• Salvatore De Rosa, Carmen Spaccarotella, Cristina Basso, Maria Pia Calabrò, Antonio Curcio, Filardi Pasquale Perrone PP Italian Society of Cardiology, Via Po 24, 00198 Rome, Italy. Department of A, Massimo Mancone, Giuseppe Mercuro, Saverio Muscoli, Savina Nodari, Roberto Pedrinelli, Gianfranco Sinagra, Ciro Indolfi, and Società Italiana di Cardiologia and the CCU Academy investigators group.
• Italian Society of Cardiology, Via Po 24, 00198 Rome, Italy.
• Eur. Heart J. 2020 Jun 7; 41 (22): 2083-2088.

AimsTo evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs).Methods And ResultsWe 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).ConclusionAdmissions 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.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

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