The collateral damage of COVID-19 to cardiovascular services: a meta-analysis

The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time...

Celý popis

Uložené v:

Podrobná bibliografia
Vydané v:	European heart journal Ročník 43; číslo 33; s. 3164
Hlavní autori:	Nadarajah, Ramesh, Wu, Jianhua, Hurdus, Ben, Asma, Samira, Bhatt, Deepak L, Biondi-Zoccai, Giuseppe, Mehta, Laxmi S, Ram, C Venkata S, Ribeiro, Antonio Luiz P, Van Spall, Harriette G C, Deanfield, John E, Lüscher, Thomas F, Mamas, Mamas, Gale, Chris P
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England 01.09.2022
Predmet:	Cardiovascular Diseases - epidemiology Cardiovascular Diseases - therapy COVID-19 - epidemiology Hospital Mortality Hospitalization Humans Pandemics ST Elevation Myocardial Infarction COVID-19 Hospitalization Treatment Cardiovascular Mortality
ISSN:	1522-9645, 1522-9645
On-line prístup:	Zistit podrobnosti o prístupe
Tagy:	Pridať tag Žiadne tagy, Buďte prvý, kto otaguje tento záznam!

Abstract	The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic. From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66-0.94) and revascularisation (RR 0.73, 95% CI 0.62-0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10-1.37) and heart failure (RR 1.08, 95% CI 1.04-1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave. There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification.
AbstractList	The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic.AIMSThe effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic.From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66-0.94) and revascularisation (RR 0.73, 95% CI 0.62-0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10-1.37) and heart failure (RR 1.08, 95% CI 1.04-1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave.METHODS AND RESULTSFrom January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66-0.94) and revascularisation (RR 0.73, 95% CI 0.62-0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10-1.37) and heart failure (RR 1.08, 95% CI 1.04-1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave.There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification.CONCLUSIONSThere was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification. The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic. From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66-0.94) and revascularisation (RR 0.73, 95% CI 0.62-0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10-1.37) and heart failure (RR 1.08, 95% CI 1.04-1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave. There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification.
Author	Wu, Jianhua Biondi-Zoccai, Giuseppe Lüscher, Thomas F Asma, Samira Mamas, Mamas Bhatt, Deepak L Van Spall, Harriette G C Nadarajah, Ramesh Ram, C Venkata S Gale, Chris P Hurdus, Ben Ribeiro, Antonio Luiz P Mehta, Laxmi S Deanfield, John E
