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.
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; Przybyło, P; Selim, E; Sinan, U Y; Stratinaki, M; Tica, O; Trêpa, M; Uribarri, A; Uzokov, J; Wilk, K; Czerwińska-Jelonkiewicz, K; Sionis, A; Gierlotka, M; Leonardi, S; Krychtiuk, K A; Tavazzi, G. - In: QJM-AN INTERNATIONAL JOURNAL OF MEDICINE. - ISSN 1460-2725. - 114:9(2021), pp. 642-647. [10.1093/qjmed/hcab013]
Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: a multinational study
Guerra, F;
2021-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
