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. 2022 Sep 6;14(9):1971.
doi: 10.3390/v14091971.

Takotsubo Syndrome during COVID-19 Pandemic in the Veneto Region, Italy

Marco Zuin  1 , Giacomo Mugnai  1 , Maurizio Anselmi  2 , Stefano Bonapace  3 , Paolo Bozzini  2 , Fabio Chirillo  4 , Ada Cutolo  5 , Giuseppe Grassi  6 , Daniela Mancuso  7 , Samuele Meneghin  7 , Giulio Molon  3 , Antonio Mugnolo  8 , Ivan Pantano  9 , Angela Polo  4 , Paola Purita  10 , Loris Roncon  11 , Salvatore Saccà  10 , Daniele Scarpa  6 , Domenico Tavella  12 , Sakis Themistoclakis  5 , Giovanni Turiano  13 , Roberto Valle  9 , Maddalena Widmann  12 , Edlira Zakja  13 , Alberto Zamboni  8 , Gianluca Rigatelli  14 , Claudio Bilato  1
Affiliations

Takotsubo Syndrome during COVID-19 Pandemic in the Veneto Region, Italy

Marco Zuin et al. Viruses. .

Abstract

Background: During the COVID-19 pandemic, the risk of SARS-CoV-2 infection, the public health measures of social distancing, the freedom limitations, quarantine, and the enforced homeworking under the lockdown period, as well as medical causes including COVID-19 infection per se, may have caused major emotional distress, especially in the most vulnerable patients. We aimed to evaluate the variations in the number of admissions due to Takotsubo syndrome (TTS) during the COVID-19 pandemic in the Veneto region. Methods: We retrospectively reviewed and analyzed the number of admissions because of TTS in 13 Divisions of Cardiology located in the Veneto region, the northeastern area of Italy, covering a population of more than 2.5 million inhabitants, during the two major pandemic waves of COVID-19 (the first between 15 March and 30 April 2020 and the second between 15 November and 30 December 2020) that occurred in 2020. Results: In total, 807 acute coronary syndromes were admitted in the 13 enrolling hospitals. Among these, 3.9% had TTS. Compared to the corresponding 2018 and 2019 time periods, we observed a significant increase in the number of TTS cases (+15.6%, p = 0.03 and +12.5%, p = 0.04, comparing 2018 to 2020 and 2019 to 2020, respectively). Geographical distribution of the TTS cases reflected the broad spread of the SARS-CoV-2 infection with a significant direct relationship between TTS incidence and the number of COVID-19 infections according to Pearson’s correlation (r = 0.798, p < 0.001). Conclusions: The higher incidence of TTS during the 2020 COVID-19 pandemic waves, especially in the areas that were hit hardest in terms of morbidity and mortality by the SARS-CoV-2 infection, suggest a strong direct and/or indirect role of COVID-19 in the pathogenesis of TTS.

Keywords: COVID-19; Takotsubo; epidemiology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Trends in Takotsubo syndrome hospital admission in Veneto region. Periods: 2018/1: between 15 March and 30 April 2018; 2018/2: between 15 November and 30 December 2018; 2019/1: between 15 March and 30 April 2019; 2019/2: between 15 November and 30 December 2019; 2020/1: between 15 March and 30 April 2020; 2020/2: between 15 November and 30 December 2020. (B) Crude incidence of Takotsubo syndrome over the years in Veneto region (per 100,000 inhabitants). * p < 0.05 compared to 2020; p for difference between 2018 vs 2019 = 0.621.
Figure 2
Figure 2
Map of the Veneto region showing the areas with the highest incidence of Takotsubo syndrome during the first and second pandemic waves.
See this image and copyright information in PMC

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