Author_xml	– sequence: 1 givenname: Ramesh orcidid: 0000-0001-9895-9356 surname: Nadarajah fullname: Nadarajah, Ramesh organization: Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK – sequence: 2 givenname: Jianhua orcidid: 0000-0001-6093-599X surname: Wu fullname: Wu, Jianhua organization: School of Dentistry, University of Leeds, Leeds, UK – sequence: 3 givenname: Ben orcidid: 0000-0001-8149-3449 surname: Hurdus fullname: Hurdus, Ben organization: Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK – sequence: 4 givenname: Samira surname: Asma fullname: Asma, Samira organization: Division of Data, Analytics and Delivery for Impact, World Health Organization, Geneva, Switzerland – sequence: 5 givenname: Deepak L orcidid: 0000-0002-1278-6245 surname: Bhatt fullname: Bhatt, Deepak L organization: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA – sequence: 6 givenname: Giuseppe orcidid: 0000-0001-6103-8510 surname: Biondi-Zoccai fullname: Biondi-Zoccai, Giuseppe organization: Mediterranea Cardiocentro, Napoli, Italy – sequence: 7 givenname: Laxmi S orcidid: 0000-0003-3493-1930 surname: Mehta fullname: Mehta, Laxmi S organization: Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA – sequence: 8 givenname: C Venkata S surname: Ram fullname: Ram, C Venkata S organization: Faculty of Medical and Health Sciences, Macquarie University, Sydney, Australia – sequence: 9 givenname: Antonio Luiz P orcidid: 0000-0002-2740-0042 surname: Ribeiro fullname: Ribeiro, Antonio Luiz P organization: Cardiology Service and Telehealth Center, Hospital das Clínicas, and Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil – sequence: 10 givenname: Harriette G C orcidid: 0000-0002-8370-4569 surname: Van Spall fullname: Van Spall, Harriette G C organization: Population Health Research Institute, Hamilton, Canada – sequence: 11 givenname: John E orcidid: 0000-0001-8806-6052 surname: Deanfield fullname: Deanfield, John E organization: Institute of Cardiovascular Sciences, University College, London, UK – sequence: 12 givenname: Thomas F orcidid: 0000-0002-5259-538X surname: Lüscher fullname: Lüscher, Thomas F organization: Royal Brompton & Harefield Hospital, Imperial College, London, UK – sequence: 13 givenname: Mamas orcidid: 0000-0001-9241-8890 surname: Mamas fullname: Mamas, Mamas organization: Keele Cardiovascular Research Group, Institute for Prognosis Research, University of Keele, Keele, UK – sequence: 14 givenname: Chris P orcidid: 0000-0003-4732-382X surname: Gale fullname: Gale, Chris P organization: Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/36044988$$D View this record in MEDLINE/PubMed
BookMark	eNpNkEtLAzEUhYNU7EN_gBvJ0s3YJDNJE3fS-ihUuqluhzvJjZ0yj5rMFPrvLVjB1TmLjw_OGZNB0zZIyC1nD5yZdIp92CKEbjfFLVghZhdkxKUQiVGZHPzrQzKOcccY04qrKzJMFcsyo_WIvG-2SG1bVdBhgIo6qOELaevpfP25XCTc0K6lFoIr2wNE21cQaMRwKC3GRwq0xg4SaKA6xjJek0sPVcSbc07Ix8vzZv6WrNavy_nTKrGSiS4RXinuuMjsDIXirPAydZKbAnWqUs295Nr4woHnhXJeS88lFEpnIJQ1qRATcv_r3Yf2u8fY5XUZLZ5WNNj2MRczZhjXSuoTendG-6JGl-9DWUM45n8XiB9ENmC-
CitedBy_id	crossref_primary_10_1016_j_jenvp_2023_102009 crossref_primary_10_1016_j_dsx_2023_102709 crossref_primary_10_1016_j_hfc_2023_02_001 crossref_primary_10_1111_jep_14233 crossref_primary_10_1161_CIRCRESAHA_122_321952 crossref_primary_10_1016_j_jclinepi_2024_111437 crossref_primary_10_1093_eurheartj_ehac462 crossref_primary_10_1111_1467_9566_13848 crossref_primary_10_1016_j_hlc_2022_12_008 crossref_primary_10_1016_j_ijcrp_2024_200248 crossref_primary_10_3390_ijms24032492 crossref_primary_10_1016_j_pcad_2025_06_010 crossref_primary_10_1186_s12872_025_04686_9 crossref_primary_10_1016_j_jcin_2023_10_041 crossref_primary_10_1038_s41598_024_80872_7 crossref_primary_10_1002_ehf2_14257 crossref_primary_10_3390_jcm12010335 crossref_primary_10_7759_cureus_48275 