Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York.

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The COVID-19 pandemic significantly impacted healthcare systems globally.
• Studies have indicated a notable decrease in acute coronary syndrome (ACS) admissions during the pandemic, with the reasons remaining unclear.

Purpose of the Study:

• To investigate the impact of the COVID-19 pandemic on acute coronary syndrome (ACS) admissions.
• To analyze changes in patient presentation and demographics for ACS during the pandemic compared to pre-pandemic periods.

Main Methods:

• A retrospective, multi-centered study was conducted in Upstate New York.
• Data from 180 patients with ACS (STEMI and NSTEMI) admitted in March/April 2019 (pre-pandemic) and March/April 2020 (during pandemic) were analyzed.
• Patient demographics, admission rates, and time to presentation were compared between the two periods.

Main Results:

• A significant drop of 40.7% in total ACS admissions was observed during the pandemic period (March/April 2020) compared to the same period in 2019 (P < .05).
• The proportion of NSTEMI patients presenting late ( >24 hours from symptom onset) increased during the pandemic (36.4%) compared to the pre-pandemic period (27.1%, P = .033).
• The mean age of patients presenting with ACS was higher during the pre-pandemic period (72.3 years) compared to the pandemic period (65.1 years).

Conclusions:

• The COVID-19 pandemic was associated with a substantial decrease in ACS admissions.
• The observed increase in late presentations for NSTEMI patients during the pandemic is a concerning trend.
• Reduced hospital admissions and delayed care for ACS during the pandemic may foreshadow an increase in future myocardial infarction complications.