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Pourasghari H, Tavolinejad H, Soleimanpour S, Abdi Z, Arabloo J, Bragazzi NL, Behzadifar M, Rashedi S, Omidi N, Ayoubian A, Tajdini M, Ghorashi SM, Azari S. Hospitalization, major complications and mortality in acute myocardial infarction patients during the COVID-19 era: A systematic review and meta-analysis. IJC HEART & VASCULATURE 2022; 41:101058. [PMID: 35647263 PMCID: PMC9124953 DOI: 10.1016/j.ijcha.2022.101058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/21/2022] [Accepted: 05/15/2022] [Indexed: 12/01/2022]
Abstract
Since the SARS-CoV-2 pandemic began, numerous studies have reported a concerning drop in the number of acute myocardial infarction (AMI) admissions. In the present systematic review and meta-analysis, we aimed to compare the rate of AMI admissions and major complication during the pandemic, in comparison with pre-pandemic periods. Three major databases (PubMed, Scopus, and Web of Science Core Collection) were searched. Out of 314 articles, 41 were entered into the study. Patients hospitalized for AMI were 35% less in the COVID-19 era compared with pre-pandemic periods, which was statistically significantly (OR = 0.65; 95% CI: 0.56–0.74; I2 = 99%; p < 0.001; 28 studies). Patients hospitalized for STEMI and NSTEMI were 29% and 34% respectively less in the COVID-19 era compared with periods before COVID-19, which was statistically significantly (OR = 0.71; 95% CI: 0.65 –0.78; I2 = 93%; p < 0.001; 22 studies, OR = 0.66; 95% CI: 0.58–0.73; I2 = 95%; p < 0.001; 14 studies). The overall rate of in-hospital mortality in AMI patients increased by 26% in the COVID-19 era, which was not statistically significant (OR = 1.26; 95% CI: 1.0–1.59; I2 = 22%; p < 0.001; six studies). The rate of in-hospital mortality in STEMI and NSTEMI patients increased by 15% and 26% respectively in the COVID-19 era, which was not statistically significant (OR = 1.15; 95% CI: 0.85–1.57; I2 = 48%; p = 0.035; 11 studies, OR = 1.35; 95% CI: 0.64–2.86; I2 = 45%; p = 0.157; 3 articles). These observations highlight the challenges in the adaptation of health-care systems with the impact of the COVID-19 pandemic.
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Mogharab V, Ostovar M, Ruszkowski J, Hussain SZM, Shrestha R, Yaqoob U, Aryanpoor P, Nikkhoo AM, Heidari P, Jahromi AR, Rayatdoost E, Ali A, Javdani F, Farzaneh R, Ghanaatpisheh A, Habibzadeh SR, Foroughian M, Ahmadi SR, Akhavan R, Abbasi B, Shahi B, Hakemi A, Bolvardi E, Bagherian F, Motamed M, Boroujeni ST, Jamalnia S, Mangouri A, Paydar M, Mehrasa N, Shirali D, Sanmarchi F, Saeed A, Jafari NA, Babou A, Kalani N, Hatami N. Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses. Global Health 2022; 18:58. [PMID: 35676714 PMCID: PMC9175527 DOI: 10.1186/s12992-022-00836-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023] Open
Abstract
Background Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people’s access or intention to healthcare systems. Objective To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic. Methods Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. In a systematic literature review, PubMed was quarried for each panel for studies comparing the incidence of various medical emergencies before and during the COVID-19 pandemic. Markers of failure/disruption of treatment due to delayed referral were included in the meta-analysis for each panel. Result There was a statistically significant increased pooled median time of symptom onset to admission of the acute coronary syndrome (ACS) patients; an increased rate of vasospasm of aneurismal subarachnoid hemorrhage; and perforation rate in acute appendicitis; diabetic ketoacidosis presentation rate among Type 1 Diabetes Mellitus patients; and rate of orchiectomy among testicular torsion patients in comparison of pre-COVID-19 with COVID-19 cohorts; while there were no significant changes in the event rate of ruptured ectopic pregnancy and median time of symptom onset to admission in the cerebrovascular accident (CVA) patients. Conclusions COVID-19 has largely disrupted the referral of patients for emergency medical care and patient-related delayed care should be addressed as a major health threat. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00836-2.
