Annals of Pediatric Cardiology (Jan 2021)

Impact of COVID-19 pandemic on pediatric cardiac services in India

  • Mrigank Choubey,
  • Sivasubramanian Ramakrishnan,
  • Sakshi Sachdeva,
  • Kalaivani Mani,
  • Debasree Gangopadhyay,
  • Kothandam Sivakumar,
  • Mahesh Kappanayil,
  • Mahimarangaiah Jayranganath,
  • Nageswara Rao Koneti,
  • Neeraj Awasthy,
  • Prashant Bobhate,
  • Saurabh Kumar Gupta,
  • Sushil Azad,
  • Bhargavi Dhulipudi,
  • Bhushan Sonawane,
  • Biswajit Bandopadhyay,
  • Chinnaswamy Sivaprakasam Muthukumaran,
  • Debasis Das,
  • Devaprasath Sivalingam,
  • Harpanahalli Ravi Ramamurthy,
  • Hemant Kumar Nayak,
  • Jayashree Mishra,
  • Kalyanasundaram Muthusamy,
  • Manisha Chakrabarti,
  • Nurul Islam,
  • Prashant Mahawar,
  • Prashant Shah,
  • Saileela Rajan,
  • Kavasseri Subramaniaiyer Remadevi,
  • Shaad Abqari,
  • Shiv Kumar Chaudhary,
  • Soumya Kasturi,
  • Raghavannair Suresh Kumar,
  • Anita Saxena,
  • Krishna Subramony Iyer,
  • Rajesh Sharma,
  • Raman Krishna Kumar,
  • Sitaraman Radhakrishnan,
  • Shyam Sunder Kothari,
  • Snehal Kulkarni,
  • Suresh G Rao,
  • For the PCSI-COVID-19 study group

DOI
https://doi.org/10.4103/apc.apc_133_21
Journal volume & issue
Vol. 14, no. 3
pp. 260 – 268

Abstract

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Background : COVID-19 pandemic has disrupted pediatric cardiac services across the globe. Limited data are available on the impact of COVID.19 on pediatric cardiac care in India. Aims : The aims are to study the impact of COVID-19 pandemic on the care of children with heart disease in India in terms of number of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries. Settings and Design : This is a retrospective, multicentric, observational study. Methods : We collected monthly data on the number and characteristics of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries and major hospital statistics, over a period of 5 months (April to August 2020), which coincided with the first wave of COVID-19 pandemic in India and compared it with data from the corresponding months in 2019. Results : The outpatient visits across the 24 participating pediatric cardiac centers decreased by 74.5% in 2020 (n = 13,878) as compared to the corresponding period in 2019 (n = 54,213). The reduction in the number of hospitalizations, cardiac surgeries, and catheterization procedures was 66.8%, 73.0%, and 74.3%, respectively. The reduction in hospitalization was relatively less pronounced among neonates as compared to infants/children (47.6% vs. 70.1% reduction) and for emergency surgeries as compared to elective indications (27.8% vs. 79.2%). The overall in-hospital mortality was higher in 2020 (8.1%) as compared to 2019 (4.8%), with a higher postoperative mortality (9.1% vs. 4.3%). Conclusions : The current COVID-19 pandemic significantly impacted the delivery of pediatric cardiac care across India with two-third reduction in hospitalizations and cardiac surgeries. In an already resource-constrained environment, the impact of such a massive reduction in the number of surgeries could be significant over the coming years. These findings may prove useful in formulating strategy to manage subsequent waves of ongoing COVID-19 pandemic.

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