Unusual Incidence of Acute Type A Aortic Dissection during COVID-19

Ashley T. Giammarino; John Winalski; Stevan S. Pupovac; Frank Manetta; I. Claire Sarmiento; Derek R. Brinster

doi:10.1055/a-2594-4660

International Journal of Angiology, Inhaltsverzeichnis

Int J Angiol 2025; 34(03): 215-219
DOI: 10.1055/a-2594-4660

Original Article

Unusual Incidence of Acute Type A Aortic Dissection during COVID-19

Autor*innen

Ashley T. Giammarino

¹Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, New York, New York
John Winalski

¹Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, New York, New York
Stevan S. Pupovac

¹Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, New York, New York
Frank Manetta

¹Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, New York, New York
I. Claire Sarmiento

¹Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, New York, New York
Derek R. Brinster

¹Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, New York, New York

Abstract

Seasonal variations have been identified in the incidence of Stanford acute type A aortic dissection (ATAAD), and these have been only further impacted by the recent COVID-19 pandemic. We sought to examine the incidence and presentation of ATAAD during the initial height of the COVID-19 pandemic during the year 2020 and compare this with our pre-pandemic experience. A retrospective review was undertaken of all consecutive patients who had ATAAD repair between January 2014 and December 2020. The incidence and pattern of presentation during 2020 was compared with that of the prior 6 years. A total of 339 patients underwent ATAAD during the study period, 301 (88.8%) from 2014 to 2019 (pre-COVID-19) and 38 (11.2%) during 2020 (coincident with COVID-19). We found a marked decrease in the incidence of ATAAD during COVID-19 as compared to the aggregate of our prior experience. During the height of the COVID-19 pandemic, we witnessed significantly fewer patients presenting with ATAAD, presumably due to a combination of “lockdown” restrictions, perhaps coupled with reduced influenza activity in the population. This was followed by an unusual rebound in the incidence of ATAAD, a phenomenon not previously noted.

