The COVID-19 pandemic has greatly affected Australia’s population and health-care system. Cardiovascular disease (CVD) is one of many conditions impacted directly by COVID-19, as well as by the restrictions and changes affecting health care provision which commenced in February 2020 (Zaman et al. 2020, Nadarajah et al. 2022).
Compared with people with no existing CVD, people with existing CVD have a higher risk of cardiac complications from COVID-19 (Pellicori et al. 2021). They have an increased risk of hospitalisation, intensive care admission, poorer health outcomes and death.
People with COVID-19 are at increased risk of acute cardiac injury, heart failure, arrhythmias and acute coronary syndromes (Xie et al. 2022, Hessami et al. 2021). In rare cases, COVID-19 vaccines can cause myocarditis or pericarditis (Department of Health and Aged Care 2022a).
This web page explores some of the aspects of the impact of COVID-19 on people with CVD using national data available across the COVID-19 pandemic period. Note that COVID-19 lockdowns in different jurisdictions at different times will also affect the national total.
Health service use
People living with CVD require regular contact with GPs, medical specialists and allied health services to manage their condition(s). As part of restrictions introduced to deal with COVID-19, some health services were suspended or were required to operate in new or different ways. Adaptive health care delivery models, such as telehealth consultations, and revised resource allocations were needed to help address the needs of CVD patients during COVID-19 (Zaman et al. 2020, Nadarajah et al. 2022).
Care for stroke is one example. The first wave of the pandemic in 2020 negatively impacted access to specialised stroke units in hospitals, with fewer resources available for treatment, leading to concerns about reduced quality of care for patients with stroke (Cadilhac et al. 2022). The impact of diverted resources has been sustained beyond the first wave of the pandemic (Stroke Foundation 2021).
Primary health care
MedicineInsight is a database containing de-identified electronic health records from around 450 Australian general practices. From this data, a series of annual General Practice Insights Reports are released. The data allows exploration of whether the COVID-19 pandemic decreased the likelihood that a patient with a chronic condition such as CVD would visit their GP.
The general pattern in the monthly number of clinical encounters was similar in 2019 and 2020 (NPS MedicineWise 2022). The rate of presentations per 1,000 clinical encounters for patients with a history of CVD also showed little variation over 2019 and 2020. There was no substantial difference when each quarter in 2020 was compared to the corresponding quarter in 2019:
- 27 CVD patients per 1,000 clinical encounters in Quarter 2 of 2020, compared with 28 in Quarter 2 of 2019
- 6.1 heart failure patients per 1,000 clinical encounters in Quarter 2 of 2020, compared with 6.2 in Quarter 2 of 2019.
One factor as to why that rate was unchanged is the rapid uptake of telehealth services via phone or video conferencing in April 2020 after the introduction of temporary MBS items in response to COVID-19 lockdown restrictions (NPS MedicineWise 2022, Department of Health and Aged Care 2022b).
Heart Health Checks were affected by the pandemic. Nationally, the total number of services processed fell to 2,900 per month in April 2020, compared with a monthly average of 7,200 for that year (Figure 1). Monthly averages have since increased to 8,400 in 2021, and 10,000 in January–July 2022, noting that this includes an end-of-year fall to 4,800 in January 2022 which coincided with the Omicron wave of the pandemic.