Wakati huu wa kwaresma ni wakati wa kukumbuka pamoja na kwamba Mwenyezi Mungu anatulinda tusimjaribu. Mungu ametupa uwezo wa kujua na kugundua dawa hivyo tusiache kutumia na kusubiri Mungu.
Kwa ufupi kumjaribu Mungu sio swala zuri na kuwaambia watu waache kufuata njia za kinga kama kutumia neti za mbu, chanjo mbalimbali, dawa sio sawa.
Badala ya kubishana na Mungu tutumie muda mwingi kusikiliza sauti yake anasema nini. Kwa Mungu hakuna mipaka hivyo ukiomba kwa mipaka na kufikiri Tanzania pekee ndiyo itasaidiwa sio sawa Mungu hana mipaka ya nchi.
Mungu anajali watu na mipaka ni jambo ya kisiasa sio la utu
wa taarifa tuliyopata kwa wale tuliomjua Magufuli na kujuana kifamilia ni kwamba Covid ilisababisha pacemaker yake isifanye kazi na mapigo ya moyo kuanza kwenye juu sana na chini sana na kusababisha stroke
Background
COVID-19 was first considered a pandemic on the 11th of March of 2020 by the World Health Organization. Its impact comprised not only the direct consequences of the disease but a decrease in the follow-up and interventions of patients with cardiovascular (CV) disease. In Portugal and the World, the consequences of this complex paradigm shift on emergent pacemaker implantation rates during and after this pandemic is largely unknown.
Purpose
We sought to analyse the impact of COVID-19 pandemic on emergent pacemaker implantation rate and patient profile in a tertiary hospital during the first Portuguese lockdown and subsequent post-lockdown period.
Methods
We retrospectively reviewed the clinical profile of patients who had pacemakers implanted in our hospital in an urgent/emergent setting from March 18, 2020 to May 17, 2020 (lockdown) and May 19 to July 17, 2020 (post-lockdown). This data was then directly compared to the homologous periods from the year before (H1 and H2, respectively).
Results
A total of 180 patients submitted to emergent pacemaker implantation were included.
The cohort was comprised of 29 patients who had a pacemaker implanted during lockdown, 60 post-lockdown, 38 in H1 (+31% vs lockdown) and 53 in H2. Average age and gender proportion were similar for all groups.
When comparing lockdown and post-lockdown periods, the number of cases significantly increased in the second period (+106.9%) and there was a tendency for a higher number of temporary pacemaker use (3.4% vs 16.7%; p=0.076). Patients admitted during lockdown were 7.57 times more likely to present with hypotension/shock (odds ratio (OR) 7.57; p=0.013).
Regarding lockdown and its homologous 2019 period, there was a decrease in the number of patients admitted (−23.7%). Again, there was a higher tendency for hypotension on presentation during lockdown (p=0.054).
In comparison to its homologous 2019 period, post-lockdown saw a slight increase in the number of patients (+13.2%) and more patients presented with bradycardia (16.7% vs 3.8%; p=0.026).
Also of note, no patients were admitted to the emergency department during lockdown for anomalies detected on ambulatory tests (Holter, electrocardiogram or implanted loop recorder).
Conclusion
During lockdown, clinical presentation was generally more severe, with a greater number of patients presenting with hypotension/shock. In addition, there appears to be a lockdown effect on emergent bradyarrhtmias admissions in the post-lockdown period with a profound impact: higher admission rates and more severe presentations including a higher need of temporary pacemaker. Patients with symptoms suggestive of bradyarrhythmias should be advised to present promptly regardless of the pandemic.
Funding Acknowledgement