Rates of Acute Myocardial Infarction During the COVID-19 Pandemic
Matthew T Mefford1, Jaejin An1,2, Nigel Gupta3
1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Insights
During COVID-19 stay-at-home orders, acute myocardial infarction (AMI) rates decreased. However, case fatality rates for AMI increased, highlighting the need for public health campaigns encouraging emergency medical care.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic and associated stay-at-home orders may have deterred individuals from seeking emergency care.
- Fear of contracting COVID-19 could have led to delayed or avoided treatment for critical conditions like acute myocardial infarction (AMI).
Purpose of the Study:
- To evaluate if acute myocardial infarction (AMI) rates declined during the COVID-19 pandemic stay-at-home period.
- To compare AMI rates and case fatality rates before and during the pandemic.
Main Methods:
- Calculated AMI rates per 100,000 member-weeks for Kaiser Permanente Southern California patients.
- Compared rates during the prepandemic and pandemic periods of 2020 with corresponding periods in 2019.
- Utilized Poisson regression to calculate rate ratios (RRs) and compared case fatality rates (CFRs).
Main Results:
- AMI rates were lower during the 2020 pandemic period compared to 2019 (RR, 0.85).
- A significant decrease in AMI rates was observed during the early pandemic period (March 20-May 7, 2020) (RR, 0.70).
- In-hospital and 30-day AMI case fatality rates were higher in 2020 compared to 2019 (8.8% vs 6.1% and 6.5% vs 5.0%, respectively).
Conclusions:
- Acute myocardial infarction (AMI) rates decreased during the COVID-19 pandemic stay-at-home period.
- Increased case fatality rates suggest that patients experiencing AMI during the pandemic faced worse outcomes.
- Public health initiatives are crucial to encourage seeking timely medical attention for emergencies during public health crises.
Background:
During the early phases of the COVID-19 pandemic pandemic, stay-at-home orders and fear of acquiring COVID-19 may have led to an avoidance of care for medical emergencies, including acute myocardial infarction (AMI). We evaluated whether a decline in rates of AMI occurred during the COVID-19 stay-at-home order.
Methods:
Rates of AMI per 100,000 member-weeks were calculated for Kaiser Permanente Southern California patients from January 1 to March 3, 2020 (prepandemic period) and from March 20 to July 31, 2020 (pandemic period), and during the same periods in 2019. Rate ratios (RRs) were calculated comparing the time periods using Poisson regression. Case fatality rates (CFRs) were also compared.
Results:
Rates of AMI were lower during the pandemic period of 2020 compared to the same period of 2019 [3.20 vs 3.76/100,000 member-weeks; RR, 0.85; 95% confidence interval (CI) 0.80-0.90]. There was no evidence that rates of AMI differed during the 2020 prepandemic period compared to the same period in 2019 (4.45 vs 4.24/100,000 member-weeks; RR, 0.95; 95% CI, 0.88-1.03). AMI rates were lower during the early pandemic period (March 20-May 7: RR, 0.70; 95% CI, 0.66-0.77), but not during the later pandemic period (May 8-July 31: RR, 0.95; 95% CI, 0.88-1.02) compared to 2019. In-hospital and 30-day case fatality rates were higher during the pandemic period of 2020 compared to 2019 (8.8% vs 6.1% and 6.5% vs 5.0%, respectively).
Conclusion:
AMI rates were lower during the COVID-19 pandemic compared to the same period in 2019. During stay-at-home orders, public health campaigns that encourage people to seek care for medical emergencies are warranted.
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