Impact of recurrent COVID-19 disease waves on acute myocardial infarction epidemics: results from a regional network

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The COVID-19 pandemic led to unprecedented public health interventions, including lockdowns and social distancing.
• Recurrent waves of COVID-19 necessitated sustained containment measures, raising questions about their impact on other critical health conditions.

Purpose of the Study:

• To evaluate the effect of COVID-19 containment measures on hospital admission rates for acute myocardial infarction (AMI).
• To compare AMI patient characteristics, treatments, and outcomes during the pandemic with pre-pandemic periods.

Main Methods:

• A retrospective analysis of consecutive AMI patients admitted to a regional network over one year (starting March 2020) was conducted.
• Data from the COVID-19 period (two waves: March-May 2020, October-December 2020) were compared to the preceding year.
• Hospitalization rates, reperfusion strategies, and in-hospital mortality were analyzed, with adjustments for environmental factors.

Main Results:

• Overall AMI hospitalizations increased slightly during the COVID-19 period (IRR 1.16).
• The first COVID-19 wave saw a 32% reduction in AMI admissions, while the second wave showed no significant change (3% increase).
• A substantial 92% reduction in ACS with cardiac arrest admissions occurred during the first wave, with no change in the second. COVID-19 positive ACS patients had a high mortality rate (14%).

Conclusions:

• COVID-19 containment measures were associated with a significant decrease in AMI hospitalizations during the initial pandemic wave.
• The impact of these measures on AMI admissions waned during subsequent waves.
• While overall in-hospital mortality for AMI remained comparable, COVID-19 infection posed a significant risk for ACS patients.