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

• Published in: Annals of pediatric cardiology Vol. 14; no. 3; pp. 260 - 268
• Main Authors: Choubey, Mrigank, Ramakrishnan, Sivasubramanian, Sachdeva, Sakshi, Mani, Kalaivani, Gangopadhyay, Debasree, Sivakumar, Kothandam, Kappanayil, Mahesh, Jayranganath, Mahimarangaiah, Koneti, Nageswara, Awasthy, Neeraj, Bobhate, Prashant, Gupta, Saurabh, Azad, Sushil, Dhulipudi, Bhargavi, Sonawane, Bhushan, Bandopadhyay, Biswajit, Muthukumaran, Chinnaswamy, Das, Debasis, Sivalingam, Devaprasath, Ramamurthy, Harpanahalli, Nayak, Hemant, Mishra, Jayashree, Muthusamy, Kalyanasundaram, Chakrabarti, Manisha, Islam, Nurul, Mahawar, Prashant, Shah, Prashant, Rajan, Saileela, Remadevi, Kavasseri, Abqari, Shaad, Chaudhary, Shiv, Kasturi, Soumya, Kumar, Raghavannair, Saxena, Anita, Iyer, Krishna, Sharma, Rajesh, Kumar, Raman, Radhakrishnan, Sitaraman, Kothari, Shyam, Kulkarni, Snehal, Rao, Suresh
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.07.2021; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Catheters; Children; congenital heart disease; Coronaviruses; COVID-19; Epidemics; grown up with congenital heart disease; Health aspects; Heart surgery; Hospitalization; India; low- and middle-income countries; Original; Pandemics; Pediatric cardiology; Pediatrics; severe acute respiratory syndrome and cardiac surgery; India; grown up with congenital heart disease; Congenital heart disease; low- and middle-income countries; severe acute respiratory syndrome and cardiac surgery
• ISSN: 0974-2069; 0974-5149
• DOI: 10.4103/apc.apc_133_21

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.