Am Heart J . Incidence of acute coronary syndrome during national lock-down: insights from nationwide data during the coronavirus disease 2019 (COVID-19) pandemic

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Am Heart J


. 2020 Nov 5;S0002-8703(20)30371-9.
doi: 10.1016/j.ahj.2020.11.004. Online ahead of print.
Incidence of acute coronary syndrome during national lock-down: insights from nationwide data during the coronavirus disease 2019 (COVID-19) pandemic


Lauge ?stergaard ¹ , Jawad Haider Butt ² , Kristian Kragholm ³ , Morten Schou ⁴ , Matthew Phelps ⁵ , Rikke S?rensen ² , Morten Lamberts ⁴ , Gunnar Gislason ⁶ , Christian Torp-Pedersen ⁷ , Lars K?ber ² , Emil L Fosb?l ²



Affiliations

• PMID: 33160947
• DOI: 10.1016/j.ahj.2020.11.004

Abstract

Background: Urgent recognition and treatment are needed in patients with acute coronary syndrome (ACS), however this may be difficult during the Coronavirus disease 2019 (COVID-19) pandemic with a national lock-down. We aimed to examine the incidence of ACS after national lock-down.
Methods: The Danish government announced national lock-down on March 11 2020 and first phase of reopening was announced on April 6. Using Danish nationwide registries, we identified first-time ACS admissions in A) January 1 - May 7 2017-2019, and B) January 1 - May 6 2020. Incidence rates of ACS admissions per week for the 2017-2019-period and the 2020-period were computed and incidence rate ratios (IRR) were computed using Poisson regression analysis.
Results: The number of ACS admissions were 8,204 (34.6% female, median age 68.3 years) and 2,577 (34.0% female, median age 68.5 years) for the 2017-2019- and 2020-period, respectively. No significant differences in IRRs were identified for weeks 1-9 (January 1 - March 4) for 2020 compared with week 1-9 for 2017-2019. In 2020, significant lower IRRs were identified for week 10 (March 5-11) IRR=0.71 (95% CI: 0.58-0.87), week 11 (12-18 March) IRR=0.68 (0.56-0.84), and week 14 (2 - 8 April) IRR=0.79 (0.65-0.97). No significant differences in IRRs were identified for week 15-18 (April 9 - May 6). In subgroup analysis, we identified that the main result was driven by male patients, and patients ≥60 years.
Conclusion: During the COVID-19 pandemic with an established national lock-down we identified a significant decline around 30% in the incidence of ACS admissions. Along with the reopening of society, ACS admissions were stabilized at levels equal to previous years.

Keywords: Acute coronary syndrome; COVID-19; Corona virus disease 2019.