crossref_primary_10_1590_1980_549720250033 crossref_primary_10_1590_1980_549720250033_2 crossref_primary_10_1186_s12875_024_02676_y crossref_primary_10_1136_heartjnl_2022_321754 crossref_primary_10_1002_ejhf_2727 crossref_primary_10_1016_j_cpcardiol_2023_101728 crossref_primary_10_1136_bmj_2023_075133 crossref_primary_10_1001_jamanetworkopen_2025_12919 crossref_primary_10_1093_eurpub_ckad180 crossref_primary_10_1016_j_vaccine_2023_12_074 crossref_primary_10_1093_qjmed_hcaf022 crossref_primary_10_1136_heartjnl_2024_324181 crossref_primary_10_1007_s40620_025_02376_5 crossref_primary_10_1177_00084174241245622 crossref_primary_10_1016_j_jfma_2024_10_010 crossref_primary_10_1016_j_jscai_2023_100970 crossref_primary_10_3390_jcm13113112 crossref_primary_10_1073_pnas_2309557120 crossref_primary_10_1093_eurheartj_ehac256 crossref_primary_10_3390_jcdd10050199 crossref_primary_10_1016_j_pcad_2023_01_005 crossref_primary_10_1007_s00059_023_05174_6 crossref_primary_10_1093_ehjqcco_qcae002 crossref_primary_10_1007_s10654_024_01118_4 crossref_primary_10_1186_s12913_024_10554_7 crossref_primary_10_1016_j_cjca_2023_03_005 crossref_primary_10_3390_ijerph20010689 crossref_primary_10_1001_jamanetworkopen_2023_52377 crossref_primary_10_1007_s11883_023_01131_0 crossref_primary_10_1186_s12964_022_01010_2
ContentType	Journal Article
Copyright	The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Copyright_xml	– notice: The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
DBID	CGR CUY CVF ECM EIF NPM 7X8
DOI	10.1093/eurheartj/ehac227
DatabaseName	Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic
DatabaseTitle	MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic
DatabaseTitleList	MEDLINE - Academic MEDLINE
Database_xml	– sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database
DeliveryMethod	no_fulltext_linktorsrc
Discipline	Medicine
EISSN	1522-9645
ExternalDocumentID	36044988
Genre	Meta-Analysis Systematic Review Journal Article
GrantInformation_xml	– fundername: World Health Organization grantid: 001
GroupedDBID	--- -E4 .2P .I3 .XZ .ZR 08P 0R~ 18M 1TH 29G 2WC 4.4 482 48X 53G 5GY 5RE 5VS 5WA 5WD 70D AABZA AACZT AAFWJ AAJKP AAMVS AAOGV AAPNW AAPQZ AAPXW AARHZ AAUAY AAVAP ABDFA ABEJV ABEUO ABGNP ABIXL ABJNI ABKDP ABNHQ ABNKS ABOCM ABPQP ABPTD ABQLI ABQNK ABVGC ABWST ABXVV ABZBJ ACGFO ACGFS ACPRK ACUFI ACUTJ ACUTO ACYHN ADBBV ADEYI ADEZT ADGZP ADHKW ADHZD ADIPN ADNBA ADOCK ADQBN ADRTK ADVEK ADYVW ADZXQ AEGPL AEGXH AEJOX AEKSI AEMDU AEMQT AENEX AENZO AEPUE AETBJ AEWNT AFFZL AFIYH AFOFC AFXAL AFYAG AGINJ AGKEF AGORE AGQXC AGSYK AGUTN AHGBF AHMBA AHMMS AHXPO AIAGR AIJHB AJBYB AJEEA AJNCP ALMA_UNASSIGNED_HOLDINGS ALUQC ALXQX APIBT APWMN ATGXG AXUDD BAWUL BAYMD BCGUY BCRHZ BEYMZ BHONS BTRTY BVRKM C45 CDBKE CGR CS3 CUY CVF CZ4 DAKXR DIK DILTD D~K E3Z EBS ECM EE~ EIF EMOBN ENERS F5P F9B FECEO FLUFQ FOEOM FOTVD FQBLK GAUVT GJXCC GX1 H13 H5~ HAR HW0 HZ~ IOX J21 JXSIZ KAQDR KOP KQ8 KSI KSN L7B M-Z M41 MHKGH ML0 N9A NGC NOMLY NOYVH NPM NU- O9- OAUYM OAWHX OB3 OCZFY ODMLO OGROG OJQWA OJZSN OK1 OPAEJ OVD OWPYF P2P PAFKI PEELM PQQKQ Q1. Q5Y R44 RD5 ROL ROX RUSNO RW1 RXO SEL TCURE TEORI TJX W8F WOQ X7H YAYTL YKOAZ YXANX ZKX ~91 7X8 KBUDW
ID	FETCH-LOGICAL-c502t-2f661d124c7e2610bf53d519be836381f5189fbdaf1b6df85f15ab684a26c9322
IEDL.DBID	7X8
ISICitedReferencesCount	55
