Lancet Reg Health Eur . Myocardial Infarction incidence during national lockdown in two French provinces unevenly affected by COVID-19 outbreak: An observational study

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Lancet Reg Health Eur


. 2021 Mar;2:100030.
doi: 10.1016/j.lanepe.2021.100030. Epub 2021 Jan 13.
Myocardial Infarction incidence during national lockdown in two French provinces unevenly affected by COVID-19 outbreak: An observational study


Eric Van Belle ¹ , Thibault Manigold ² , Adeline Piérache ³ , Alain Furber ⁴ , Nicolas Debry ⁵ , Anne Luycx-Bore ⁶ , Jean-Jacques Bauchart ⁷ , Olivier Nugue ⁸ , François Huchet ⁹ , Mathieu Bic ¹⁰ , François Vinchon ¹¹ , Smaïn Sayah ¹² , Alexandre Fournier ¹³ , Eric Decoulx ¹⁴ , Usman Mouhammad ¹⁵ , Jérôme Clerc ¹⁶ , Aurélie Manchuelle ¹⁷ , Tahar Lazizi ¹⁸ , Akram Chmait ¹⁹ , Julien Jeannetteau ²⁰ , Pierre Hénon ²¹ , Mickael Bonin ² , Marie Dupret-Minet ²² , Ashok Tirouvanziam ²³ , David Molcard ²⁴ , Fabien Arabucki ²⁵ , Antoine Py ²⁶ , Fabrice Prunier ⁴ , Cédric Delhaye ¹ , Gilles Lemesle ¹ , Guillaume Schurtz ¹ , Alessandro Cosenza ¹ , Hugues Spillemaeker ¹ , Basile Verdier ¹ , Tom Denimal ¹ , Thibault Pamart ¹ , Habib Sylla ¹ , Dany Janah ¹ , David Aouate ¹ , Sina Porouchani ¹ , Valérie Guillez ¹ , Guillaume Bonnet ²⁷ , Julien Ternacle ²⁷ , Julien Labreuche ³ , Guillaume Cayla ²⁸ , Flavien Vincent ¹



Affiliations

• PMID: 34173627
• PMCID: PMC7938895
• DOI: 10.1016/j.lanepe.2021.100030

Free PMC article

Abstract

Background: A reduction of admission for MI has been reported in most countries affected by COVID-19. No clear explanation has been provided.
Methods: To report the incidence of myocardial infarction (MI) admission during COVID-19 pandemic and in particular during national lockdown in two unequally affected French provinces (10-million inhabitants) with a different media strategy, and to describe the magnitude of MI incidence changes relative to the incidence of COVID-19-related deaths. A longitudinal study to collect all MIs from January 1 until May 17, 2020 (study period) and from the identical time period in 2019 (control period) was conducted in all centers with PCI-facilities in northern "Hauts-de-France" province and western "Pays-de-la-Loire" Province. The incidence of COVID-19 fatalities was also collected.
Findings: In "Hauts-de-France", during lockdown (March 18-May 10), 1500 COVID-19-related deaths were observed. A 23% decrease in MI-IR (IRR=0.77;95%CI:0.71-0.84, p<0.001) was observed for a loss of 272 MIs (95%CI:-363,-181), representing 18% of COVID-19-related deaths. In "Pays-de-la-Loire", 382 COVID-19-related deaths were observed. A 19% decrease in MI-IR (IRR=0.81; 95%CI=0.73-0.90, p<0.001) was observed for a loss of 138 MIs (95%CI:-210,-66), representing 36% of COVID-19-related deaths. While in "Hauts-de-France" the MI decline started before lockdown and recovered 3 weeks before its end, in "Pays-de-la-Loire", it started after lockdown and recovered only by its end. In-hospital mortality of MI patients was increased during lockdown in both provinces (5.0% vs 3.4%, p=0.02).
Interpretation: It highlights one of the potential collateral damages of COVID-19 outbreak on cardiovascular health with a dramatic reduction of MI incidence. It advocates for a careful and weighted communication strategy in pandemic crises.
Funding: The study was conducted without external funding.

Keywords: COVID-19 outbreak; COVID-19, Coronavirus disease 2019; Clinical outcome; MI, Myocardial Infarction; Mortality; Myocardial Infarction; NSTEMI, non ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction.