"Missing" acute coronary syndrome hospitalizations during the COVID-19 era in Greece: Medical care avoidance combined with a true reduction in incidence?

Clinical Cardiology
Michail PapafaklisLampros K Michalis

Abstract

Reports from countries severely hit by the COVID-19 pandemic suggest a decline in acute coronary syndrome (ACS)-related hospitalizations. The generalizability of this observation on ACS admissions and possible related causes in countries with low COVID-19 incidence are not known. ACS admissions were reduced in a country spared by COVID-19. We conducted a nationwide study on the incidence rates of ACS-related admissions during a 6-week period of the COVID-19 outbreak and the corresponding control period in 2019 in Greece, a country with strict social measures, low COVID-19 incidence, and no excess in mortality. ACS admissions in the COVID-19 (n = 771) compared with the control (n = 1077) period were reduced overall (incidence rate ratio [IRR]: 0.72, P < .001) and for each ACS type (ST-segment elevation myocardial infarction [STEMI]: IRR: 0.76, P = .001; non-STEMI: IRR: 0.74, P < .001; and unstable angina [UA]: IRR: 0.63, P = .002). The decrease in STEMI admissions was stable throughout the COVID-19 period (temporal correlation; R2 = 0.11, P = .53), whereas there was a gradual decline in non-STEMI/UA admissions (R2 = 0.75, P = .026) following the progressively stricter social measures. During the COVID-19 period, patients admitte...Continue Reading

References

Jan 25, 2018·The New England Journal of Medicine·Jeffrey C KwongJonathan B Gubbay
Mar 18, 2020·Circulation. Cardiovascular Quality and Outcomes·Chor-Cheung Frankie TamChung-Wah Siu
Apr 14, 2020·Journal of the American College of Cardiology·Santiago GarciaTimothy D Henry
Apr 29, 2020·The New England Journal of Medicine·Ovidio De FilippoGaetano M De Ferrari

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Citations

Sep 9, 2021·Scandinavian Journal of Public Health·Mikko UimonenVille M Mattila

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