Lower ST-elevation myocardial infarction incidence during COVID-19 epidemic in Northern Europe

Association between work situation and life satisfaction during the COVID-19 pandemic: prospective cohort study in Norway

OBJECTIVES

To estimate the impact of being laid off from work, having to work from home or having been diagnosed with COVID-19 on self-reported satisfaction with life.

DESIGN

Nationwide population-based cohort study.

SETTING

Norway.

PARTICIPANTS

We followed more than 80 000 participants in an ongoing cohort study, the Norwegian Mother, Father and Child Cohort Study (MoBa), during the COVID-19 pandemic. We analysed current life satisfaction in April and again in September/October 2020 for subjects whose work situation and infection status had changed.

MAIN OUTCOME MEASURES

Self-reported satisfaction with life, using a scale from 0 (worst) to 10 (best). We analysed the scale both continuously and as a binary variable (<or ≥6).

RESULTS

Temporary and permanent layoffs, working from a home-based office, and getting a COVID-19 diagnosis were all associated with modestly, but significantly lower concurrent life satisfaction, both in the total on a population level and for subjects experiencing a change in job status between spring and autumn. The associations with change in work situation were stronger for men. For men with permanent job loss, the adjusted odds ratio (OR) for low life satisfaction (<6) was 3.2 (95% CI 2.4 to 4.2) in April and 4.9 (95% CI 3.5 to 6.9) in autumn. Among all, a suspected or confirmed COVID-19 diagnosis was associated with an adjusted OR for low life satisfaction of 1.9 (95% CI 1.6 to 2.3) in spring. The strength of associations between work situation and life satisfaction did not vary much across socio-economic strata, but layoffs were more common among those with low education.

CONCLUSION

Layoffs, home office and infection status had clear impact on the quality of life as measured with a global life satisfaction scale. These findings suggest that social differentials in quality of life, are increasing during the pandemic.

COVID-19 pandemic and coronary angiography for ST-elevation myocardial infarction, use of mechanical support and mechanical complications in Canada; a Canadian Association of Interventional Cardiology national survey

Background

As a result of the COVID-19 pandemic first wave, reductions in ST-elevation myocardial infarction (STEMI) invasive care, ranging from 23% to 76%, have been reported from various countries. Whether this change had any impact on coronary angiography (CA) volume or on mechanical support device use for STEMI and post-STEMI mechanical complications in Canada is unknown.

Methods

We administered a Canada-wide survey to all cardiac catheterization laboratory directors, seeking the volume of CA use for STEMI performed during the period from March 1 2020 to May 31, 2020 (pandemic period), and during 2 control periods (March 1, 2019 to May 31, 2019 and March 1, 2018 to May 31, 2018). The number of left ventricular support devices used, as well as the number of ventricular septal defects and papillary muscle rupture cases diagnosed, was also recorded. We also assessed whether the number of COVID-19 cases recorded in each province was associated with STEMI-related CA volume.

Results

A total of 41 of 42 Canadian catheterization laboratories (98%) provided data. There was a modest but statistically significant 16% reduction (incidence rate ratio [IRR] 0.84; 95% confidence interval 0.80-0.87) in CA for STEMI during the first wave of the pandemic, compared to control periods. IRR was not associated with provincial COVID-19 caseload. We observed a 26% reduction (IRR 0.74; 95% confidence interval 0.61-0.89) in the use of intra-aortic balloon pump use for STEMI. Use of an Impella pump and mechanical complications from STEMI were exceedingly rare.

Conclusions

We observed a modest 16% decrease in use of CA for STEMI during the pandemic first wave in Canada, lower than the level reported in other countries. Provincial COVID-19 caseload did not influence this reduction.

Prevalence of mental disorders, suicidal ideation and suicides in the general population before and during the COVID-19 pandemic in Norway: A population-based repeated cross-sectional analysis

Background

Self-report data on mental distress indicate a deterioration of population mental health in many countries during the COVID-19 pandemic. A Norwegian epidemiological diagnostic psychiatric interview survey was conducted from January to September 2020, allowing for comparison of mental disorder and suicidal ideation prevalence from before through different pandemic periods. Prevalence of suicide deaths were compared between 2020 and 2014-2018.

Methods

Participants from the Trøndelag Health Study (HUNT) in Trondheim were recruited through repeated probability sampling. Using the Composite International Diagnostic Interview (CIDI 5.0) (n = 2154), current prevalence of mental disorders and suicidal ideation was examined in repeated cross-sectional analyzes. Data on suicide deaths was retrieved from the Norwegian Cause of Death Registry and compared for the months March to May in 2014-2018 and 2020.

Findings

Prevalence of current mental disorders decreased significantly from the pre-pandemic period (January 28th to March 11th 2020; 15•3% (95% CI 12•4-18•8)) to the first pandemic period (March 12th - May 31st; 8•7% (6•8-11•0)). Prevalences were similar between the pre-pandemic period and the interim (June 1st July 31st; 14•2% (11•4-17•5)) and second periods (August 1st-September 18th; 11•9% (9•0-15•6)). No significant differences were observed in suicidal ideation or in suicide deaths.

Interpretation

Except for a decrease in mental disorders in the first pandemic period, the findings suggest stable levels of mental disorders, suicidal ideation and suicide deaths during the first six months of the COVID-19 pandemic compared to pre-pandemic levels. Potential methodological and contextual explanations of these findings compared with findings from other studies are discussed.

Funding

None.

The cardiac complications of COVID-19: many publications, multiple uncertainties

Since the first description of COVID-19 in December 2019, more than 63,000 publications have described its virology, clinical course, management, treatment and prevention. Most physicians are now encountering, or will soon encounter, patients with COVID-19 and must attempt to simultaneously assimilate this avalanche of information while managing an entirely novel disease with few guiding precedents. It is increasingly clear that, although primarily a respiratory illness, COVID-19 is associated with cardiovascular complications. However, the true incidence of direct cardiac complications remains unclear, as all complications thus far reported can also occur in patients without COVID-19. In this review, we briefly summarise and critically appraise the data on cardiac complications associated with COVID-19 and describe some cases from our own experience. We identify unresolved questions and highlight the many uncertainties in this developing field.