key: cord-0918552-gox3rmzi
authors: Taylor, Bethany; Egolum, Ugochukwu; Patel, Nisha; Ling, Hua
title: Changes in the pattern of Heart Failure and Diuresis Clinic Utilization during COVID-19 Pandemic
date: 2020-08-25
journal: Heart Lung
DOI: 10.1016/j.hrtlng.2020.08.010
sha: ce9e047958555daee5886de99cb6fd0fc37f8a95
doc_id: 918552
cord_uid: gox3rmzi

nan

. The data were collected from Jan 11 th to July 3 rd , 2020. The mean weekly visits to the diuresis clinic were 3.82 ± 1.89 from Jan 11 th to Mar 27 th , 1.25 ± 0.5 from Mar 21 st to Apr 17 th , and 4.00 ± 1.7 from Apr 18 th to July 3 rd . In terms of the ratios between visits to the diuresis clinic and visits to HF clinics, the numbers from Jan 11 th to Mar 27 th , Mar 21 st to Apr 17 th , and Apr 18 th to July 3 rd were 3%, 1%, and 3%, respectively. The decrease in patients at the diuresis clinic was more pronounced than the reduction in the scheduled regular HF visits during Mar 21 st to Apr 17 th . The number of visits to diuresis clinic returned to historical values immediately after reopening on Apr 24 th and was maintained thereafter. No surge in visits to diuresis clinic was observed, despite the "diuresis clinic debt" incurred during the Public Health State of Emergency and Shelter-in-Place periods.

During the time of Shelter-In-Place order, many patients rescheduled their appointments to a later date which could explain the lowered visits at that time. 3 Some patients chose to receive clinical services via telehealth, but concerns were raised in terms of the effectiveness of virtual physical exams and the limitation of obtaining laboratory checks potentially reducing medication titrations. 4 The decline in visits observed at our diuresis clinic is concerning as there may be decompensated patients staying at home and delaying their care. Alternatively, there may be improved adherence to medical therapy 5 leading to reduced episodes of acute HF and need for visits to the diuresis clinic.

With COVID-19 cases on the rise, health care systems need to be prepared for changing patterns of resources utilization by patients. Whether there will be a "rebound" effect with a surge in outpatient HF visits or need for IV diuresis amid this rise in COVID-19 cases remains to be seen. Furthermore, the long-term impact of delayed or deferred HF care are unclear. Fig. 1 . Pattern of weekly HF visits and patients at outpatient diuresis clinic at Northeast Georgia Health System from Jan 11 st to July 3 rd , 2020.

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