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The COVID-19 pandemic has been a game changer worldwide, including for healthcare organisation, whatever the healthcare system in use. Understanding how it has impacted acute medical conditions such as acute myocardial infarction (AMI) and their management is of major importance for the future.
Since the beginning of the pandemic, numerous reports have described a decrease in the number of hospital admissions for AMI. The present meta-analysis by Rattka and colleagues summarises the data reported up to August 2020 on admissions and in-hospital mortality for ST-segment elevation myocardial infarction (STEMI) during the pandemic.1 Ten studies were included, 2 from China and the rest from European countries. Overall, baseline characteristics did not differ between patients admitted in the pre-COVID era and during the first wave of the pandemic. A 25% reduction in daily admissions for STEMI was observed. Time from symptom onset to first medical contact remained unchanged, while door-to-balloon times, when reported, increased. The decrease in hospital admissions for STEMI was remarkably constant (around 25%), except for two small, single-centre series in Italy. Compared with the pre-COVID period, mortality in STEMI patients admitted during the pandemic was essentially unchanged.
Since last August, we and others reported similar findings,2–5 and similar trends have been described for stroke.6 In a survey including 21 hospitals in France and comparing data from the 4 weeks before institution of the nationwide lockdown and the 4 weeks following the date of the lockdown, we found a 24% decrease in STEMI admissions, similar baseline characteristics, similar use of reperfusion therapy and numerically higher but not significantly different in-hospital …
Contributors ND wrote the draft and EM made the critical revision of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.