Lifting COVID-19 Shelter-in-Place Restrictions: Impact on Heart Failure Hospitalizations in Northeast Georgia.

Introduction: During the COVID-19 pandemic, the heart failure (HF) community has witnessed unprecedented declines in HF related patient visits and hospitalizations On April 24th, Georgia became the first state to allow businesses to reopen after the coronavirus shutdown Here, we describe the trend in HF hospitalizations before the state of emergency, during Shelter-in-Place order, and after the reopening The data was collected at the Northeast Georgia Health System, which is a large, quaternary care, community health system with 713 beds and a large HF/left ventricular assist device program Research Question or Hypothesis: Did the COVID-19 cause a decline of HF hospitalizations during Shelter-in-Place order followed by a surge in hospitalizations once restrictions were lifted? Study Design: Retrospective study Methods: Data was retrospectively collected using the electronic health record system from February 1st to June 12th in 2020 to obtain numbers of weekly HF hospitalizations Before the state of emergency, during Shelter-in-Place order, and after the reopening were defined as 02/01/20 - 03/06/20, 03/07/20 - 05/08/20, and 05/09/20 - 06/12/20, respectively This data was compared to the same period in 2019 (Jan 31st [due to a shorter February] to June 12th) Results: Weekly HF hospitalizations before the state of emergency were comparable between 2019 and 2020, with an average admission rate of 27 4 and 28 2 (P = 0 785), respectively During Shelter-in-Place order, there was a significant reduction of 36 5% in mean weekly admissions from 33 2 ± 4 7 in 2019 to 21 1 ± 5 3 in 2020 (P < 0 001) Two weeks after the reopening, the weekly hospitalizations returned to a similar level as it was observed in 2019 (28 4 ± 4 2 in 2019 vs 29 8 ± 5 0 in 2020, P = 0 288) Conclusion: No surge in HF hospitalization was observed after a decline in weekly HF hospitalizations, despite the “hospitalization debt” incurred during the Public Health State of Emergency and Shelter-in-Place periods