• Holger M Nef, Albrecht Elsässer, Helge Möllmann, Mohammed Abdel-Hadi, Timm Bauer, Martin Brück, Holger Eggebrecht, Joachim R Ehrlich, Markus W Ferrari, Stephan Fichtlscherer, Ulrich Hink, Hans Hölschermann, Rifat Kacapor, Oliver Koeth, Serguei Korboukov, Steffen Lamparter, Alexander J Laspoulas, Ralf Lehmann, Christoph Liebetrau, Tobias Plücker, Jörn Pons-Kühnemann, Volker Schächinger, Bernhard Schieffer, Peter Schott, Matthias Schulze, Claudius Teupe, Mariuca Vasa-Nicotera, Michael Weber, Christoph Weinbrenner, Gerald Werner, Christian W Hamm, Oliver Dörr, and CoVCAD –Study Group.
• Department of Cardiology, Justus Liebig University Giessen, University Hospital Giessen, Medical Clinic I, Klinikstrasse 33, 35392, Giessen, Germany. holger.nef@innere.med.uni-giessen.de.
• Clin Res Cardiol. 2021 Feb 1; 110 (2): 292-301.

AimsDuring the COVID-19 pandemic, hospital admissions for cardiac care have declined. However, effects on mortality are unclear. Thus, we sought to evaluate the impact of the lockdown period in central Germany on overall and cardiovascular deaths. Simultaneously we looked at catheterization activities in the same region.Methods And ResultsData from 22 of 24 public health-authorities in central Germany were aggregated during the pandemic related lockdown period and compared to the same time period in 2019. Information on the total number of deaths and causes of death, including cardiovascular mortality, were collected. Additionally, we compared rates of hospitalization (n = 5178) for chronic coronary syndrome (CCS), acute coronary syndrome (ACS), and out of hospital cardiac arrest (OHCA) in 26 hospitals in this area. Data on 5,984 deaths occurring between March 23, 2020 and April 26, 2020 were evaluated. In comparison to the reference non-pandemic period in 2019 (deaths: n = 5832), there was a non-significant increase in all-cause mortality of 2.6% [incidence rate ratio (IRR) 1.03, 95% confidence interval (CI) 0.99-1.06; p = 0.16]. Cardiovascular and cardiac mortality increased significantly by 7.6% (IRR 1.08, 95%-CI 1.01-1.14; p = 0.02) and by 11.8% (IRR 1.12, 95%-CI 1.05-1.19; p < 0.001), respectively. During the same period, our data revealed a drop in cardiac catherization procedures.ConclusionDuring the COVID-19-related lockdown a significant increase in cardiovascular mortality was observed in central Germany, whereas catherization activities were reduced. The mechanisms underlying both of these observations should be investigated further in order to better understand the effects of a pandemic-related lockdown and social-distancing restrictions on cardiovascular care and mortality.

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