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

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.