Cholesterol testing rates decline amid COVID-19 pandemic
Cholesterol testing dropped during the COVID-19 pandemic, raising concerns about providing patients with proper preventive care, according to a study published in the American Journal of Preventive Cardiology.
“The COVID-19 pandemic caused by SARS-CoV-2 has led to reductions in outpatient medical care and routine preventive screening for cancer and diabetes mellitus,” Esra D. Gumuser, MD, MS, resident physician at Massachusetts General Hospital, and colleagues wrote. “Primary and secondary cardiovascular disease prevention guidelines advise routine cholesterol screening and surveillance for individuals aged 40 years and particularly those with established atherosclerotic cardiovascular disease. However, data on cholesterol testing since the start of the COVID-19 pandemic are limited.”
To characterize trends in cholesterol testing since the start of COVID-19, researchers extracted the data of cholesterol tests performed within the Mass General Brigham health system from March to September 2020 and compared them with weekly cholesterol testing rates for the same period in 2019.
The study included 296,599 tests for 220,215 individuals aged at least 40 years, of which 112,143 occurred in 2020 and 184,456 occurred in 2019.
The researchers found an overall cholesterol testing decline of 39.2% from 2019 to 2020 (weekly mean, 6,361 tests in 2019 vs. 3,867 tests in 2020; P = 2.6 x 10-5) with the greatest reduction in cholesterol testing rates seen during the early months of the pandemic (March-May 2020; up to 92% weekly reduction from same period in 2019).
Upon further analysis, researchers noted a 71.8% decline in testing rates from March to mid-June 2020 compared with the same period in 2019 (weekly mean, 6,669 tests in 2019 vs. 1,879 tests in 2020; P = 1 x 10-7).
However, the researchers wrote, by August 2020, weekly cholesterol testing returned to normal rates, with no differences from mid-June through September (6,072 tests per week in 2019 vs. 5,722 tests per week in 2020; P = .26).
“A concerning potential implication of these findings is that we’ve neglected important aspects of preventive care since the onset of COVID-19; it’s worth remembering that cardiovascular disease remains the leading cause of death in the U.S. and management of blood cholesterol is a cornerstone of cardiovascular disease prevention, especially for secondary and high-risk primary prevention populations,” Michael Honigberg, MD, MPP, cardiologist and researcher at Massachusetts General Hospital and instructor of medicine at Harvard Medical School, told Healio. “I’m concerned that there are high-risk patients whom we’re missing and/or undertreating as a result of broad reductions in preventive care. As vaccination reaches larger numbers of our patients, hopefully patients and clinicians will feel more comfortable resuming routine care and we can start catching up with the parts of preventive care such as cholesterol screening.”
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Michael Honigberg, MD, MPP, can be reached at email@example.com.