Publication

Abstract : The wider health impacts of the coronavirus disease 2019 (COVID-19) pandemic are of increasing concern, with an increase in rates of non-COVID-19 excess mortality observed. In England and the United States, the early pandemic was accompanied by a decline in patient visits to Emergency Departments (EDs), including those for cardiac diseases.1,2 The decline may have been influenced by patient’s reluctance to visit hospital due to the public health messages to protect National Health Service capacity, concerns about the risk of coronavirus infection, or difficulties in accessing medical care. The impact of delayed or nonpresentation to EDs with suspected cardiac disease on cardiac mortality is unknown. In this study, we used instrumental variable analysis to estimate the effects of reduced ED visits on cardiac mortality in England.