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Affiliation(s)
- Vahid Mogharab
- Department of Pediatrics, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mahshid Ostovar
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Jakub Ruszkowski
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.,Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Rajeev Shrestha
- Palliative Care and Chronic Disease Unit, Green Pasteur Hospital, Pokhara, Nepal
| | - Uzair Yaqoob
- Postgraduate trainee, Surgical Department, Hamdard University Hospital Karachi, Karachi, Pakistan
| | - Poorya Aryanpoor
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Amir Mohammad Nikkhoo
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Parasta Heidari
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Athar Rasekh Jahromi
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Esmaeil Rayatdoost
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Anwar Ali
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
| | - Farshid Javdani
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Roohie Farzaneh
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aref Ghanaatpisheh
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Seyed Reza Habibzadeh
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Foroughian
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayyed Reza Ahmadi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Akhavan
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Abbasi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
| | - Behzad Shahi
- Department of Emergency Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Arman Hakemi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Bolvardi
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Bagherian
- Department of Emergency Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mahsa Motamed
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sheida Jamalnia
- Medical Journalism Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Mangouri
- Fellowship of Vascular Surgery and Endovascular Therapy, Division of Vascular Surgery and Endovascular Therapy, Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Paydar
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Neda Mehrasa
- Shiraz Azad University, Dental Branch, Shiraz, Iran
| | | | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Ayesha Saeed
- Department of Biochemistry, Government College University, Faisalabad, Pakistan
| | - Narges Azari Jafari
- Neuroscience Research Department Center, Kashan University of Medical Science, Kashan, Iran
| | - Ali Babou
- Pharmaceutical Sciences Department, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Navid Kalani
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Naser Hatami
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
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Yeh CC, Chien CY, Lee TY, Liu CH. Effect of the COVID-19 Pandemic on Emergency Department Visits of Patients with an Emergent or Urgent Diagnosis. Int J Gen Med 2022; 15:4657-4664. [PMID: 35548587 PMCID: PMC9081622 DOI: 10.2147/ijgm.s362615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose During the coronavirus disease 2019 (COVID-19) pandemic, visits to emergency department (ED) have significantly declined worldwide. The purpose of this study was to identify the trend of visits to ED for different diseases at the peak and slack stages of the epidemic. Patients and Methods This was a retrospective observational study conducted in a tertiary referral medical center in northern Taiwan. We recorded weekly ED visits for myocardial infarction with or without ST-elevation (STEMI or NSTEMI), out-of-hospital cardiac arrest (OHCA), acute stroke, and congestive heart failure from 2016 to 2021. We compared the local epidemic peak periods (calendar weeks 4–18, 2020 and calendar weeks 21–31, 2021) and its corresponding slack periods (calendar weeks 4–18, 2021 and calendar weeks 21–31, 2020) with the baseline period (2016–2019) using Mann–Whitney test to identify the difference. Results We observed a significant decline in ED visits (median [Q1, Q3]) during the epidemic for OHCA (6 [5, 7] and 5 [4, 6], p = 0.046, for baseline and peak period, respectively, in week 4–18), acute stroke (41.5 [38, 47] and 35 [28, 39], p < 0.001, in week 4–18, 40 [35, 45] and 35 [28, 40], p = 0.039, in week 21–31) and CHF (28 [24.25, 33] and 19 [12, 23], p < 0.001, in week 4–18, 18 [16, 23] and 13 [11, 16], p = 0.001, in week 21–31). Significant difference was not observed in patients with NSTEMI and STEMI in both week 4–18 and 21–31, and cardiac arrest in week 21–31. There was a rebound in ED visits in the slack period. Conclusion This study revealed that ED visits significantly declined during the COVID-19 epidemic and rebounded in the slack period. The trend was significant for acute stroke and heart failure but was relatively less prominent effect for emergent events such as cardiac arrest or myocardial infarction.
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Affiliation(s)
- Chung-Cheng Yeh
- Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Yu Chien
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Emergency Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Hao Liu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Correspondence: Chun-Hao Liu, Department of Child & Adolescent Psychiatry, Chang Gung Memorial Hospital at Linkou, No. 5, Fu-Hsin St., Gueshan District, Taoyuan City, 333, Taiwan, Tel +886-3-3281200 #2479, Email
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Jardim BC, Migowski A, Corrêa FDM, Silva GAE. Covid-19 in Brazil in 2020: impact on deaths from cancer and cardiovascular diseases. Rev Saude Publica 2022; 56:22. [PMID: 35476100 PMCID: PMC9004704 DOI: 10.11606/s1518-8787.2022056004040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To analyze the impact of the covid-19 pandemic on mortality from cancer and cardiovascular diseases (CVD) as underlying cause and comorbidity in Brazil and Brazilian regions in 2020. METHODS We used the 2019 and 2020 databases of the Mortality Information System (SIM) to analyze deaths occurring between March and December of each year that had cancer or CVD as the underlying cause or comorbidity. Deaths from covid-19 in 2020 were also analyzed. To estimate the Standardized Mortality Ratio (SMR) and the excess of deaths, 2019 data were considered as standard. RESULTS Between March and December 2020, there were 181,377 deaths from cancer and 291,375 deaths from cardiovascular diseases in Brazil, indicating reduction rates of 9.7% and 8.8%, respectively, compared to the same period of the previous year. The pattern was maintained in the five Brazilian regions, with lower variation for cancer (-8.4% in the South to -10.9% in the Midwest). For CVD, the variation was greater, from -2.2% in the North to -10.5 in the Southeast and South. In the same period of 2020, these diseases were classified as comorbidities in 18,133 deaths from cancer and 188,204 deaths from cardiovascular diseases, indicating a proportional excess compared to data from 2019, of 82.1% and 77.9%, respectively. This excess was most significant in the Northern Region, with a ratio of 2.5 between observed and expected deaths for the two conditions studied. CONCLUSIONS Excess deaths from cancer and CVD as comorbidities in 2020 may indicate that covid-19 had an important impact among patients with these conditions.
