Effect of COVID-19 on outpatient services in patients with aortovascular disease: a UK multicentre study

Abstract

Introduction: The SARS-CoV-2 coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare services worldwide. Outpatient services have necessarily been restructured to accommodate COVID-19 patients and to maintain social distancing measures. The aim of our study was to investigate how the COVID-19 pandemic has affected outpatient healthcare provision for patients with aortovascular disease. Methods: In this prospective study, a standardised proforma was circulated to seven aortic centres in the UK. Data on outpatient encounters were collected from March to July 2020. Captured data included demographic details, disease pattern, type of encounter (face-to-face, video or telephone), clinic outcome and availability of imaging. Results: A total of 632 patients were included in the study, including 164 (25.9%) new referrals. In this cohort, clinic settings have shifted towards remote consultations, with 424 (67.1%) patients undergoing telephone appointments. Over a third of new patients (34.8%) had a delay in diagnostic tests, which might be attributable to the indirect effects of COVID-19. A total of 102 (16.1%) patients were added to a surgical waiting list following clinic. Conclusions: To the best of our knowledge, this is the largest study of outpatient activity during the COVID-19 pandemic in patients with aortovascular disease. We demonstrate how the speciality has adapted to accommodate government-endorsed changes in healthcare provision, and question how COVID-19 may have affected access to diagnostics. Finally, we discuss how COVID-19 will affect patients added to surgical waiting lists.