Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study

Armario X.; Carron J.; Simpkin A.J.; Elhadi M.; Kennedy C.; Abdel-Wahab M.; Bleiziffer S.; Lefèvre T.; Wolf A.; Pilgrim T.; Villablanca P.A.; Blackman D.J.; Van Mieghem N.M.; Hengstenberg C.; Swaans M.J.; Prendergast B.D.; Patterson T.; Barbanti M.; Webb J.G.; Behan M.; Resar J.; Chen M.; Hildick-Smith D.; Spence M.S.; Zweiker D.; Bagur R.; Teles R.; Ribichini F.L.; Jagielak D.; Park D.-W.; Kornowski R.; Wykrzykowska J.J.; Bunc M.; Estévez-Loureiro R.; Poon K.; Götberg M.; Jeger R.V.; Ince H.; Packer E.J.S.; Angelillis M.; Nombela-Franco L.; Guo Y.; Savontaus M.; Al-Moghairi A.M.; Parasca C.A.; Kliger C.; Roy D.; Molnár L.; Silva M.; White J.; Yamamoto M.; Carrilho-Ferreira P.; Toggweiler S.; Voudris V.; Ohno Y.; Rodrigues I.; Parma R.; Ojeda S.; Toutouzas K.; Regueiro A.; Grygier M.; AlMerri K.; Cruz-González I.; Fridrich V.; de la Torre Hernández J.M.; Noble S.; Kala P.; Asmarats L.; Kurt I.H.; Bosmans J.; Erglis M.; Casserly I.; Iskandarani D.; Bhindi R.; Kefer J.; Yin W.-H.; Rosseel L.; Kim H.-S.; O'Connor S.; Hellig F.; Sztejfman M.; Mendiz O.; Pineda A.M.; Seth A.; Pllaha E.; de Brito F.S., Jr.; Bajoras V.; Balghith M.A.; Lee M.; Eid-Lidt G.; Vandeloo B.; Vaz V.D.; Alasnag M.; Ussia G.P.; Tay E.; Mayol J.; Gunasekaran S.; Sardella G.; Buddhari W.; Kao H.-L.; Dager A.; Tzikas A.; Gudmundsdottir I.J.; Edris A.; Gutiérrez Jaikel L.A.; Arias E.A.; Al-Hijji M.; Ertürk M.; Conde-Vela C.; Boljević D.; Ferrero Guadagnoli A.; Hermlin T.; ElGuindy A.M.; Lima-Filho M.D.O.; de Moura Santos L.; Perez L.; Maluenda G.; Akyüz A.R.; Alhaddad I.A.; Amin H.; So C.-Y.; Al Nooryani A.A.; Vaca C.; Albistur J.; Nguyen Q.N.; Arzamendi D.; Grube E.; Modine T.; Tchétché D.; Hayashida K.; Latib A.; Makkar R.R.; Piazza N.; Søndergaard L.; McEvoy J.W.; Mylotte D. · JACC: Cardiovascular Interventions (2024) · DOI: 10.1016/j.jcin.2023.10.041

Resumen

Background: The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. Objectives: This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. Methods: This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. Results: We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (−52%; P = 0.001), Central-South America (−33%; P < 0.001), and Asia (−29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. Conclusions: TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.