Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era
Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era
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DOI：
10.1093/eurheartj/ehaa409
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发表时间：
2020-06-07
影响因子：
39.3
通讯作者：
Indolfi, Ciro
中科院分区：
文献类型：
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作者：
De Rosa, Salvatore;Spaccarotella, Carmen;Indolfi, Ciro
目的：评估 COVID-19 大流行对意大利心脏监护病房 (CCU) 患者入院的影响。方法和结果：我们进行了一项多中心、观察性、全国范围的调查，收集 COVID-19 爆发期间 1 周内意大利 CCU 因急性心肌梗死 (AMI) 入院的数据，与 2019 年同期相比。我们观察到，与 2019 年同期相比，AMI 入院人数减少了 48.4% 2019 年（P < 0.001）。对于 ST 段抬高型心肌梗死 [STEMI； 26.5%，95%置信区间（CI）21.7-32.3； P = 0.009] 和非 STEMI（NSTEMI；65.1%，95% CI 60.3-70.3；P < 0.001）。在 STEMI 中，女性（41.2%；P = 0.011）的减少幅度高于男性（17.8%；P = 0.191）。意大利北部 (52.1%)、意大利中部 (59.3%) 和意大利南部 (52.1%) 的 AMI 入院人数也出现了类似的下降。与2019年相比，大流行期间STEMI病例死亡率大幅上升[风险比（RR）= 3.3，95% CI 1.7-6.6； P<0.001]。并发症的发生率也相应增加（RR = 1.8，95% CI 1.1-2.8；P = 0.009）。 结论：在意大利全国范围内的 COVID-19 大流行期间，因 AMI 入院的人数显着减少，死亡率和并发症发生率也相应增加。这是一个严重的社会问题，需要科学界、医疗界和公共监管机构的关注。
Aims: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs).Methods and Results: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009).Conclusion: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.