According to a new study published in the European Heart Journal – Quality of Care and Clinical Outcomes, individuals who had heart attacks during the first Covid-19 lockdown in the UK and Spain are predicted to live 1.5 and 2 years less, respectively, than their pre-pandemic counterparts.
Moreover, the experts estimate the additional costs to the UK and Spanish economies to rise as high as £36.6 million (€41.3 million) and €88.6 million, respectively, largely due to work absenteeism.
Heart attacks require urgent medical interventions with stents – called “percutaneous coronary intervention” (PCI) – to open the blocked arteries and restore blood flow. Delays resulting in lack of oxygen can lead to irreversible damage to the heart muscle and can cause heart failure or other complications.
During the first wave of the pandemic, as officials told people to stay at home and some routine emergency care was halted, about 40 percent fewer heart attack patients went to hospital. Those remaining at home following a heart attack were more than twice as likely to die, while those who delayed going to the hospital were nearly twice as likely to have significant complications which could have been avoided compared to people receiving prompt treatment.
“Restrictions to treatment of life-threatening conditions have immediate and long-term negative consequences for individuals and society as a whole,” said study corresponding author William Wijns, a professor of Interventional Cardiology at the University of Galway in Ireland. “Back-up plans must be in place so that emergency services can be retained even during natural or health catastrophes.”
The researchers estimated the long-term clinical and economic implications of reduced heart attack treatment during the first lockdowns in the UK and Spain in patients with ST-elevation myocardial infarction (STEMI), in which an artery supplying blood to the heart is completely blocked.
Survival projections took into account age, hospitalization status, and time to treatment using published data from both countries and compared them to data from one year before the pandemic. The data analysis revealed that 77 percent of STEMI patients in the UK were hospitalized before the pandemic compared to 44 percent during the first lockdown, with the equivalent rates in Spain being 74 percent and 57 percent.
By using a model estimating long-term survival, quality of life, and costs related to STEMI, the scientists found that patients who had a STEMI during the first UK lockdown would lose an average of 1.55 years compared to those presenting with this condition before the pandemic.
Moreover, those with a STEMI during the lockdown were predicted to lose about one year and two months of life in perfect health. In the case of Spain, the equivalent figures were 2.03 years of life lost, and one year and seven months of life in perfect health lost.
In addition, the researchers performed a cost analysis that took into account factors such as initial hospitalization and treatment, follow-up treatment, management of heart failure, and productivity loss in patients unable to return to work.
The investigation revealed that, in the UK – with an incidence of 49,332 STEMIs per year – reduced access to PCI during the first month of lockdown would cost an extra £36.6 million (€41.3 million) over the lifetime of the patients, while in Spain – with an annual incidence of 52,954 STEMIs – reduced access to PCI at the beginning of the pandemic would cost an additional €88.6 million over the patients’ lifetimes.
“The findings illustrate the repercussions of delayed or missed care. Patients and societies will pay the price of reduced heart attack treatment during just one month of lockdown for years to come. Health services need a list of lifesaving therapies that should always be delivered, and resilient healthcare systems must be established that can switch to emergency plans without delay. Public awareness campaigns should emphasize the benefits of timely care, even during a pandemic or other crisis,” Wijns concluded.