ISICitedReferencesURI	http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000805261800001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN	1522-9645
IngestDate	Sun Sep 28 04:14:25 EDT 2025 Mon Jul 21 06:07:55 EDT 2025
IsDoiOpenAccess	false
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Issue	33
Keywords	COVID-19 Hospitalization Treatment Cardiovascular Mortality
Language	English
License	The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-c502t-2f661d124c7e2610bf53d519be836381f5189fbdaf1b6df85f15ab684a26c9322
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ORCID	0000-0001-8149-3449 0000-0001-8806-6052 0000-0002-5259-538X 0000-0003-3493-1930 0000-0001-6103-8510 0000-0002-2740-0042 0000-0002-1278-6245 0000-0003-4732-382X 0000-0001-9895-9356 0000-0001-6093-599X 0000-0002-8370-4569 0000-0001-9241-8890
OpenAccessLink	https://academic.oup.com/eurheartj/article-pdf/43/33/3164/45585810/ehac227.pdf
PMID	36044988
PQID	2709018658
PQPubID	23479
ParticipantIDs	proquest_miscellaneous_2709018658 pubmed_primary_36044988
PublicationCentury	2000
PublicationDate	2022-09-01
PublicationDateYYYYMMDD	2022-09-01
PublicationDate_xml	– month: 09 year: 2022 text: 2022-09-01 day: 01
PublicationDecade	2020
PublicationPlace	England
PublicationPlace_xml	– name: England
PublicationTitle	European heart journal
PublicationTitleAlternate	Eur Heart J
PublicationYear	2022
SSID	ssj0008616
Score	2.5980577
SecondaryResourceType	review_article
Snippet	The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was...
SourceID	proquest pubmed
SourceType	Aggregation Database Index Database
StartPage	3164
SubjectTerms	Cardiovascular Diseases - epidemiology Cardiovascular Diseases - therapy COVID-19 - epidemiology Hospital Mortality Hospitalization Humans Pandemics ST Elevation Myocardial Infarction
Title	The collateral damage of COVID-19 to cardiovascular services: a meta-analysis
URI	https://www.ncbi.nlm.nih.gov/pubmed/36044988 https://www.proquest.com/docview/2709018658
Volume	43
WOSCitedRecordID	wos000805261800001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText
inHoldings	1
isFullTextHit
isPrint
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV09T8MwELWAIsTC90f5kpFYrSZO4pxZEAIqGFo6AOoWOY4tQDQpTcrv55ymqhiQkFi8RbJOz_defOd7hFz4XIDiRjPOQbNQWY9J0JJpgDRGDECcQW02Eff7MBzKQXPhVjZtlfOcWCfqrNDujrzDYw-pC5Awr8afzLlGuepqY6GxTFoBShnX0hUPF9PCQdTWp0hRnEkRRvOqpgw6ZjpxjtHVe8e8Ks15_LvCrJmmu_nfPW6RjUZj0usZKLbJksl3yFqvqaLvkh5ig9YAcM-PP2imRphVaGHpzePLwy3zJa0Kqn90qtKySSqXVNGRqRRTzTiTPfLcvXu6uWeNrQLTkccrxi1ycoa8rmOD_09eaqMgQyGXGgjwNPo28kHaNFPWT0VmIbJ-pFIBoeJCo9zj-2QlL3JzSCiqJyGV9IwwfmhVBGmE8sEEwgYo_IRuk_N5oBKEratFqNwU0zJZhKpNDmbRTsaz-RpJILwwlABHf_j6mKxz9yCh7vo6IS2Lh9acklX9Vb2Vk7MaD7j2B71vkKG_Bw
linkProvider	ProQuest
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+collateral+damage+of+COVID-19+to+cardiovascular+services%3A+a+meta-analysis&rft.jtitle=European+heart+journal&rft.au=Nadarajah%2C+Ramesh&rft.au=Wu%2C+Jianhua&rft.au=Hurdus%2C+Ben&rft.au=Asma%2C+Samira&rft.date=2022-09-01&rft.issn=1522-9645&rft.eissn=1522-9645&rft.volume=43&rft.issue=33&rft.spage=3164&rft_id=info:doi/10.1093%2Feurheartj%2Fehac227&rft.externalDBID=NO_FULL_TEXT
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1522-9645&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1522-9645&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1522-9645&client=summon