Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era
Author:
De Rosa Salvatore12ORCID, Spaccarotella Carmen12, Basso Cristina13, Calabrò Maria Pia14, Curcio Antonio12, Filardi Pasquale Perrone15, Mancone Massimo16, Mercuro Giuseppe17, Muscoli Saverio18, Nodari Savina19, Pedrinelli Roberto110ORCID, Sinagra Gianfranco111, Indolfi Ciro12ORCID, Angelini Filippo, Barillà Francesco, Bartorelli Antonio, Benedetto Francesco, Bernabò Paola, Bolognese Leonardo, Briani Martina, Cacciavillani Luisa, Calabrese Alice, Calabrò Paolo, Caliendo Luigi, Calò Leonardo, Casella Gianni, Casu Gavino, Cavallini Claudio, Ciampi Quirino, Ciccone Marco, Comito Michele, Corrada Elena, Crea Filippo, D’Andrea Antonello, D’Urbano Maurizio, De Caterina Raffaele, De Ferrari Gaetano, De Ponti Roberto, Della Mattia Alessio, Di Mario Carlo, Donazzan Luca, Esposito Giovanni, Fedele Francesco, Ferraro Alessandro, Galasso Gennaro, Galiè Nazzareno, Gnecchi Massimiliano, Golino Paolo, Golia Bruno, Guarini Pasquale, Indolfi Ciro, Leonardi Sergio, Locuratolo Nicola, Luzza Francesco, Manganiello Vincenzo, Francesca Marchetti Maria, Marenzi Giancarlo, Margonato Alberto, Meloni Luigi, Metra Marco, Milo Marco, Mongiardo Annalisa, Monzo Luca, Morisco Carmine, Nodari Savina, Novo Giuseppina, Pancaldi Stefano, Parollo Matteo, Paternò Giovanni, Patti Giuseppe, Priori Silvia, Ravera Amelia, Giuseppe Rebuzzi Antonio, Rossi Massimo, Scherillo Marino, Semprini Franco, Senni Michele, Sibilio Gerolamo, Sinagra Gianfranco, Siviglia Massimo, Tamburino Corrado, Tortorici Gianfranco, Versace Francesco, Villari Bruno, Volpe Massimo,
Affiliation:
1. Italian Society of Cardiology, Via Po 24, 00198 Rome, Italy 2. Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy 3. Cardiovascular Pathology Unit, University of Padua, Padua, Italy 4. Department of Human Pathology, University of Messina, Messina, Italy 5. Department of Advanced Biomedical Sciences, Federico II University, Naples and Mediterranea Cardiocentro, Naples Italy 6. Sapienza University of Rome, Rome, Italy 7. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy 8. Department of Medicine, ‘Tor Vergata’ University of Rome, Rome, Italy 9. Department of Cardiology, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy 10. Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy 11. Cardiovascular Department, University of Trieste, Trieste, Italy
Abstract
Abstract
Aims
To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs).
Methods and Results
We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7–32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3–70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7–6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1–2.8; P = 0.009).
Conclusion
Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine
Cited by
715 articles.
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