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
Objectives: we analyze all possible, multifactorial correlations between COVID-19 pandemic and epidemiological in-hospital epidemiologic variations in ischemic heart disease burden. Design: 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 northest area of Italy in the city of Gorizia, comparing data collected in a period of two months (February and March) about definite diagnosis of myocardial infarction in the years 2019 and 2020 (COVID- 19 peak exposure interval) respectively. Methods: We retrospectively analyzed data regarding the two months of February and March 2020 about admissions to our Intensive Cardiac Care Unit (ICCU) with 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). Results: 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). Conclusions: we showed an overall decrease of diagnosis of acute coronary syndromes during CODIV-19 pandemic; we relate this amount decrease of diagnosis to general underuse of cardiologic public services leading to 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 generalized fear of COVID-19 in-hospital contagion.
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