tetano
Editor, Senior Moderator
Am J Med
. 2020 Sep 30;S0002-9343(20)30825-1.
doi: 10.1016/j.amjmed.2020.08.043. Online ahead of print.
Impact of coronavirus disease 2019 (COVID-19) outbreak on acute admissions at the emergency and cardiology departments across Europe
Mateusz Sokolski[SUP] 1 [/SUP], Piotr Gajewski[SUP] 1 [/SUP], Robert Zymlinski[SUP] 1 [/SUP], Jan Biegus[SUP] 1 [/SUP], Jurrien M Ten Berg[SUP] 2 [/SUP], Wilbert Bor[SUP] 2 [/SUP], Frieder Braunschweig[SUP] 3 [/SUP], Daniel Caldeira[SUP] 4 [/SUP], Florim Cuculi[SUP] 5 [/SUP], Emilia D'Elia[SUP] 6 [/SUP], Istvan Ferenc Edes[SUP] 7 [/SUP], Mateusz Garus[SUP] 8 [/SUP], John P Greenwood[SUP] 9 [/SUP], Frank R Halfwerk[SUP] 10 [/SUP], Gerhard Hindricks[SUP] 11 [/SUP], Juhani Knuuti[SUP] 12 [/SUP], Steen Dalby Kristensen[SUP] 13 [/SUP], Ulf Landmesser[SUP] 14 [/SUP], Lars H Lund[SUP] 3 [/SUP], Alexander Lyon[SUP] 15 [/SUP], Alexandre Mebazaa[SUP] 16 [/SUP], B?la Merkely[SUP] 7 [/SUP], Sylwia Nawrocka-Millward[SUP] 8 [/SUP], Fausto J Pinto[SUP] 4 [/SUP], Frank Ruschitzka[SUP] 17 [/SUP], Edimir Semedo[SUP] 10 [/SUP], Michele Senni[SUP] 6 [/SUP], Alireza Sepehri Shamloo[SUP] 11 [/SUP], Jacob Sorensen[SUP] 13 [/SUP], Carsten Stengaard[SUP] 13 [/SUP], Holger Thiele[SUP] 11 [/SUP], Stefan Toggweiler[SUP] 5 [/SUP], Andrzej Tukiendorf[SUP] 18 [/SUP], Patrick M Verhorst[SUP] 10 [/SUP], David Jay Wright[SUP] 19 [/SUP], Pepe Zamorano[SUP] 20 [/SUP], Michel Zuber[SUP] 5 [/SUP], Jagat Narula[SUP] 21 [/SUP], Jeroen J Bax[SUP] 22 [/SUP], Piotr Ponikowski[SUP] 23 [/SUP]
Affiliations
Abstract
Purpose: We evaluated whether the severe acute respiratory syndrome coronavirus 2 pandemic was associated with changes in the pattern of acute cardiovascular admissions across European centres.
Methods: We set-up a multi-centre, multi-national, pan-European observational registry in 15 centres from 12 countries. All consecutive acute admissions to emergency departments and cardiology departments throughout a 1-month period during the COVID-19 outbreak were compared with an equivalent 1-month period in 2019. The acute admissions to cardiology departments were classified into 5 major categories: acute coronary syndrome, acute heart failure, arrhythmia, pulmonary embolism and other.
Results: Data from 54331 patients were collected and analysed. Nine centres provided data on acute admissions to emergency departments comprising 50384 patients: 20226 in 2020 vs 30158 in 2019 - incidence rate ratio (IRR) with 95% confidence interval (95%CI): 0.66(0.58-0.76). The risk of death at the emergency departments was higher in 2020 vs 2019: odds ratio (OR) with 95%CI: 4.1(3.0-5.8), P<0.0001. All 15 centers provided data on acute cardiology departments admissions: 3007 patients in 2020 vs 4452 in 2019, respectively, IRR(95%CI): 0.68(0.64-0.71). In 2020, there were less admissions with IRR(95%CI): acute coronary syndrome: 0.68(0.63-0.73), acute heart failure: 0.65(0.58-0.74), arrhythmia: 0.66(0.60-0.72), other: 0.68(0.62-0.76); we found a relatively higher percentage of pulmonary embolism admissions in 2020: OR(95%CI): 1.5(1.1-2.1), P=0.02. Among patients with acute coronary syndrome there were fewer admissions with unstable angina: 0.79(0.66-0.94), non-ST segment elevation myocardial infarction: 0.56(0.50-0.64) and ST-segment elevation myocardial infarction: 0.78(0.68-0.89).
Conclusion: In the European centres during the COVID-19 outbreak, there were fewer acute cardiovascular admissions. Also, fewer patients were admitted to the emergency departments with 4-times higher death risk at the emergency departments.
Keywords: COVID-19; SARS-CoV2; acute cardiovascular admissions; acute coronary syndrome; outbreak.
