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Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: a multinational study.
Araiza-Garaygordobil, D; Montalto, C; Martinez-Amezcua, P; Cabello-Lopez, A; Gopar-Nieto, R; Alabrese, R; Almaghraby, A; Catoya-Villa, S; Chacon-Diaz, M; Kaufmann, C C; Corbi-Pascual, M; Deharo, P; El-Tahlawi, M; Elgohari-Abdelwahab, A; Guerra, F; Jarakovic, M; Martinez-Gomez, E; Moderato, L; Montero, S; Morejon-Barragan, P; Omar, A M; Jorge-Pérez, P; Przybylo, P; Selim, E; Sinan, U Y; Stratinaki, M; Tica, O; Trêpa, M; Uribarri, A; Uzokov, J; Wilk, K; Czerwinska-Jelonkiewicz, K; Sionis, A; Gierlotka, M; Leonardi, S; Krychtiuk, K A; Tavazzi, G.
  • Araiza-Garaygordobil D; Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, México.
  • Montalto C; Department of Cardiology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Martinez-Amezcua P; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, USA.
  • Cabello-Lopez A; Occupational Health Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México.
  • Gopar-Nieto R; Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, México.
  • Alabrese R; Department of Cardiology, Parma University Hospital, Italy.
  • Almaghraby A; Department of Cardiology and Angiology, University of Alexandria, Egypt.
  • Catoya-Villa S; Department of Cardiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  • Chacon-Diaz M; Cardiology Clinic and Intensive Cardiac Care, Instituto Nacional Cardiovascular INCOR-Essalud, Lima, Perú.
  • Kaufmann CC; 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
  • Corbi-Pascual M; Coronary Care Unit, Cardiology Service, Albacete General Hospital, Albacete.
  • Deharo P; Aix Marseille University, Inserm, Inra, C2VN, Marseille, France.
  • El-Tahlawi M; Department of Cardiology, Zagazig University Hospital, Zagazig, Egypt.
  • Elgohari-Abdelwahab A; Department of Cardiology, Ministry of Health, Riyadh, Saudi Arabia.
  • Guerra F; Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Ospedali Riuniti "Umberto I-Lancisi-Salesi", Ancona, Italy.
  • Jarakovic M; Cardiology Intensive Care Unit, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
  • Martinez-Gomez E; Acute Cardiovascular Care Unit, Hospital Clínico San Carlos, Madrid, Spain.
  • Moderato L; Cardiology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy.
  • Montero S; Acute Cardiovascular Care Unit, Cardiology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.
  • Morejon-Barragan P; Coronary Care Unit, Cardiology Service, UAI University Hospital, Buenos Aires, Argentina.
  • Omar AM; Tripoli University Hospital, Tripoli, Libya.
  • Jorge-Pérez P; Acute Cardiovascular Care Unit, Cardiology Department, Canary Islands University Hospital, Tenerife, Spain.
  • Przybylo P; Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland.
  • Selim E; Coronary Care Unit, Emergency Department and Cardiology Clinic, Alhada Armed Forces Hospital, Taif, Saudi Arabia.
  • Sinan UY; Department of Cardiology, PH and ACHD, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkey.
  • Stratinaki M; Cardiology Department, General Hospital Venizeleio, Heraklion, Crete, Greece.
  • Tica O; Faculty of Medicine and Pharmacy, University of Oradea; Emergency County Clinical Hospital of Oradea, Romania.
  • Trêpa M; Cardiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
  • Uribarri A; Cardiovascular Care Unit, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
  • Uzokov J; Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan.
  • Wilk K; Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
  • Czerwinska-Jelonkiewicz K; Intensive Therapy Unit, Harefield Hospital, Royal Brompton & Harefield NHS Fundation Trust, London, UK.
  • Sionis A; Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Gierlotka M; Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland.
  • Leonardi S; Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology-Fondazione IRCCS Policlinico San Matteo, and Department of Molecular Medicine, University of Pavia, Pavia, Italy.
  • Krychtiuk KA; Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Austria.
  • Tavazzi G; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy.
QJM ; 114(9): 642-647, 2021 Nov 13.
Article in English | MEDLINE | ID: covidwho-1041021
ABSTRACT

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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Coronary Syndrome / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Humans Language: English Journal: QJM Journal subject: Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Coronary Syndrome / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Humans Language: English Journal: QJM Journal subject: Medicine Year: 2021 Document Type: Article