Decrease in surgical case volume of Type A Aortic Dissection during the COVID-19 pandemic raises public health concern

A recent study done in New York reveals a need to balance public health mandatory social distancing due to COVID-19 with the importance of seeking immediate medical treatment in the presence of sudden severe symptoms associated with aortic dissections.

The COVID-19 pandemic has created additional burden in emergency departments, such as more layers of screening, reduced individual patient attention, rationing of timely CT scanning, and confusing the atypical symptoms of type A aortic dissection with common COVID-19 presentations.

In addition, public health messages promoting social distancing and news reports focused on the death toll associated with COVID-19 have created a sense of anxiety in society.

Ismail El-Hamamsy, MD, PhD, et al., compiled data from 11 hospitals and health systems in New York that provide cardiac surgical services, to investigate the impact of COVID-19 on the incidence of acute type A aortic dissections.

The researchers captured all cases of surgical repair from Jan. 1, 2018 to April 15, 2020. March 1, 2020 was used as the post-COVID date to correspond to the first reported COVID-19 case in New York city.

The study showed a significant drop in the monthly surgical case volume of acute type A aortic dissection from 12.8±4.6 cases/month before-COVID to 3.0 ±1.0 cases/month after-COVID, representing a 76.5% decrease in volume

Incidentally, the number of at-home deaths in NYC reached an 8- to 10-fold increase compared to the same period in 2019, raising concerns about the impact of the pandemic on non-COVID related health conditions.

The decrease in patients presenting with type A aortic dissections "serves as a word of caution,” the research concludes.

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It is critical for patients with aortic disease to be aware of severe symptoms and not hesitate to seek urgent medical attention during the pandemic. If visiting the hospital emergency department, it might be helpful to inform the doctors of a possible aortic event due to an underlying genetic condition.

KEYWORDS:

COVID-19; aortic dissection; pandemic.

For other helpful resources about COVID-19 and genetic aortic disorders click here