Emergency calls for time-depending during COVID-19 outbreak in center Italy

In the present study we analysed the emergency calls to the Umbrian Emergency Medical System (reached by dialling the emergency telephone number 118), that occurred for time-dependent-illnesses during the pandemic. Our analysis included all out-of- hospital ACSs, strokes and cardiac arrests electronically stored in the Emergency Department database. During the trimester 1st February- 30th April a total of 61,867 and 63,194 calls were registered in 2019 and 2020, respectively. In year 2020, compared to year 2019, there was a significant reduction in the frequency of calls to 118 for ACS (0.009% vs 0.14% 2=25.71, p=0.01), a non-significant reduction in the calls due to stroke (0.48% vs 0.5% 2=1.1, p=0.2) and cardiac arrest (0.43% vs 0.47%;2=2.85, p=0.09). Overall, these findings strongly suggest that, during the COVID-19 pandemic, a lower attention has been posed to time-dependent illness. This dramatically led to a general underutilization of the emergency medical system, and consequently reduced the number of time-dependent hospitalizations. Considering the differences among ACS calls with respect to stroke calls, we could speculate that patients who have a clinical presentation with mild symptoms have preferred to stay at home, given the widespread fear of going to hospitals.

COVID-19 and its impact on acute coronary syndrome in-hospital epidemiology: a multifactorial analysis from a single-center Hospital in the north-east region of Italy

We analyze all possible, multifactorial correlations between coronavirus 2019 (COVID-19) pandemic and epidemiological in-hospital epidemiologic variations in ischemic heart disease burden. We developed a simple retrospective study surveying all acute coronary syndrome cases reporting an epidemiological analysis of a single-center University Italian Hospital located in the north-east area of Italy in the city of Gorizia, comparingdata collected in two months (February and March) about the definite diagnosis of myocardial infarction in the years 2019 and 2020 (COVID-19 peak exposure interval) respectively. We retrospectively analyzed data regarding the two months of February and March 2020 about admissions to our Intensive Cardiac Care Unit (ICCU) with a confirmed diagnosis of acute coronary syndrome. Differences among the two study periods were assessed using the chi(2) test. Statistical significances were set at P<0.05. All analyses were conducted using IBM SPSS software version 24.0 (IBM Corp. Armonk, NY, USA). We showed a remarkable decrease of acute coronary syndrome cases diagnosed and admitted to our Intensive Cardiac Care Unit when comparing the interval period between February and March 2019 to the same months of 2020. This rate was significantly lower than either the rate during the earlier period in the same year [95% confidence interval (CI), 0.63 to 0.80;P<0.001]. We showed an overall decrease in diagnosis of acute coronary syndromes during the COVID-19 pandemic;we relate this amount decrease in diagnosis to general underuse of cardiologic public services leading to a reduced number of admissions for acute coronary syndrome cases and possibly undertreatment and death of out-of-hospital, silenced critical clinical cardiologic pictures due to a generalized fear of COVID-19 in-hospital contagion.

Epidemiology of emergency calls for time-dependent acute illnesses during COVID-19 outbreak in Umbria region (Italy).

The recent literature reported an inverse correlation between COVID-19 pandemic and hospital admissions for Acute Coronary Syndromes (ACS).