Abstract
AimsThe coronavirus SARS-CoV-2 outbreak led to the most recent pandemic of the twenty-first century. To contain spread of the virus, many nations introduced a public lockdown. How the pandemic itself and measures of social restriction affect hospital admissions due to acute cardiac events has rarely been evaluated yet.Methods and ResultsGerman public authorities announced measures of social restriction between March 21st and April 20th, 2020. During this period, all patients suffering from an acute cardiac event admitted to our hospital (N = 94) were assessed and incidence rate ratios (IRR) of admissions for acute cardiac events estimated, and compared with those during the same period in the previous three years (2017–2019, N = 361). Admissions due to cardiac events were reduced by 22% as compared to the previous years (n = 94 vs. an average of n = 120 per year for 2017–2019). Whereas IRR for STEMI 1.20 (95% CI 0.67–2.14) and out-of-hospital cardiac arrest IRR 0.82 (95% CI 0.33–2.02) remained similar, overall admissions with an IRR of 0.78 (95% CI 0.62–0.98) and IRR for NSTEMI with 0.46 (95% CI 0.27–0.78) were significantly lower. In STEMI patients, plasma concentrations of high-sensitivity troponin T at admission were significantly higher (644 ng/l, IQR 372–2388) compared to 2017–2019 (195 ng/l, IQR 84–1134; p = 0.02).ConclusionThe SARS-CoV-2 pandemic and concomitant social restrictions are associated with reduced cardiac events admissions to our tertiary care center. From a public health perspective, strategies have to be developed to assure patients are seeking and getting medical care and treatment in time during SARS-CoV-2 pandemic.
Highlights
Sudden, unforeseen, or stressful events, like natural disasters or sports finals that affect a large number of people in defined areas, are known to potentially increase the risk of cardiac events including cardiac arrhythmia, acute coronary syndrome, and even out-of-hospital cardiac arrest [1,2,3].Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Spread of the novel coronavirus (SARS-CoV-2) resulted in a rapidly expanding global pandemic with substantial regional differences in overall infection numbers, the number of infected getting COVID-19 disease and requiring medical treatment, and the percentage of those in severe condition requiring treatment in an intensive care unit
Owing to the During the study period and the comparative periods, a total of 455 patients with acute cardiac events were admitted to Ulm University Hospital and included into the study (Table 1)
None of the 2020 cohort was tested positive for SARS-CoV-2 infection by PCR
Summary
Spread of the novel coronavirus (SARS-CoV-2) resulted in a rapidly expanding global pandemic with substantial regional differences in overall infection numbers, the number of infected getting COVID-19 disease and requiring medical treatment, and the percentage of those in severe condition requiring treatment in an intensive care unit. It has been reported that in Austria, hospital admissions due to acute coronary syndrome declined significantly during March 2020, suggesting a potential undersupply of patients with cardiac disease during the COVID-19 outbreak [4]. As shown in a very recent report from Northern Italy, a region hit very hard by the pandemic, hospital admissions due to acute coronary syndrome (ACS) were significantly reduced as compared to the months before the pandemic as well as the same period in the previous year [5]. Extensive public health measures were initiated on March 21st, 2020 to minimize
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