ArticleNeurology2022
Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During the First 2 COVID-19 Waves in the Netherlands.
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Article in Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 21 citations in OpenAlex.
- The prevalence and incidence of young onset dementia in the Netherlands: a prospective study in two catchment areas.Alzheimer's research & therapy · 2026Article
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- Proportional Stroke Mortality in Espírito Santo, Brazil: A 20-Year Joinpoint Regression Study.Epidemiologia (Basel, Switzerland) · 2025Article
- The effect of Covid-19 pandemic on the primary health care utilization and cost: an interrupted time series analysis.Cost effectiveness and resource allocation : C/E · 2025Article
- Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data.BMC primary care · 2024Article
- Lessons learned for pandemic preparedness in the neurodegenerative research and clinical fields: an advice report based on Parkinson's disease as an example.BMC neurology · 2024Article
- An Interrupted Time-Series Analysis of the Impact of COVID-19 on Hospitalizations for Vascular Events in 3 Canadian Provinces.CJC open · 2024Article
- Sex Disparity in Stroke Mortality among Adults: A Time Series Analysis in the Greater Vitoria Region, Brazil (2000-2021).Epidemiologia (Basel, Switzerland) · 2024Article
- Dutch GP healthcare consumption in COVID-19 heterogeneous regions: an interregional time-series approach in 2020-2021.BJGP open · 2024Article
- Outreach work in Belgian primary care practices during COVID-19: results from the cross-sectional PRICOV-19 study.BMC primary care · 2024Article
- Delivering Primary Health Care (PHC) Services for Controlling NCDs During the COVID-19 Pandemic: A Scoping Review.Journal of prevention (2022) · 2023Article
- Changes in incidence of hospitalization for cardiovascular diseases during the COVID-19 pandemic in The Netherlands in 2020.Scientific reports · 2023Article
- The impact of the SARS-CoV-2 pandemic on cause-specific mortality patterns: a systematic literature review.Zeitschrift fur Gesundheitswissenschaften = Journal of public health · 2022Review
- The long-term impact of the COVID-19 pandemic on primary and specialized care provision and disease recognition in Germany.Frontiers in public health · 2022Observational
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15 authors at 1 institution in 1 country.
Premysl VelekFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands. p.velek@erasmusmc.nl.
Marije J SplinterFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
M Kamran IkramFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
M Arfan IkramFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Maarten J G LeeningFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.ORCID 0000-0002-4143-4839
Johan van der LeiFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Tim Olde HartmanFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Lilian L PetersFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Huibert TangeFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Frans H RuttenFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Henk van WeertFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.ORCID 0000-0001-6370-4724
Frank J WoltersFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.ORCID 0000-0003-2226-4050
Patrick J E BindelsFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Silvan LicherFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Evelien I T de SchepperFrom the Departments of Epidemiology (P.V., M.J.S., M.K.I., M.A.I., M.J.G.L., F.J.W., S.L.), General Practice (P.V., P.J.E.B., E.I.T.d.S.), Cardiology (M.J.G.L.), Neurology (M.K.I.), Medical Informatics (J.v.d.L.), and Radiology and Nuclear Medicine (F.J.W.), Erasmus MC-University Medical Centre Rotterdam; Department of Primary and Community Care (T.o.H.), Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre; Department of General Practice & Elderly Medicine/Midwifery Science (L.L.P.), University Medical Centre Groningen; Midwifery Science, Vrije Universiteit Amsterdam (L.L.P.), and Department of General Practice (H.v.W.), Amsterdam Public Health, Amsterdam University Medical Centre; Department of Family Practice (H.T.), CAPHRI School for Public Health and Primary Care, Maastricht University; and Department of General Practice (F.H.R.), Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands.
Radboud University Nijmegen · NL
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAlthough there is evidence of disruption in acute cerebrovascular and cardiovascular care during the coronavirus disease 2019 (COVID-19) pandemic, its downstream effect in primary care is less clear. We investigated how the pandemic affected utilization of cerebrovascular and cardiovascular care in general practices (GPs) and determined changes in GP-recorded diagnoses of selected cerebrovascular and cardiovascular outcomes.
methodsFrom electronic health records of 166,929 primary care patients aged 30 or over within the Rotterdam region, the Netherlands, we extracted the number of consultations related to cerebrovascular and cardiovascular care, and first diagnoses of selected cerebrovascular and cardiovascular risk factors (hypertension, diabetes, lipid disorders), conditions, and events (angina, atrial fibrillation, TIA, myocardial infarction, stroke). We quantified changes in those outcomes during the first COVID-19 wave (March-May 2020) and thereafter (June-December 2020) by comparing them to the same period in 2016-2019. We also estimated the number of potentially missed diagnoses for each outcome.
resultsThe number of GP consultations related to cerebrovascular and cardiovascular care declined by 38% (0.62, 95% confidence interval 0.56-0.68) during the first wave, as compared to expected counts based on prepandemic levels. Substantial declines in the number of new diagnoses were observed for cerebrovascular events: 37% for TIA (0.63, 0.41-0.96) and 29% for stroke (0.71, 0.59-0.84), while no significant changes were observed for cardiovascular events (myocardial infarction [0.91, 0.74-1.14], angina [0.77, 0.48-1.25]). The counts across individual diagnoses recovered following June 2020, but the number of GP consultations related to cerebrovascular and cardiovascular care remained lower than expected throughout the June to December period (0.93, 0.88-0.98). DISCUSSION: While new diagnoses of acute cardiovascular events remained stable during the COVID-19 pandemic, diagnoses of cerebrovascular events declined substantially compared to prepandemic levels, possibly due to incorrect perception of risk by patients. These findings emphasize the need to improve symptom recognition of cerebrovascular events among the general public and to encourage urgent presentation despite any physical distancing measures.
Indexed as
Cardiovascular DiseasesCOVID-19Primary Health CareStrokeAdultHumansNetherlandsPandemics
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