Impact of COVID-19 in coronary heart disease follow-up in primary care

Ileana Gefaell, Sara Ares Blanco, Marta Pérez-Álvarez, Marina Guisado-Clavero, Cristina Muñoz, Marta Castelo-Jurado

Keywords: Coronary Disease, COVID-19, Follow-Up Studies, Sex

The monitoring of coronary heart disease (CHD) is carried out mainly by Primary Care. During the COVID-19 pandemic, the normal follow-up was delayed.

Research questions:
Has the COVID-19 pandemic affected the cardiovascular monitoring of CHD in men and women?

Observational follow-up study of an ambispective cohort in Madrid. Participants: Patients with CHD prior to 2020, > 45 years (n:151). Time period: from 28/02/2020 to 12/1/2020. Variables: data from BT (HbA1c%, total cholesterol, LDL-c, HDL-c), BMI and blood pressure (BP), in two time periods. First cut: data before 03/13/2020. Second cut: first available data after 03/13/2020. Data collection: electronic medical record. Analysis: STATA 16

151 patients were enrolled (aged: 72.2 ±13.2, 65.6% male), 72.2% had hypertension, 66.2% had BMI >26 Kg/m², 64.9% had dyslipidemia and 41.1% were diabetic.There were no differences in comorbidities between sexes except for hypertension, predominantly in women (83%, p=0.037).
The median HbA1c% was 6.5% (IQR 5.9-7.6), mean total cholesterol (TC) was 146 mg/dl , HDL-c 46.4mg/dl, LDL-c 74.5, mean BP was 129.4 / 72.3mmHg before lockdown. We found differences between women and men in TC 154.4 vs141.6 mg/dl (p=0.024) and HDL-c 53.2 vs 42.8md/dl (p<0.001)
In the second cut: mean TC 140.2mg/dl, HDL-c 46.5mg/dl, LDL-c 71.6mg/dl. SBP was 130.7/ 70mmHg. The same differences in women vs men were observed: TC 153 vs 133mg/dl (p=0.036) and HDL-c 51.5 vs 43.7 (p=0.02)

Patients kept similar cardiovascular monitoring despite the pandemic during the first 9 months. Women had higher TC and HDL than men.

Points for discussion:
New hypothesis around the results


Possible explanations