this study evaluated the implications of the COVID-19 pandemic on PVT admissions and characteristics in a tertiary referral center.
Methods: Data from all the consecutive patients hospitalized due to PVT between February 2020 and February 2021 (the first year of the pandemic) were collected from medical records and compared clinically with the corresponding time before the pandemic (February 2019 through February 2020). Variables of interest included the number of hospitalization, patient and valve characteristics, diagnostic and management strategies, and in-hospital events.
Results: Forty patients (32.5% male, age: 54.0 [46.5-62.0 y] comprised the study population. We observed a considerable decline in hospitalization rates during the pandemic, from 31 to 9 patients. Admitted patients were 8 years younger, had a higher proportion of the New York Heart Association functional class III or IV symptoms (44.4% vs 22.6%), were more often treated with fibrinolysis (33.3% vs 22.6%) or surgical approaches (33.3% vs 22.6%), and were discharged 6 days sooner.
Conclusion: We described a reduction in PVT hospitalization. Patients presented with a higher proportion of severe dyspnea and had increased treatment with fibrinolysis/surgical approaches. These observations highlight the necessity of the active surveillance of patients with prosthetic valves by caregivers for timely diagnosis and appropriate management during the pandemic.

1. Dangas GD, Weitz JI, Giustino G, Makkar R, Mehran R. Prosthetic Heart Valve Thrombosis. J Am Coll Cardiol 2016;68:2670-2689.
2. Barandon L, Clerc P, Chauvel C, Plagnol P. Native aortic valve thrombosis: a rare cause of acute ischemia of the lower limb. Interact Cardiovasc Thorac Surg 2004;3:675-677.
3. Schoen FJ, Gotlieb AI. Heart valve health, disease, replacement, and repair: a 25-year cardiovascular pathology perspective. Cardiovasc Pathol 2016;25:341-352.
4. WHO COVID-19 Dashboard. Geneva: World Health Organization. 2020 [Available from: https://covid19.who.int/. )Access date:1 March 2023)
5. McAndrew J, O'Leary J, Cotter D, Cannon M, MacHale S, Murphy KC, Barry H. Impact of initial COVID-19 restrictions on psychiatry presentations to the emergency department of a large academic teaching hospital. Ir J Psychol Med 2021;38:108-115.
6. Ferrero F, Ossorio MF, Torres FA, Debaisi G. Impact of the COVID-19 pandemic in the paediatric emergency department attendances in Argentina. Arch Dis Child 2021;106:e5.
7. Bromage DI, Cannatà A, Rind IA, Gregorio C, Piper S, Shah AM, McDonagh TA. The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic. Eur J Heart Fail 2020;22:978-984.
8. Gluckman TJ, Wilson MA, Chiu ST, Penny BW, Chepuri VB, Waggoner JW, Spinelli KJ. Case Rates, Treatment Approaches, and Outcomes in Acute Myocardial Infarction During the Coronavirus Disease 2019 Pandemic. JAMA Cardiol 2020;5:1419-1424.
9. Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung SH, Ambrosy AP, Sidney S, Go AS. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction. N Engl J Med 2020;383:691-693.
10. Barten DG, Latten GHP, van Osch FHM. Reduced Emergency Department Utilization During the Early Phase of the COVID-19 Pandemic: Viral Fear or Lockdown Effect? Disaster Med Public Health Prep 2022;16:36-39.
11. Garrafa E, Levaggi R, Miniaci R, Paolillo C. When fear backfires: Emergency department accesses during the Covid-19 pandemic. Health Policy 2020;124:1333-1339.
12. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C, Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020 Mar 26;368:m1091. doi: 10.1136/bmj.m1091. Erratum in: BMJ 2020;368:m1295.
13. Poorhosseini H, Abbasi SH. The Tehran heart center, Eur Heart J 2018;39:2695–2696
14. Page EM, Ariëns RAS. Mechanisms of thrombosis and cardiovascular complications in COVID-19. Thromb Res 2021;200:1-8.
15. Roudaut R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart 2007;93:137-142.
16. Cannatà A, Bromage DI, Rind IA, Gregorio C, Bannister C, Albarjas M, Piper S, Shah AM, McDonagh TA. Temporal trends in decompensated heart failure and outcomes during COVID-19: a multisite report from heart failure referral centres in London. Eur J Heart Fail 2020;22:2219-2224.
17. Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States. Health Aff (Millwood) 2020;39:2010-2017.
18. Kiss P, Carcel C, Hockham C, Peters SAE. The impact of the COVID-19 pandemic on the care and management of patients with acute cardiovascular disease: a systematic review. Eur Heart J Qual Care Clin Outcomes 2021;7:18-27.
19. Ghoreishi A, Arsang-Jang S, Sabaa-Ayoun Z, Yassi N, Sylaja PN, Akbari Y, et al. Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results. J Stroke Cerebrovasc Dis 2020;29:105321.
20. Scognamiglio G, Fusco F, Merola A, Palma M, Correra A, Sarubbi B. Caring for adults with CHD in the era of coronavirus disease 2019 pandemic: early experience in an Italian tertiary centre. Cardiol Young 2020;30:1405-1408.
21. Firouzi A, Hosseini Z, Norouzi Z, Hosseini Z, Amirpour A, Talakoob H, Amin A, Soleimani A, Moradifar N, Karbalai S, Mozafarybazargani M, Hekmat H, Maleki M, Sadeghipour P, Mirbod SM, Ghorbanpoor Kohnaki M, Bakhshandeh H, KalaeiNia M, Habibizade FS, Iraninejad S, Baay M, Khalilipur E. The Pragmatic Role of COVID-19 on the Thrombus Grade of Patients with Contemporary ST-Segment-Elevation Myocardial Infarction. J Tehran Heart Cent 2022;17:103-111.
22. De Rosa S, Spaccarotella C, Basso C, Calabrò MP, Curcio A, Filardi PP, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Sinagra G, Indolfi C; Società Italiana di Cardiologia and the CCU Academy investigators group. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 2020;41:2083-2088.
23. Mohsenizadeh SA, Alidoosti M, Jalali A, Tofighi S, Salarifar M, Poorhosseini H, Jenab Y, Ahmadian T. Comparison of Angiographic and Clinical Outcomes After Primary Percutaneous Coronary Intervention for ST-elevation Myocardial Infarction Between Patients With and Without Concomitant COVID-19 Infection. Crit Pathw Cardiol 2022;21:141-146
24. Omidi N, Forouzannia SK, Poorhosseini H, Tafti SHA, Salehbeigi S, Lotfi-Tokaldany M. Prosthetic heart valves and the COVID-19 pandemic era: What should we be concerned about? J Card Surg 2020;35:2500-2505.
25. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, Jain SS, Burkhoff D, Kumaraiah D, Rabbani L, Schwartz A, Uriel N. COVID-19 and Cardiovascular Disease. Circulation 2020;141:1648-1655.
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IssueVol 18 No 2 (2023): J Teh Univ Heart Ctr QRcode
SectionBrief Report
DOI https://doi.org/10.18502/jthc.v18i2.13324
Keywords
Heart valve prosthesis Heart valve diseases COVID-19 Hospitalization

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1.
Jameie M, Safarian Nematabad M, Mansouri P, Jalali A, Aghajai F, Lotfi-Tokaldany M, Aghajani H. The Impact of the COVID-19 Pandemic on Hospitalization Rates due to Prosthetic Valve Thrombosis. J Tehran Heart Cent. 2023;18(2):136-141.