Impact of COVID-19 on Chest Pain Consultations in Primary Care
Author Information
Author(s): Simone van den Bulk, Jasper W. A. van Egeraat, Annelieke H. J. Petrus, Mattijs E. Numans, Tobias N. Bonten
Primary Institution: Leiden University Medical Center
Hypothesis
This study aims to assess the impact of the COVID-19 lockdown on the number of patients presenting with chest pain in primary care.
Conclusion
During the COVID-19 lockdown, the number of chest pain consultations and registered acute coronary syndrome diagnoses in primary care decreased significantly.
Supporting Evidence
- Chest pain consultations decreased from 9,228 before lockdown to 680 during lockdown.
- The incidence rate of chest pain consultations was 6.16 per 1000 person-years during lockdown compared to an expected 7.55.
- Telephone consultations increased from 22% before lockdown to 48% during lockdown.
- Fewer patients were referred to the hospital during lockdown, with referrals dropping from 19% to 9.9%.
- The incidence rate ratio for chest pain consultations during lockdown was 0.62.
Takeaway
During the COVID-19 lockdown, fewer people went to their doctor for chest pain, and many were seen over the phone instead of in person.
Methodology
Routine primary care data from the Extramural LUMC Academic Network in the Netherlands were analyzed using an interrupted time series analysis.
Potential Biases
Misclassification bias may occur if GPs used different codes for chest pain or did not register hospital diagnoses accurately.
Limitations
The study is observational, which prevents drawing causal conclusions, and there is a risk of misclassification bias in the data.
Participant Demographics
Patients consulting their GP for chest pain during lockdown had a mean age of 65 years, with 57% being women.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI 7.03–8.12
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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