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Observational Study
. 2020 Jun 7;41(22):2083-2088.
doi: 10.1093/eurheartj/ehaa409.

Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

Salvatore De Rosa  1   2 , Carmen Spaccarotella  1   2 , Cristina Basso  1   3 , Maria Pia Calabrò  1   4 , Antonio Curcio  1   2 , Pasquale Perrone Filardi  1   5 , Massimo Mancone  1   6 , Giuseppe Mercuro  1   7 , Saverio Muscoli  1   8 , Savina Nodari  1   9 , Roberto Pedrinelli  1   10 , Gianfranco Sinagra  1   11 , Ciro Indolfi  1   2 ; Società Italiana di Cardiologia and the CCU Academy investigators group
Collaborators, Affiliations
Observational Study

Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

Salvatore De Rosa et al. Eur Heart J. .

Erratum in

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.

Keywords: Acute myocardial infarction; COVID-19; Cardiac care units; SARS-CoV2; STEMI.

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Figures

Figure 1
Figure 1
Admissions for acute myocardial infarction across Italy. The figure reports the number of admissions registered among Italian cardiac care units (CCUs) during the week 12–19 March 2020, in the midst of the COVID-19 emergency (yellow bars) and during the same week of the previous year (blue bars) for comparison.
Figure 2
Figure 2
Case fatality rates for acute myocardial infarction. The figure reports case fatality rates among patients admitted for AMI during the week 12–19 March 2020, in the midst of the COVID-19 emergency (yellow bars) and during the same week of the previous year (blue bars).
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