COVID-19 and its impact on acute coronary syndrome in-hospital epidemiology: a multifactorial analysis from a single-center Hospital in the north-east region of Italy

Submitted: 31 October 2020
Accepted: 30 December 2020
Published: 25 January 2021
Abstract Views: 911
PDF: 516
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


We analyze all possible, multifactorial correlations between coronavirus 2019 (COVID-19) pandemic and epidemiological in-hospital epidemiologic variations in ischemic heart disease burden. We developed a simple retrospective study surveying all acute coronary syndrome cases reporting an epidemiological analysis of a single-center University Italian Hospital located in the north-east area of Italy in the city of Gorizia, comparingdata collected in two months (February and March) about the definite diagnosis of myocardial infarction in the years 2019 and 2020 (COVID-19 peak exposure interval) respectively. We retrospectively analyzed data regarding the two months of February and March 2020 about admissions to our Intensive Cardiac Care Unit (ICCU) with a confirmed diagnosis of acute coronary syndrome. Differences among the two study periods were assessed using the χ2 test. Statistical significances were set at P<0.05. All analyses were conducted using IBM SPSS software version 24.0 (IBM Corp. Armonk, NY, USA). We showed a remarkable decrease of acute coronary syndrome cases diagnosed and admitted to our Intensive Cardiac Care Unit when comparing the interval period between February and March 2019 to the same months of 2020. This rate was significantly lower than either the rate during the earlier period in the same year [95% confidence interval (CI), 0.63 to 0.80; P<0.001]. We showed an overall decrease in diagnosis of acute coronary syndromes during the COVID-19 pandemic; we relate this amount decrease in diagnosis to general underuse of cardiologic public services leading to a reduced number of admissions for acute coronary syndrome cases and possibly undertreatment and death of out-of-hospital, silenced critical clinical cardiologic pictures due to a generalized fear of COVID-19 in-hospital contagion.



PlumX Metrics


Download data is not yet available.


Du Toit A. Outbreak of a novel coronavirus. Nat Rev Microbiol 2020;18:123. DOI:
DPCM 22 marzo 2020. Ulteriori disposizioni attuative del decreto-legge 23 febbraio 2020, n. 6, recante misure urgenti in materia di contenimento e gestione dell’emergenza epidemiologica da COVID-19, applicabili sull’intero territorio nazionale. Gazzetta Ufficiale Repubblica Italiana [Official Gazette of the Italian Republic] n. 76 del 22 marzo 2020. Available from: Accessed: 6 April 2020.
De Filippo O, D’Ascenzo F, Angelini F, et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in Northern Italy. N Engl J Med 2020;383:88-9. DOI:
Giordano A, Biondi-Zoccai G, Frati G, Bartorelli AL. Management of structural heart disease and acute coronary syndromes in the COVID-19 pandemic. Curr Atheroscler Rep 2020;22:29. DOI:
De Rosa S, Spaccarotella C, Basso C, et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 2020;41:2083-8. DOI:
Istat. Mortalità per territorio di evento. Available from: Accessed: 25 July 2020.
L’Angiocola PD, Monti M. COVID-19: the critical balance between appropriate governmental restrictions and expected economic, psychological and social consequences in Italy. Are we going in the right direction?. Acta Biomed 2020;91:35-8.
Kar SK, Arafat SMY, Sharma P, Dixit A, et al. COVID-19 pandemic and addiction: Current problems and future concerns. Asian J Psychiatr 2020;51:102064. DOI:
Zhang J, Lu H, Zeng H, et al. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain Behav Immun. 2020 Apr 15; pii: S0889-1591(20)30535-3 [Epub ahead of print].
AboutPharma. Emergenza Covid-19, impatto sulle percezioni dei consumatori tra psicosi ed engagement; March 16, 2020. Available from: Accessed: 6 April 2020.
Clerici M, Durbano F, Spinogatti F, et al. Psychiatric hospitalization rates in Italy before and during COVID-19: did they change? An analysis of register data. Ir J Psychol Med 2020 [Epub ahead of print]. DOI:
Lazzerini M, Barbi E, Apicella A, et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health 2020;4:e10-e11. DOI:
Toner L, Koshy AN, Hamilton GW, et al. Acute coronary syndromes undergoing percutaneous coronary intervention in the COVID-19 era: comparable case volumes but delayed symptom onset to hospital presentation. Eur Heart J Qual Care Clin Outcomes 2020; pii: qcaa038 [Epub ahead of print]. DOI:

How to Cite

L’Angiocola, P. D. ., & Monti, M. (2021). COVID-19 and its impact on acute coronary syndrome in-hospital epidemiology: a multifactorial analysis from a single-center Hospital in the north-east region of Italy. Italian Journal of Medicine, 15(2).