Less air pollution did not explain the decline in admissions for AMI during the first wave of COVID-19 pandemic in Sardinia, Italy

Abstract

During the COVID-19 pandemic, hospitalizations for acute myocardial infarction (AMI) decreased worldwide. We compared the admissions for AMI in the four regional 24/7 cath lab during the national lockdown, the 8 weeks before the lockdown, the 8 weeks after the e lockdown, and the corresponding time period in 2019 and we analyzed the average level of pollution in the studies areas. A marked decline in AMI admissions was observed during the lockdown period in comparison with the 8 weeks before the lockdown (p < 0.0001) and a significant increase in the 8 weeks after the lockdown (p < 0.00001). No significant change in air pollutants density were highlighted. Since air pollution did not change substantially in our region, the environment factor cannot explain the decline in the number of admissions for AMI we recorded during the lockdown. Fear of contagion is the most plausible reason for the drop of hospitalizations during the lockdown period.

Keywords: Acute myocardial infarction; COVID-19 pandemic; acute cardiovascular events; air pollution; lockdown.

Figure 1.

The figure shows the maps of the average level of pollution in the study area (NO2, PM2.5, PM10, O3, SO2) from the “Atmosphere Monitoring Service” of the “Copernicus” program of the “European Space Agencies during four different observation periods.

Figure 2.

The graph shows the rate of AMI admissions during the the 8 weeks before the start of the lockdown, during the lockdown, during the corresponding periods of the 2019 and in the early phase of reopening.