Keywords

aortic dissection - COVID-19 - population - incidence - influenza

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Referenzen

References
1 Pape LA, Awais M, Woznicki EM. et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol 2015; 66 (04) 350-358
2 Evangelista A, Isselbacher EM, Bossone E. et al.; IRAD Investigators. Insights from the International Registry of Acute Aortic Dissection. A 20-year experience of collaborative clinical research. Circulation 2018; 137 (17) 1846-1860
3 Wundram M, Falk V, Eulert-Grehn JJ. et al. Incidence of acute type A aortic dissection in emergency departments. Sci Rep 2020; 10 (01) 7434
4 Rausei S, Ferrara F, Zurleni T. et al.; for Italian Association of Hospital Surgeons, and Collected Data Contributors. Dramatic decrease of surgical emergencies during COVID-19 outbreak. J Trauma Acute Care Surg 2020; 89 (06) 1085-1091
5 Ceresoli M, Coccolini F, Magnone S. et al.; Appendicitis-COVID Study Group. The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic. Eur J Trauma Emerg Surg 2021; 47 (05) 1359-1365
6 Lazzati A, Raphael Rousseau M, Bartier S. et al. Impact of COVID-19 on surgical emergencies: nationwide analysis. BJS Open 2021; 5 (03) zrab039
7 Takagi H, Ando T, Umemoto T. (ALICE [All-Literature Investigation of Cardiovascular Evidence] Group). Meta-analysis of seasonal incidence of aortic dissection. Am J Cardiol 2017; 120 (04) 700-707
8 Benouaich V, Soler P, Gourraud PA, Lopez S, Rousseau H, Marcheix B. Impact of meteorological conditions on the occurrence of acute type A aortic dissections. Interact Cardiovasc Thorac Surg 2010; 10 (03) 403-406
9 Mehta RH, Manfredini R, Bossone E. et al.; International Registry of Acute Aortic Dissection (IRAD) Investigators. The winter peak in the occurrence of acute aortic dissection is independent of climate. Chronobiol Int 2005; 22 (04) 723-729
10 DeAnda Jr A, Grossi EA, Balsam LB. et al. The chronobiology of Stanford type A aortic dissections: a comparison of northern versus southern hemispheres. Aorta (Stamford) 2015; 3 (06) 182-186
11 Wu Z, Li Y, Zhou W. et al. Seasonal incidence of ruptured abdominal aortic aneurysm and the influence of atmospheric pressure: a systematic review and meta-analysis. Int J Biometeorol 2018; 62 (09) 1733-1743
12 Ashur C, Norton E, Farhat L. et al. Higher admission rates and in-hospital mortality for acute type A aortic dissection during Influenza season: a single center experience. Sci Rep 2020; 10 (01) 4723
13 Haidari M, Wyde PR, Litovsky S. et al. Influenza virus directly infects, inflames, and resides in the arteries of atherosclerotic and normal mice. Atherosclerosis 2010; 208 (01) 90-96
14 Abou-Ismail MY, Diamond A, Kapoor S, Arafah Y, Nayak L. The hypercoagulable state in COVID-19: Incidence, pathophysiology, and management. Thromb Res 2020; 194: 101-115
15 Yin Z, Kang Z, Yang D, Ding S, Luo H, Xiao E. A comparison of clinical and chest CT findings in patients with influenza A (H1N1) virus infection and coronavirus disease (COVID-19). AJR Am J Roentgenol 2020; 215 (05) 1065-1071
16 Olsen SJ, Azziz-Baumgartner E, Budd AP. et al. Decreased influenza activity during the COVID-19 pandemic - United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (37) 1305-1309
17 Soo RJJ, Chiew CJ, Ma S, Pung R, Lee V. Decreased influenza incidence under COVID-19 control measures, Singapore. Emerg Infect Dis 2020; 26 (08) 1933-1935
18 Itaya T, Furuse Y, Jindai K. Does COVID-19 infection impact on the trend of seasonal influenza infection? 11 countries and regions, from 2014 to 2020. Int J Infect Dis 2020; 97: 78-80
19 Ashur C, Conlon A, Eagle KA, Hoffmann-Bowman MA. Influenza infection and aortic dissection: a commentary on the association between a viral syndrome and major cardiac evens in the context of the current COVID-19 pandemic. J Allergy Infect Dis 2020; 1: 9-14
20 Maringe C, Spicer J, Morris M. et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol 2020; 21 (08) 1023-1034
21 Garcia S, Albaghdadi MS, Meraj PM. et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol 2020; 75 (22) 2871-2872
22 Wong LE, Hawkins JE, Langness S, Murrell KL, Iris P, Sammann A. Where are all the patients? Addressing Covid-19 fear to encourage sick patients' to seek emergency care. NEJM Catal 2020; 1: 12
23 Kurihara H, Marrano E, Ceolin M. et al.; Lombardy Emergency Surgery Group during Covid19 outbreak. Impact of lockdown on emergency general surgery during first 2020 COVID-19 outbreak. Eur J Trauma Emerg Surg 2021; 47 (03) 677-682
24 Apisarnthanarak A, Siripraparat C, Apisarnthanarak P. et al. Patients' anxiety, fear, and panic related to coronavirus disease 2019 (COVID-19) and confidence in hospital infection control policy in outpatient departments: A survey from four Thai hospitals. Infect Control Hosp Epidemiol 2021; 42 (10) 1288-1290
25 Baudry A, Mariet AS, Benzenine E. et al. Cardiovascular surgical emergencies in France, before, during and after the first lockdown for COVID-19 in 2020: a comparative nationwide retrospective cohort study. Life (Basel) 2021; 11 (11) 1245
26 He L, Lu F, Du X. et al. Impact of COVID-19 pandemic on hospital admissions of acute coronary syndrome: a Beijing inpatient database study. Lancet Reg Health West Pac 2022; 19: 100335