tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Thibault Manigold[SUP] 2 [/SUP], Adeline Piérache[SUP] 3 [/SUP], Alain Furber[SUP] 4 [/SUP], Nicolas Debry[SUP] 5 [/SUP], Anne Luycx-Bore[SUP] 6 [/SUP], Jean-Jacques Bauchart[SUP] 7 [/SUP], Olivier Nugue[SUP] 8 [/SUP], François Huchet[SUP] 9 [/SUP], Mathieu Bic[SUP] 10 [/SUP], François Vinchon[SUP] 11 [/SUP], Smaïn Sayah[SUP] 12 [/SUP], Alexandre Fournier[SUP] 13 [/SUP], Eric Decoulx[SUP] 14 [/SUP], Usman Mouhammad[SUP] 15 [/SUP], Jérôme Clerc[SUP] 16 [/SUP], Aurélie Manchuelle[SUP] 17 [/SUP], Tahar Lazizi[SUP] 18 [/SUP], Akram Chmait[SUP] 19 [/SUP], Julien Jeannetteau[SUP] 20 [/SUP], Pierre Hénon[SUP] 21 [/SUP], Mickael Bonin[SUP] 2 [/SUP], Marie Dupret-Minet[SUP] 22 [/SUP], Ashok Tirouvanziam[SUP] 23 [/SUP], David Molcard[SUP] 24 [/SUP], Fabien Arabucki[SUP] 25 [/SUP], Antoine Py[SUP] 26 [/SUP], Fabrice Prunier[SUP] 4 [/SUP], Cédric Delhaye[SUP] 1 [/SUP], Gilles Lemesle[SUP] 1 [/SUP], Guillaume Schurtz[SUP] 1 [/SUP], Alessandro Cosenza[SUP] 1 [/SUP], Hugues Spillemaeker[SUP] 1 [/SUP], Basile Verdier[SUP] 1 [/SUP], Tom Denimal[SUP] 1 [/SUP], Thibault Pamart[SUP] 1 [/SUP], Habib Sylla[SUP] 1 [/SUP], Dany Janah[SUP] 1 [/SUP], David Aouate[SUP] 1 [/SUP], Sina Porouchani[SUP] 1 [/SUP], Valérie Guillez[SUP] 1 [/SUP], Guillaume Bonnet[SUP] 27 [/SUP], Julien Ternacle[SUP] 27 [/SUP], Julien Labreuche[SUP] 3 [/SUP], Guillaume Cayla[SUP] 28 [/SUP], Flavien Vincent[SUP] 1 [/SUP]
Affiliations
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.
. 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[SUP] 1 [/SUP], Thibault Manigold[SUP] 2 [/SUP], Adeline Piérache[SUP] 3 [/SUP], Alain Furber[SUP] 4 [/SUP], Nicolas Debry[SUP] 5 [/SUP], Anne Luycx-Bore[SUP] 6 [/SUP], Jean-Jacques Bauchart[SUP] 7 [/SUP], Olivier Nugue[SUP] 8 [/SUP], François Huchet[SUP] 9 [/SUP], Mathieu Bic[SUP] 10 [/SUP], François Vinchon[SUP] 11 [/SUP], Smaïn Sayah[SUP] 12 [/SUP], Alexandre Fournier[SUP] 13 [/SUP], Eric Decoulx[SUP] 14 [/SUP], Usman Mouhammad[SUP] 15 [/SUP], Jérôme Clerc[SUP] 16 [/SUP], Aurélie Manchuelle[SUP] 17 [/SUP], Tahar Lazizi[SUP] 18 [/SUP], Akram Chmait[SUP] 19 [/SUP], Julien Jeannetteau[SUP] 20 [/SUP], Pierre Hénon[SUP] 21 [/SUP], Mickael Bonin[SUP] 2 [/SUP], Marie Dupret-Minet[SUP] 22 [/SUP], Ashok Tirouvanziam[SUP] 23 [/SUP], David Molcard[SUP] 24 [/SUP], Fabien Arabucki[SUP] 25 [/SUP], Antoine Py[SUP] 26 [/SUP], Fabrice Prunier[SUP] 4 [/SUP], Cédric Delhaye[SUP] 1 [/SUP], Gilles Lemesle[SUP] 1 [/SUP], Guillaume Schurtz[SUP] 1 [/SUP], Alessandro Cosenza[SUP] 1 [/SUP], Hugues Spillemaeker[SUP] 1 [/SUP], Basile Verdier[SUP] 1 [/SUP], Tom Denimal[SUP] 1 [/SUP], Thibault Pamart[SUP] 1 [/SUP], Habib Sylla[SUP] 1 [/SUP], Dany Janah[SUP] 1 [/SUP], David Aouate[SUP] 1 [/SUP], Sina Porouchani[SUP] 1 [/SUP], Valérie Guillez[SUP] 1 [/SUP], Guillaume Bonnet[SUP] 27 [/SUP], Julien Ternacle[SUP] 27 [/SUP], Julien Labreuche[SUP] 3 [/SUP], Guillaume Cayla[SUP] 28 [/SUP], Flavien Vincent[SUP] 1 [/SUP]
Affiliations
- PMID: 34173627
- PMCID: PMC7938895
- DOI: 10.1016/j.lanepe.2021.100030
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.