. 2020 Sep 30;S0002-9343(20)30825-1.
doi: 10.1016/j.amjmed.2020.08.043. Online ahead of print.
Impact of coronavirus disease 2019 (COVID-19) outbreak on acute admissions at the emergency and cardiology departments across Europe
Mateusz Sokolski[SUP] 1 [/SUP], Piotr Gajewski[SUP] 1 [/SUP], Robert Zymlinski[SUP] 1 [/SUP], Jan Biegus[SUP] 1 [/SUP], Jurrien M Ten Berg[SUP] 2 [/SUP], Wilbert Bor[SUP] 2 [/SUP], Frieder Braunschweig[SUP] 3 [/SUP], Daniel Caldeira[SUP] 4 [/SUP], Florim Cuculi[SUP] 5 [/SUP], Emilia D'Elia[SUP] 6 [/SUP], Istvan Ferenc Edes[SUP] 7 [/SUP], Mateusz Garus[SUP] 8 [/SUP], John P Greenwood[SUP] 9 [/SUP], Frank R Halfwerk[SUP] 10 [/SUP], Gerhard Hindricks[SUP] 11 [/SUP], Juhani Knuuti[SUP] 12 [/SUP], Steen Dalby Kristensen[SUP] 13 [/SUP], Ulf Landmesser[SUP] 14 [/SUP], Lars H Lund[SUP] 3 [/SUP], Alexander Lyon[SUP] 15 [/SUP], Alexandre Mebazaa[SUP] 16 [/SUP], B?la Merkely[SUP] 7 [/SUP], Sylwia Nawrocka-Millward[SUP] 8 [/SUP], Fausto J Pinto[SUP] 4 [/SUP], Frank Ruschitzka[SUP] 17 [/SUP], Edimir Semedo[SUP] 10 [/SUP], Michele Senni[SUP] 6 [/SUP], Alireza Sepehri Shamloo[SUP] 11 [/SUP], Jacob Sorensen[SUP] 13 [/SUP], Carsten Stengaard[SUP] 13 [/SUP], Holger Thiele[SUP] 11 [/SUP], Stefan Toggweiler[SUP] 5 [/SUP], Andrzej Tukiendorf[SUP] 18 [/SUP], Patrick M Verhorst[SUP] 10 [/SUP], David Jay Wright[SUP] 19 [/SUP], Pepe Zamorano[SUP] 20 [/SUP], Michel Zuber[SUP] 5 [/SUP], Jagat Narula[SUP] 21 [/SUP], Jeroen J Bax[SUP] 22 [/SUP], Piotr Ponikowski[SUP] 23 [/SUP]
Affiliations
- PMID: 33010226
- DOI: 10.1016/j.amjmed.2020.08.043
Abstract
Purpose: We evaluated whether the severe acute respiratory syndrome coronavirus 2 pandemic was associated with changes in the pattern of acute cardiovascular admissions across European centres.
Methods: We set-up a multi-centre, multi-national, pan-European observational registry in 15 centres from 12 countries. All consecutive acute admissions to emergency departments and cardiology departments throughout a 1-month period during the COVID-19 outbreak were compared with an equivalent 1-month period in 2019. The acute admissions to cardiology departments were classified into 5 major categories: acute coronary syndrome, acute heart failure, arrhythmia, pulmonary embolism and other.
Results: Data from 54331 patients were collected and analysed. Nine centres provided data on acute admissions to emergency departments comprising 50384 patients: 20226 in 2020 vs 30158 in 2019 - incidence rate ratio (IRR) with 95% confidence interval (95%CI): 0.66(0.58-0.76). The risk of death at the emergency departments was higher in 2020 vs 2019: odds ratio (OR) with 95%CI: 4.1(3.0-5.8), P<0.0001. All 15 centers provided data on acute cardiology departments admissions: 3007 patients in 2020 vs 4452 in 2019, respectively, IRR(95%CI): 0.68(0.64-0.71). In 2020, there were less admissions with IRR(95%CI): acute coronary syndrome: 0.68(0.63-0.73), acute heart failure: 0.65(0.58-0.74), arrhythmia: 0.66(0.60-0.72), other: 0.68(0.62-0.76); we found a relatively higher percentage of pulmonary embolism admissions in 2020: OR(95%CI): 1.5(1.1-2.1), P=0.02. Among patients with acute coronary syndrome there were fewer admissions with unstable angina: 0.79(0.66-0.94), non-ST segment elevation myocardial infarction: 0.56(0.50-0.64) and ST-segment elevation myocardial infarction: 0.78(0.68-0.89).
Conclusion: In the European centres during the COVID-19 outbreak, there were fewer acute cardiovascular admissions. Also, fewer patients were admitted to the emergency departments with 4-times higher death risk at the emergency departments.
Keywords: COVID-19; SARS-CoV2; acute cardiovascular admissions; acute coronary syndrome; outbreak.