Status of Acute Myocardial Infarction in Southern India During COVID-19 Lockdown: A Multicentric Study
Ramachandran Meenakshisundaram1,2, Subramanian Senthilkumaran1, Ponniah Thirumalaikolundusubramanian3
1Manian Medical Centre, Erode, Tamil Nadu, India.
Insights
The study found a significant reduction in acute myocardial infarction (MI) cases during the COVID-19 lockdown. This decrease in heart attacks may be linked to changes in modifiable risk factors during this period.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic led to global lockdowns, impacting healthcare access and lifestyle.
- Reported cases of acute myocardial infarction (MI) showed a global decline during the pandemic.
Purpose of the Study:
- To quantify acute MI cases during the COVID-19 lockdown in Tamil Nadu, India.
- To explore potential reasons for observed changes in acute MI incidence.
Main Methods:
- A multicentric retrospective observational study was conducted.
- Data on ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI) were collected from 12 private hospitals across four cities.
- Lockdown period data (April 2020) was compared with pre-lockdown (Jan-Feb 2020) and prior year periods (April 2018, 2019).
Main Results:
- A significant reduction (P<.001) in total MI, STEMI, and NSTEMI cases was observed during the April 2020 lockdown compared to previous periods.
- The reduction in NSTEMI cases was not statistically significant in Trichy when compared to Jan-Feb 2020.
- Overall acute MI incidence decreased across all studied cities.
Conclusions:
- The COVID-19 lockdown was associated with a significant decrease in acute MI cases.
- Alterations in modifiable risk factors during the lockdown may explain the reduced incidence.
- Public education and policies targeting modifiable risk factors are recommended.
Abstract:
There has been a reduction in the reported cases of acute myocardial infarction (MI) across the globe during the outbreak of coronavirus disease 2019 (COVID-19) (severe acute respiratory distress syndrome coronavirus 2). An attempt was made to find out the number of acute MI cases treated during the COVID-19 lockdown period (April 2020) and highlight the possible reasons for the changes in the occurrence. A multicentric retrospective observational study was performed to collect the selected data from 12 private hospitals distributed in 4 cities-Madurai, Trichy (Thiruchirapalli), Erode, and Salem-of the Tamil Nadu state in southern India. There was a significant (P<.001) reduction in ST-segment elevation MI (STEMI), non-STEMI (NSTEMI), and total (STEMI and NSTEMI together) cases during the lockdown period (April 1 to 30, 2020) as compared with no-lockdown periods such as January and February 2020 and April 2019 and April 2018 in all cities, whereas the reduction was not significant for NSTEMI in Trichy when data for the lockdown period was compared with those for January and February 2020. Overall, there is a reduction in acute MI cases, which may be due to alterations in modifiable risk factors during the COVID-19 lockdown period. Hence, implementation of public education and polices on controlling modifiable risk factors is likely to pay dividends.
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