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Meta-Analysis
. 2021 Jun;8(1):e001645.
doi: 10.1136/openhrt-2021-001645.

Global effect of COVID-19 pandemic on the rate of acute coronary syndrome admissions: a comprehensive review of published literature

Ayman Helal  1   2 , Lamis Shahin  3 , Mahmoud Abdelsalam  4 , Mokhtar Ibrahim  5   6
Affiliations
Meta-Analysis

Global effect of COVID-19 pandemic on the rate of acute coronary syndrome admissions: a comprehensive review of published literature

Ayman Helal et al. Open Heart. 2021 Jun.

Abstract

Background: The COVID-19 pandemic has disrupted healthcare systems across the world. The rate of acute coronary syndrome (ACS) admissions during the pandemic has varied significantly.

Objectives: The purpose of this study is to investigate the effect of the pandemic on ACS hospital admissions and to determine whether this is related to the number of COVID-19 cases in each country.

Method: Search engines including PubMed, Embase, Ovid and Google Scholar were searched from December 2019 to the 15 September 2020 to identify studies reporting ACS admission data during COVID-19 pandemic months in 2020 compared with 2019 admissions.

Results: A total of 40 studies were included in this multistudy analysis. They demonstrated a 28.1% reduction in the rate of admission with ACS during the COVID-19 pandemic period compared with the same period in 2019 (total of 28 613 patients in 2020 vs 39 225 in 2019). There was a significant correlation between the absolute risk reduction in the total number of ACS cases and the number of COVID-19 cases per 100 000 population (Pearson correlation=0.361 (p=0.028)). However, the correlation was not significant for each of the ACS subgroups: non-ST-elevation myocardial infarction (STEMI) (p=0.508), STEMI (p=0883) and unstable angina (p=0.175).

Conclusion: There was a significant reduction in the rate of ACS admission during the COVID-19 pandemic period compared with the same period in 2019 with a significant correlation with COVID-19 prevalence.

Keywords: COVID-19; acute coronary syndrome; myocardial infarction.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Meta-analysis screening system. ACS, acute coronary syndrome.
Figure 2
Figure 2
Rate of admissions with acute coronary syndrome (ACS) across all papers included.
Figure 3
Figure 3
The number of acute coronary syndrome (ACS) admissions in 2019 and 2020 in each study.
Figure 4
Figure 4
Comparison between the number of admissions with STEMI, NSTEMI and UA in 2019 and 2020. NSTEMI, non-ST-elevation myocardial infarction.
Figure 5
Figure 5
The correlation between Absolute risk reduction (ARR) of acute coronary syndrome admissions and the published number of COVID-19 cases in each study.
See this image and copyright information in PMC

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