Aims: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). Methods and Results: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009). Conclusion: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.

Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era / S. De Rosa, C. Spaccarotella, C. Basso, M.P. Calabro, A. Curcio, P.P. Filardi, M. Mancone, G. Mercuro, S. Muscoli, S. Nodari, R. Pedrinelli, G. Sinagra, C. Indolfi, F. Angelini, F. Barilla, A. Bartorelli, F. Benedetto, P. Bernabo, L. Bolognese, M. Briani, L. Cacciavillani, A. Calabrese, P. Calabro, L. Caliendo, L. Calo, G. Casella, G. Casu, C. Cavallini, Q. Ciampi, M. Ciccone, M. Comito, E. Corrada, F. Crea, A. D'Andrea, M. D'Urbano, R. De Caterina, G. De Ferrari, R. De Ponti, A. Della Mattia, C. DI Mario, L. Donnazzan, G. Esposito, F. Fedele, A. Ferraro, G. Galasso, N. Galie, M. Gnecchi, P. Golino, B. Golia, P. Guarini, C. Indolfi, S. Leonardi, N. Locuratolo, F. Luzza, V. Manganiello, M. Francesca Marchetti, G. Marenzi, A. Margonato, L. Meloni, M. Metra, M. Milo, A. Mongiardo, L. Monzo, C. Morisco, S. Nodari, G. Novo, S. Pancaldi, M. Parollo, G. Paterno, G. Patti, S. Priori, A. Ravera, A. Giuseppe Rebuzzi, M. Rossi, M. Scherillo, F. Semprini, M. Senni, G. Sibilio, G. Sinagra, M. Siviglia, C. Tamburino, G. Tortorici, F. Versace, B. Villari, M. Volpe. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 41:22(2020 Jun 07), pp. 2083-2088. [10.1093/eurheartj/ehaa409]

Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

C. Basso;F. Angelini;A. Bartorelli;M. Briani;G. Casella;G. Casu;F. Crea;G. De Ferrari;G. Galasso;
2020-06-07

Abstract

Aims: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). Methods and Results: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009). Conclusion: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.
Acute myocardial infarction; Cardiac care units; COVID-19; SARS-CoV2; STEMI; Aged; Aged, 80 and over; Female; Hospitalization; Humans; Italy; Male; Middle Aged; Betacoronavirus; Coronavirus Infections; Myocardial Infarction; Pandemics; Pneumonia, Viral
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/772432
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