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Affiliation(s)
- Beatriz Cordeiro Jardim
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
| | - Arn Migowski
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
- Instituto Nacional de CardiologiaCoordenação de Ensino e PesquisaNúcleo de EpidemiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia. Coordenação de Ensino e Pesquisa. Núcleo de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Flávia de Miranda Corrêa
- Instituto Nacional de CâncerCoordenação de Prevenção e VigilânciaDivisão de Detecção Precoce e Apoio à Organização de RedeRio de JaneiroRJBrasilInstituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Rio de Janeiro, RJ, Brasil
| | - Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hésio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hésio Cordeiro. Rio de Janeiro, RJ, Brasil
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Cannata A, Watson SA, Daniel A, Giacca M, Shah AM, McDonagh TA, Scott PA, Bromage DI. Impact of the COVID-19 pandemic on in-hospital mortality in cardiovascular disease: a meta-analysis. Eur J Prev Cardiol 2021; 29:1266-1274. [PMID: 34297822 PMCID: PMC8344916 DOI: 10.1093/eurjpc/zwab119] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/25/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023]
Abstract
Aims The COVID-19 pandemic has resulted in excess mortality due to both COVID-19 directly and other conditions, including cardiovascular (CV) disease. We aimed to explore the excess in-hospital mortality, unrelated to COVID-19 infection, across a range of CV diseases. Methods and results A systematic search was performed for studies investigating in-hospital mortality among patients admitted with CV disease without SARS-CoV-2 infection compared with a period outside the COVID-19 pandemic. Fifteen studies on 27 421 patients with CV disease were included in the analysis. The average in-hospital mortality rate was 10.4% (n = 974) in the COVID-19 group and 5.7% (n = 1026) in the comparator group. Compared with periods outside the COVID-19 pandemic, the pooled risk ratio (RR) demonstrated increased in-hospital mortality by 62% during COVID-19 [95% confidence interval (CI) 1.20–2.20, P = 0.002]. Studies with a decline in admission rate >50% during the COVID-19 pandemic observed the greatest increase in mortality compared with those with <50% reduction [RR 2.74 (95% CI 2.43–3.10) vs. 1.21 (95% CI 1.07–1.37), P < 0.001]. The observed increased mortality was consistent across different CV conditions (P = 0.74 for interaction). Conclusions In-hospital mortality among patients admitted with CV diseases was increased relative to periods outside the pandemic, independent of co-infection with COVID-19. This effect was larger in studies with the biggest decline in admission rates, suggesting a sicker cohort of patients in this period. However, studies were generally poorly conducted, and there is a need for further well-designed studies to establish the full extent of mortality not directly related to COVID-19 infection.
