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

De Rosa, S.; Spaccarotella, C.; Basso, C.; Calabro, M. P.; Curcio, A.; Filardi, P. P.; Mancone, M.; Mercuro, G.; Muscoli, S.; Nodari, S.; Pedrinelli, R.; Sinagra, G.; Indolfi, C.; Angelini, F.; Barilla, F.; Bartorelli, A.; Benedetto, F.; Bernabo, P.; Bolognese, L.; Briani, M.; Cacciavillani, L.; Calabrese, A.; Calabro, P.; Caliendo, L.; Calo, L.; Casella, G.; Casu, G.; Cavallini, C.; Ciampi, Q.; Ciccone, M.; Comito, M.; Corrada, E.; Crea, F.; D'Andrea, A.; D'Urbano, M.; De Caterina, R.; De Ferrari, G.; De Ponti, R.; Della Mattia, A.; DI Mario, C.; Donnazzan, L.; Esposito, G.; Fedele, F.; Ferraro, A.; Galasso, G.; Galie, N.; Gnecchi, M.; Golino, P.; Golia, B.; Guarini, P.; Indolfi, C.; Leonardi, S.; Locuratolo, N.; Luzza, F.; Manganiello, V.; Francesca Marchetti, M.; Marenzi, G.; Margonato, A.; Meloni, L.; Metra, M.; Milo, M.; Mongiardo, A.; Monzo, L.; Morisco, C.; Nodari, S.; Novo, G.; Pancaldi, S.; Parollo, M.; Paterno, G.; Patti, G.; Priori, S.; Ravera, A.; Giuseppe Rebuzzi, A.; Rossi, M.; Scherillo, M.; Semprini, F.; Senni, M.; Sibilio, G.; Sinagra, G.; Siviglia, M.; Tamburino, C.; Tortorici, G.; Versace, F.; Villari, B.; Volpe, M.

doi:10.1093/eurheartj/ehaa409

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.

Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era / De Rosa, S.; Spaccarotella, C.; Basso, C.; Calabro, M. P.; Curcio, A.; Filardi, P. P.; Mancone, M.; Mercuro, G.; Muscoli, S.; Nodari, S.; Pedrinelli, R.; Sinagra, G.; Indolfi, C.; Angelini, F.; Barilla, F.; Bartorelli, A.; Benedetto, F.; Bernabo, P.; Bolognese, L.; Briani, M.; Cacciavillani, L.; Calabrese, A.; Calabro, P.; Caliendo, L.; Calo, L.; Casella, G.; Casu, G.; Cavallini, C.; Ciampi, Q.; Ciccone, M.; Comito, M.; Corrada, E.; Crea, F.; D'Andrea, A.; D'Urbano, M.; De Caterina, R.; De Ferrari, G.; De Ponti, R.; Della Mattia, A.; DI Mario, C.; Donnazzan, L.; Esposito, G.; Fedele, F.; Ferraro, A.; Galasso, G.; Galie, N.; Gnecchi, M.; Golino, P.; Golia, B.; Guarini, P.; Indolfi, C.; Leonardi, S.; Locuratolo, N.; Luzza, F.; Manganiello, V.; Francesca Marchetti, M.; Marenzi, G.; Margonato, A.; Meloni, L.; Metra, M.; Milo, M.; Mongiardo, A.; Monzo, L.; Morisco, C.; Nodari, S.; Novo, G.; Pancaldi, S.; Parollo, M.; Paterno, G.; Patti, G.; Priori, S.; Ravera, A.; Giuseppe Rebuzzi, A.; Rossi, M.; Scherillo, M.; Semprini, F.; Senni, M.; Sibilio, G.; Sinagra, G.; Siviglia, M.; Tamburino, C.; Tortorici, G.; Versace, F.; Villari, B.; Volpe, M.. - In: EUROPEAN HEART JOURNAL. - ISSN 1522-9645. - 41:22(2020), pp. 2083-2088. [10.1093/eurheartj/ehaa409]