TY - JOUR
T1 - Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes
T2 - A multinational study
AU - Araiza-Garaygordobil, D.
AU - Montalto, C.
AU - Martinez-Amezcua, P.
AU - Cabello-Lopez, A.
AU - Gopar-Nieto, R.
AU - Alabrese, R.
AU - Almaghraby, A.
AU - Catoya-Villa, S.
AU - Chacon-Diaz, M.
AU - Kaufmann, C. C.
AU - Corbi-Pascual, M.
AU - Deharo, P.
AU - El-Tahlawi, M.
AU - Elgohari-Abdelwahab, A.
AU - Guerra, F.
AU - Jarakovic, M.
AU - Martinez-Gomez, E.
AU - Moderato, L.
AU - Montero, S.
AU - Morejon-Barragan, P.
AU - Omar, A. M.
AU - Jorge-Pérez, P.
AU - Przybyło, P.
AU - Selim, E.
AU - Sinan, U. Y.
AU - Stratinaki, M.
AU - Tica, O.
AU - Trêpa, M.
AU - Uribarri, A.
AU - Uzokov, J.
AU - Wilk, K.
AU - Czerwińska-Jelonkiewicz, K.
AU - Sionis, A.
AU - Gierlotka, M.
AU - Leonardi, S.
AU - Krychtiuk, K. A.
AU - Tavazzi, G.
N1 - Publisher Copyright:
© 2021 The Author(s) 2021.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Background: COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS). Aim: To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared. Design: Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period. Results: A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different. Conclusions: Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.
AB - Background: COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS). Aim: To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared. Design: Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period. Results: A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different. Conclusions: Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.
UR - http://www.scopus.com/inward/record.url?scp=85112574282&partnerID=8YFLogxK
U2 - 10.1093/qjmed/hcab013
DO - 10.1093/qjmed/hcab013
M3 - Artículo
C2 - 33486512
AN - SCOPUS:85112574282
SN - 1460-2725
VL - 114
SP - 642
EP - 647
JO - QJM
JF - QJM
IS - 9
ER -