"Missing" acute coronary syndrome hospitalizations during the COVID-19 era in Greece: Medical care avoidance combined with a true reduction in incidence?
Clin Cardiol
; 43(10): 1142-1149, 2020 Oct.
Article
in English
| MEDLINE | ID: covidwho-840712
ABSTRACT
BACKGROUND:
Reports from countries severely hit by the COVID-19 pandemic suggest a decline in acute coronary syndrome (ACS)-related hospitalizations. The generalizability of this observation on ACS admissions and possible related causes in countries with low COVID-19 incidence are not known.HYPOTHESIS:
ACS admissions were reduced in a country spared by COVID-19.METHODS:
We conducted a nationwide study on the incidence rates of ACS-related admissions during a 6-week period of the COVID-19 outbreak and the corresponding control period in 2019 in Greece, a country with strict social measures, low COVID-19 incidence, and no excess in mortality.RESULTS:
ACS admissions in the COVID-19 (n = 771) compared with the control (n = 1077) period were reduced overall (incidence rate ratio [IRR] 0.72, P < .001) and for each ACS type (ST-segment elevation myocardial infarction [STEMI] IRR 0.76, P = .001; non-STEMI IRR 0.74, P < .001; and unstable angina [UA] IRR 0.63, P = .002). The decrease in STEMI admissions was stable throughout the COVID-19 period (temporal correlation; R2 = 0.11, P = .53), whereas there was a gradual decline in non-STEMI/UA admissions (R2 = 0.75, P = .026) following the progressively stricter social measures. During the COVID-19 period, patients admitted with ACS presented more frequently with left ventricular systolic impairment (22.2 vs 15.5% control period; P < .001).CONCLUSIONS:
We observed a reduction in ACS hospitalizations during the COVID-19 outbreak in a country with strict social measures, low community transmission, and no excess in mortality. Medical care avoidance behavior is an important factor for these observations, while a true reduction of the ACS incidence due to self-isolation/quarantining may have also played a role.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Acute Coronary Syndrome
/
COVID-19
/
Hospitalization
Type of study:
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
Clin Cardiol
Year:
2020
Document Type:
Article
Affiliation country:
Clc.23424
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