• Acta cardiologica · Jul 2020

    Impact of COVID-19-related public containment measures on the ST elevation myocardial infarction epidemic in Belgium: a nationwide, serial, cross-sectional study.

    • Marc J Claeys, Jean-François Argacha, Philippe Collart, Marc Carlier, Olivier Van Caenegem, Peter R Sinnaeve, Walter Desmet, Philippe Dubois, Francis Stammen, Sofie Gevaert, Suzanne Pourbaix, Patrick Coussement, Christophe Beauloye, Patrick Evrard, Olivier Brasseur, Frans Fierens, Patrick Marechal, Dan Schelfaut, Vincent Floré, and Claude Hanet.
    • Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium.
    • Acta Cardiol. 2020 Jul 30: 1-7.

    AimsThe current study assessed the impact of COVID-19-related public containment measures (i.e. lockdown) on the ST elevation myocardial infarction (STEMI) epidemic in Belgium.Methods And ResultsClinical characteristics, reperfusion therapy modalities, COVID-19 status and in-hospital mortality of consecutive STEMI patients who were admitted to Belgian hospitals for percutaneous coronary intervention (PCI) were recorded during a three-week period starting at the beginning of the lockdown period on 13 March 2020. Similar data were collected for the same time period for 2017-2019. An evaluation of air quality revealed a 32% decrease in ambient NO2 concentrations during lockdown (19.5 µg/m³ versus 13.2 µg/m³, p < .001). During the three-week period, there were 188 STEMI patients admitted for PCI during the lockdown versus an average 254 STEMI patients before the lockdown period (incidence rate ratio = 0.74, p = .001). Reperfusion strategy was predominantly primary PCI in both time periods (96% versus 95%). However, there was a significant delay in treatment during the lockdown period, with more late presentations (>12 h after onset of pain) (14% versus 7.6%, p = .04) and with longer door-to-balloon times (median of 45 versus 39 min, p = .02). Although the in-hospital mortality between the two periods was comparable (5.9% versus 6.7%), 5 of the 7 (71%) COVID-19-positive STEMI patients died.ConclusionThe present study revealed a 26% reduction in STEMI admissions and a delay in treatment of STEMI patients. Less exposure to external STEMI triggers (such as ambient air pollution) and/or reluctance to seek medical care are possible explanations of this observation.

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