Unpredictable Fall of Severe Emergent Cardiovascular Diseases Hospital Admissions During the COVID‐19 Pandemic: Experience of a Single Large Center in Northern Italy

Abstract

Background Northern Italy is one of the epicenters of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV 2) pandemic in Europe. The impact of the pandemic and the consequent lockdown on medical emergencies other than those SARS‐CoV 2 pandemic related is largely unknown. The aim of this study was to analyze the epidemiologic impact of coronavirus disease 2019 pandemic on hospital admission for severe emergent cardiovascular diseases ( SECD s) in a single Northern Italy large tertiary referral center. Methods and Results We quantified SECD s admissions to the Cardiology Division of Udine University Hospital between March 1, 2020 and March 31, 2020 and compared them with those of the same time frame during 2019. Compared with March 2019, we observed a significant reduction in all SECD s admissions: −30% for ST ‐segment–elevation acute coronary syndromes, −66% for non‐ ST ‐segment–elevation acute coronary syndromes and −50% for severe bradyarrhythmia. Conclusions A significant decrease in all SECD s admissions has been observed during the SARS‐CoV 2. pandemic and was unlikely caused by a reduction in the incidence of cardiovascular diseases. Fear of contagion may have contributed to the unpredictable drop of SECD s. Social education about early recognition of symptoms of life‐threatening cardiac conditions requiring appropriate care in a timely fashion may help to reduce this counterproductive phenomenon.

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

“…In interpreting these findings, it should be considered that the COVID-19 outbreak markedly changed the pattern of Emergency Departments (EDs) referral in Italy, with figures up to a 50% reduction accesses to hospitals and EDs unrelated to COVID-19 [12,13]. A reduction up to 50% in urgent pacemaker implants for severe bradyarrhythmias was previously reported, in agreement with our national survey, by analysis performed on a single hospital basis or on a regional basis [14,15]. The reduction in urgent pacemaker implants may imply a lack of prevention for the potential harmful consequences of bradyarrhythmias and, indeed, a relative increase in the proportion of patients presenting with syncope due to bradyarrhythmias was already observed [15].…”

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

“…The decrease was significant for STEMI (26.5%) and NSTEMI (65.1%), both in North Italy and in Central/South Italy [ 116 ]. Moreover, in a single large center in northern Italy, data obtained in March 2020 compared to March 2019 showed a significant reduction of 30% for STEMI, 66% for NSTEMI, and 50% for severe bradyarrhythmia [ 5 ]. These findings were confirmed by our experience, as we assessed a significant decline in STEMI admissions to the ICU-Cardiology Department of Ospedale del Cuore-Massa between 1 January and 10 June 2020, with respect to data collected in the same period in 2019 ( Figure 1 , panel A).…”

“…Nonetheless, despite these common features and interactive factors, a significant decrease in patient admissions to intensive coronary unit (ICU) has been observed following containment measures, suggesting that other determinants may reduce the capacity to quickly manage acute patients who are simultaneously or not infected with COVID-19 [ 5 , 6 , 7 , 8 ].…”

Effects of SARS Cov-2 epidemic on the obstetrical and gynecological emergency service accesses. What happened and what shall we expect now?

“…Thus, causing a decrease of healthcare resources for the treatment of mild or nonurgent cases. Further, the lockdown and the fear about the risk of infection in the hospital has lowered the admission to Emergency Services (ES) [2,3] The scientific community questions the possible effects of these changes on the population health. Oncologists have warned of possible future increases in the diagnosis of colorectal cancer due to a reduction in screening programs leading to a diagnostic delay with a detection of cancers at more advanced stages [4].…”