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Affiliation(s)
- Antonio Cannata
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre of Excellence, 125 Coldharbour Lane, London SE5 9NU, UK.,Department of Cardiology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - Samuel A Watson
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre of Excellence, 125 Coldharbour Lane, London SE5 9NU, UK.,Department of Cardiology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - Allen Daniel
- Department of Cardiology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - Mauro Giacca
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre of Excellence, 125 Coldharbour Lane, London SE5 9NU, UK
| | - Ajay M Shah
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre of Excellence, 125 Coldharbour Lane, London SE5 9NU, UK
| | - Theresa A McDonagh
- Department of Cardiology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - Paul A Scott
- Department of Cardiology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
| | - Daniel I Bromage
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre of Excellence, 125 Coldharbour Lane, London SE5 9NU, UK.,Department of Cardiology, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
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Baumhardt M, Dreyhaupt J, Winsauer C, Stuhler L, Thiessen K, Stephan T, Markovic S, Rottbauer W, Imhof A, Rattka M. The Effect of the Lockdown on Patients With Myocardial Infarction During the COVID-19 Pandemic–A Systematic Review and Meta-Analysis. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:447-453. [PMID: 34114546 PMCID: PMC8383188 DOI: 10.3238/arztebl.m2021.0253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 01/17/2021] [Accepted: 05/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The phenomenon of declining numbers of patients presenting with myocardial infarction was reported from the beginning of the COVID-19 pandemic onward. It was thought that measures introduced to stem the pandemic, such as the lockdown, contributed to this development. However, the data on hospital admissions, delay times, and mortality are not consistent. METHODS Our systematic literature review and meta-analysis embraced studies reporting the number of hospital admissions of patients with ST-segment elevation myocardial infarction (STEMI) and/or non-ST-segment elevation myocardial infarction (NSTEMI) during lockdown episodes. We also collected data on patient- and system-related delay times and on mortality. RESULTS Data from 27 studies on a total of 81 163 patients were included in our meta-analysis. We found that the number of hospital admissions of patients with myocardial infarction was significantly lower during the lockdown than before the pandemic (incidence rate ratio [IRR] = 0.516 [0.403; 0.660], I2 = 98%). This was true both for patients with STEMI (IRR = 0.620 [0.514; 0.746], I2 = 96%) and for patients with NSTEMI (IRR = 0.454 [0.354; 0.584], I2 = 96%). However, we found no significant difference in the time from hospital admission to cardiac catheterization, or in mortality, in relation to the time from symptom onset to first medical contact. CONCLUSION In this study, we have shown that the lockdown due to COVID-19 was associated with a marked decline in the number of hospital admissions of patients with myocardial infarction. As no significant effect on delay times or mortality was observed, it seems that timely medical care continued to be delivered.
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Affiliation(s)
- Michael Baumhardt
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Jens Dreyhaupt
- Institute for Epidemiology and Medical Biometrics, University of Ulm
| | - Claudia Winsauer
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Lina Stuhler
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Kevin Thiessen
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Tilman Stephan
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Sinisa Markovic
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Wolfgang Rottbauer
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Armin Imhof
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
| | - Manuel Rattka
- Department of Internal Medicine II, Cardiology, Pneumonology and Internal Intensive Care Medicine, University Hospital Ulm
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7
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Stirparo G, Oradini-Alacreu A, Migliori M, Villa GF, Botteri M, Fagoni N, Signorelli C, Sechi GM, Zoli A. Public health impact of the COVID-19 pandemic on the emergency healthcare system. J Public Health (Oxf) 2021; 44:e149-e152. [PMID: 34156071 PMCID: PMC8344573 DOI: 10.1093/pubmed/fdab212] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 12/26/2022] Open
Abstract
Background The Lombardy region has been the Italian region most affected by the coronavirus disease 2019 (COVID-19) pandemic in 2020. The emergency healthcare system was under deep stress throughout the past year due to the admission of COVID-19 patients to the emergency department (ED) and had to be thoroughly reorganized. Methods We performed a retrospective descriptive analysis of patients admitted into the ED recorded in the Lombardy online regional portal called EUOL (Emergenza e Urgenza OnLine). We compared the data registered in the EUOL with the patients admitted to the EDs from 1 January 2019 to 31 December 2019 and from 1 January 2020 to 31 December 2020. Results The number of admissions to the ED decreased by 32.5% in 2020 compared with 2019, reaching the lowest number in March and April. However, the percentage of patients hospitalized after ED significantly increased in 2020 compared with 2019 (P < 0.0001), reflecting the management of patients with a more severe clinical condition. More patients arrived at the ED by ambulance in 2020 (21.7% in 2020 versus 15.1% in 2019; P < 0.0001), particularly during March and April. Conclusions This analysis showed the importance of monitoring the pandemic’s evolution in order to treat more critically ill patients, despite a lower number of patients.
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Affiliation(s)
- G Stirparo
- Faculty of Medicine, School of Public Health - University of Vita-Salute San Raffaele, Milano 20132, Italy.,Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano 20124, Italy
| | - A Oradini-Alacreu
- Faculty of Medicine, School of Public Health - University of Vita-Salute San Raffaele, Milano 20132, Italy
| | - M Migliori
- Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano 20124, Italy
| | - G F Villa
- Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano 20124, Italy
| | - M Botteri
- Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano 20124, Italy.,AAT Brescia, Agenzia Regionale Emergenza Urgenza (AREU), ASST Spedali Civili di Brescia, Brescia 25123, Italy
| | - N Fagoni
- AAT Brescia, Agenzia Regionale Emergenza Urgenza (AREU), ASST Spedali Civili di Brescia, Brescia 25123, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia 25123, Italy
| | - C Signorelli
- Faculty of Medicine, School of Public Health - University of Vita-Salute San Raffaele, Milano 20132, Italy
| | - G M Sechi
- Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano 20124, Italy
| | - A Zoli
- Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano 20124, Italy
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