TCT CONNECT-223 Effects of the COVID-19 Pandemic on a Population Older Than 75 Years With Previous Percutaneous Coronary Revascularization: Subanalysis of the SIERRA 75 Registry

Abstract

Background In the coronavirus disease-2019 (COVID-19) pandemic, elderly people with cardiovascular risk factors and/or cardiovascular disease have been the most seriously affected. We sought to evaluate the impact of the pandemic, due to both the social confinement and the infection itself, in the population of patients older than 75 years of age with previous percutaneous coronary revascularization. Methods A subgroup of patients from the SIERRA 75 registry were included in the study. This is a prospective registry of patients older than 75 years undergoing percutaneous revascularization in 42 centers in Spain and Portugal. The follow-up of the patients has been updated, covering the entire period of outbreak and confinement (March 14–May 10, 2020) through direct telephone contact to carry out a specific questionnaire for patients and their relatives. In addition, all electronic health records have been reviewed. Results A total of 709 patients have been included, of whom 17 had died in the 12.5 ± 3.4 months follow-up before the start of the outbreak and lockdown. Therefore, 692 patients were followed during the study period (mean age of 80.8 ± 4.2 years, 37% women). During this period, 11 (1.6%) had confirmed COVID-19 (age 81.2 ± 5 years, 36% women) of which 8 were admitted to the hospital but none in the intensive care unit. Among the 11 cases, 2 (18%) died, an 80-year-old man and a 76-year-old woman, both in Hospital. COVID-19 incidence was higher than in the global population in the region (1.6% vs. 0.4%; p < 0.0001). During this period of confinement, 91 patients (13%) presented cardiac symptoms (21 stable angina, 82 dyspnea, and 6 syncope). Medical attention was demanded by 43 (6.2%), of whom 22 were admitted in hospitals. There were 4 cases with acute coronary syndrome and 4 underwent revascularization. Death was reported in 7 (1%) patients (2 due to COVID-19, 4 due to cardiovascular disease, and 1 due to multiple pathologies). The monthly mortality rate in this period was 2.6 times higher than in the previous months. Outpatient visits were canceled in 119 cases (17%) but 108 were contacted by phone. Conclusion In this elderly population with coronary artery disease revascularized before the pandemic, an increase in cardiovascular and general morbidity as well as in total mortality was observed during the outbreak and confinement period. Incidence of COVID-19 was higher than in the general population. Mortality among COVID-19 patients was very high. Categories OTHER: COVID-19