31 days of COVID-19—cardiac events during restriction of public life—a comparative study

Abstract

Aims The coronavirus SARS-CoV-2 outbreak led to the most recent pandemic of the twenty-first century. To contain spread of the virus, many nations introduced a public lockdown. How the pandemic itself and measures of social restriction affect hospital admissions due to acute cardiac events has rarely been evaluated yet. Methods and Results German public authorities announced measures of social restriction between March 21st and April 20th, 2020. During this period, all patients suffering from an acute cardiac event admitted to our hospital (N = 94) were assessed and incidence rate ratios (IRR) of admissions for acute cardiac events estimated, and compared with those during the same period in the previous three years (2017–2019, N = 361). Admissions due to cardiac events were reduced by 22% as compared to the previous years (n = 94 vs. an average of n = 120 per year for 2017–2019). Whereas IRR for STEMI 1.20 (95% CI 0.67–2.14) and out-of-hospital cardiac arrest IRR 0.82 (95% CI 0.33–2.02) remained similar, overall admissions with an IRR of 0.78 (95% CI 0.62–0.98) and IRR for NSTEMI with 0.46 (95% CI 0.27–0.78) were significantly lower. In STEMI patients, plasma concentrations of high-sensitivity troponin T at admission were significantly higher (644 ng/l, IQR 372–2388) compared to 2017–2019 (195 ng/l, IQR 84–1134; p = 0.02). Conclusion The SARS-CoV-2 pandemic and concomitant social restrictions are associated with reduced cardiac events admissions to our tertiary care center. From a public health perspective, strategies have to be developed to assure patients are seeking and getting medical care and treatment in time during SARS-CoV-2 pandemic.

Hospital admissions during Covid-19 lock-down in Germany: Differences in discretionary and unavoidable cardiovascular events

“…While we found a similar reduction of around 20% for discretionary cardiovascular admissions during the Covid-19 lock-down period, the rate of unavoidable admissions remained unchanged. These findings are in line with a report from a single emergency department at the University Hospital Ulm (Germany) with a cohort of 94 patients [ 7 ]. They saw a reduction in patients presenting with NSTEMI but not other forms of cardiovascular events, including STEMI and out of hospital cardiac arrest.…”

Reduced Rate of Inpatient Hospital Admissions in 18 German University Hospitals During the COVID-19 Lockdown

“…This effect may have been caused by the more restrictive lockdown regulations in these two countries. However, the reduction in myocardial infarctions observed in our study was much higher than the 25% reduction found in a dedicated analysis of the German health insurance company DAK from April 2020 ( 32 ) and the 22% reduction for cardiac events in 2020 compared to the average of 2017 to 2019 reported from Ulm University Hospital ( 33 ).…”

Temporal trends in the presentation of cardiovascular and cerebrovascular emergencies during the COVID-19 pandemic in Germany: an analysis of health insurance claims

“…While an association between acute viral respiratory disease and subsequent cardiovascular events had been described for other diseases (e.g., influenza) [5,6], several centers reported a decline in hospital admissions for acute cardiovascular and cerebrovascular emergencies during the COVID pandemic [7][8][9][10][11][12][13][14][15][16][17][18][19]. Since acute cardiovascular and cerebrovascular diseases remain leading causes for morbidity and mortality, further investigation of this concerning trend is warranted to identify potential implications for both health-care professionals and regulators.…”