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Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

Armario, X. ; Götberg, M. LU ; McEvoy, J.W. and Mylotte, D. (2024) In JACC: Cardiovascular Interventions 17(3). p.374-387
Abstract
Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. Results: We included 130 centers from 61 countries, including... (More)
Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. Results: We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (−52%; P = 0.001), Central-South America (−33%; P < 0.001), and Asia (−29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises. (Less)
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Contribution to journal
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published
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keywords
aortic valve stenosis, coronavirus disease 2019, transcatheter aortic valve replacement, valvular heart disease, Aortic Valve, Aortic Valve Stenosis, COVID-19, Humans, Pandemics, Registries, Risk Factors, Transcatheter Aortic Valve Replacement, Treatment Outcome, Africa, Article, Asia, controlled study, disease registry, human, incidence, major clinical study, observational study, pandemic, private hospital, rural area, social status, South America, urban area, valve-in-valve transcatheter aortic valve implantation, volume, aortic valve, diagnostic imaging, procedures, register, risk factor, transcatheter aortic valve implantation, treatment outcome
in
JACC: Cardiovascular Interventions
volume
17
issue
3
pages
14 pages
publisher
Elsevier
external identifiers
  • scopus:85184040813
ISSN
1936-8798
DOI
10.1016/j.jcin.2023.10.041
language
English
LU publication?
yes
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faeb53da-35b2-481c-ba91-a07cec8fa298
date added to LUP
2024-03-12 15:45:36
date last changed
2024-03-12 15:46:25
@article{faeb53da-35b2-481c-ba91-a07cec8fa298,
  abstract     = {{Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. Results: We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P &lt; 0.001) and 7% (P &lt; 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (−52%; P = 0.001), Central-South America (−33%; P &lt; 0.001), and Asia (−29%; P &lt; 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P &lt; 0.001) and economic status (P &lt; 0.001), higher COVID-19 incidence (P &lt; 0.001), and more stringent public health restrictions (P &lt; 0.001) experienced a greater reduction in TAVR activity. Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.}},
  author       = {{Armario, X. and Götberg, M. and McEvoy, J.W. and Mylotte, D.}},
  issn         = {{1936-8798}},
  keywords     = {{aortic valve stenosis; coronavirus disease 2019; transcatheter aortic valve replacement; valvular heart disease; Aortic Valve; Aortic Valve Stenosis; COVID-19; Humans; Pandemics; Registries; Risk Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome; Africa; Article; Asia; controlled study; disease registry; human; incidence; major clinical study; observational study; pandemic; private hospital; rural area; social status; South America; urban area; valve-in-valve transcatheter aortic valve implantation; volume; aortic valve; diagnostic imaging; procedures; register; risk factor; transcatheter aortic valve implantation; treatment outcome}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{374--387}},
  publisher    = {{Elsevier}},
  series       = {{JACC: Cardiovascular Interventions}},
  title        = {{Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study}},
  url          = {{http://dx.doi.org/10.1016/j.jcin.2023.10.041}},
  doi          = {{10.1016/j.jcin.2023.10.041}},
  volume       = {{17}},
  year         = {{2024}},
}