Indirect impact of the COVID-19 pandemic on hospitalisations for cardiometabolic conditions and their management: A systematic review

Samuel Seidu*, Setor K Kunutsor, Xavier Cos, Kamlesh Khunti

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

24 Citations (Scopus)
16 Downloads (Pure)


Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic crisis in health care systems worldwide. These may have significant implications for the management of cardiometabolic diseases. We conducted a systematic review of published evidence to assess the indirect impact of the COVID-19 pandemic on hospitalisations for cardiovascular diseases and their management.

Methods: Studies that evaluated volume of hospitalisations for cardiometabolic conditions and their management with comparisons between the COVID-19 and pre-COVID periods were identified from MEDLINE, Embase and the reference list of relevant studies from January 2020 to 25 February 2021.

Results: We identified 103 observational studies, with most studies assessing hospitalisations for acute cardiovascular conditions such as acute coronary syndrome, ischemic strokes and heart failure. About 89% of studies reported a decline in hospitalisations during the pandemic compared to pre-pandemic times, with reductions ranging from 20.2 to 73%. Severe presentation, less utilization of cardiovascular procedures, and longer patient- and healthcare-related delays were common during the pandemic. Most studies reported shorter length of hospital stay during the pandemic than before the pandemic (1-8 vs 2-12 days) or no difference in length of stay. Most studies reported no change in in-hospital mortality among hospitalised patients.

Conclusion: Clinical care of patients for acute cardiovascular conditions, their management and outcomes have been adversely impacted by the COVID-19 pandemic. Patients should be educated via population-wide approaches on the need for timely medical contact and health systems should put strategies in place to provide timely care to patients at high risk.
Original languageEnglish
Pages (from-to)653-681
Number of pages29
JournalPrimary Care Diabetes
Issue number4
Early online date28 May 2021
Publication statusPublished - Aug 2021

Bibliographical note

Funding Information:
This study was supported with a research grant from Primary Care Diabetes Europe (PCDE) . PCDE as a society, has received sponsorship from Novo Nordisk, Eli Lilly and Roche Diagnostics, but the companies had no input in the study.

Publisher Copyright:
© 2021 Primary Care Diabetes Europe

Structured keywords

  • Covid19


  • COVID-19
  • impact
  • hospitalisation
  • diabetes
  • acute coronary syndrome
  • stroke cardiovascular disease
  • systematic review


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