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10.1371/journal.pone.0249043

http://scihub22266oqcxt.onion/10.1371/journal.pone.0249043
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33755715!7987182!33755715
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suck abstract from ncbi


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pmid33755715      PLoS+One 2021 ; 16 (3): e0249043
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  • The impact of the coronavirus disease and Tele-Heart Failure Clinic on cardiovascular mortality and heart failure hospitalization in ambulatory patients with heart failure #MMPMID33755715
  • Puwanant S; Sinphurmsukskul S; Krailak L; Nakaviroj P; Boonbumrong N; Siwamogsatham S; Chettakulanurak K; Ariyachaipanich A; Boonyaratavej S
  • PLoS One 2021[]; 16 (3): e0249043 PMID33755715show ga
  • BACKGROUND: We sought to investigate the impact of the COVID-19 pandemic and the Tele-HF Clinic (Tele-HFC) program on cardiovascular death, heart failure (HF) rehospitalization, and heart transplantation rates in a cohort of ambulatory HF patients during and after the peak of the pandemic. METHODS: Using the HF clinic database, we compared data of patients with HF before, during, and after the peak of the pandemic (January 1 to March 17 [pre-COVID], March 17 to May 31 [peak-COVID], and June 1 to October 1 [post-COVID]). During peak-COVID, all patients were managed by Tele-HFC or hospitalization. After June 1, patients chose either a face-to-face clinic visit or a continuous tele-clinic visit. RESULTS: Cardiovascular death and medical titration rates were similar in peak-COVID compared with all other periods. HF readmission rates were significantly lower in peak-COVID (8.7% vs. 2.5%, p<0.001) and slightly increased (3.5%) post-COVID. Heart transplant rates were substantially increased in post-COVID (4.5% vs. peak-COVID [0%], p = 0.002). After June 1, 38% of patients continued with the Tele-HFC program. Patients managed by the Tele-HFC program for <6 months were less likely to have HF with reduced ejection fraction (73% vs. 54%, p = 0.005) and stage-D HF (33% vs. 14%, p = 0.001), and more likely to achieve the target neurohormonal blockade dose (p<0.01), compared with the >/=6-month Tele-HFC group. CONCLUSIONS: HF rehospitalization and transplant rates significantly declined during the pandemic in ambulatory care of HF. However, reduction in these rates did not affect subsequent 5-month hospitalization and cardiovascular mortality in the setting of Tele-HFC program and continuum of advanced HF therapies.
  • |Adult[MESH]
  • |Aged[MESH]
  • |Ambulatory Care Facilities[MESH]
  • |COVID-19/*pathology/virology[MESH]
  • |Cardiovascular Diseases/*diagnosis/mortality[MESH]
  • |Databases, Factual[MESH]
  • |Female[MESH]
  • |Heart Failure/*diagnosis/mortality/therapy[MESH]
  • |Heart Transplantation[MESH]
  • |Hospitalization/*statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Patient Readmission/statistics & numerical data[MESH]
  • |SARS-CoV-2/isolation & purification[MESH]
  • |Severity of Illness Index[MESH]


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