TY - JOUR
T1 - Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on Acute Admissions at the Emergency and Cardiology Departments Across Europe
AU - Sokolski, Mateusz
AU - Gajewski, Piotr
AU - Zymliński, Robert
AU - Biegus, Jan
AU - Berg, Jurrien M.Ten
AU - Bor, Wilbert
AU - Braunschweig, Frieder
AU - Caldeira, Daniel
AU - Cuculi, Florim
AU - D'Elia, Emilia
AU - Edes, Istvan Ferenc
AU - Garus, Mateusz
AU - Greenwood, John P.
AU - Halfwerk, Frank R.
AU - Hindricks, Gerhard
AU - Knuuti, Juhani
AU - Kristensen, Steen Dalby
AU - Landmesser, Ulf
AU - Lund, Lars H.
AU - Lyon, Alexander
AU - Mebazaa, Alexandre
AU - Merkely, Béla
AU - Nawrocka-Millward, Sylwia
AU - Pinto, Fausto J.
AU - Ruschitzka, Frank
AU - Semedo, Edimir
AU - Senni, Michele
AU - Sepehri Shamloo, Alireza
AU - Sorensen, Jacob
AU - Stengaard, Carsten
AU - Thiele, Holger
AU - Toggweiler, Stefan
AU - Tukiendorf, Andrzej
AU - Verhorst, Patrick M.
AU - Wright, David Jay
AU - Zamorano, Pepe
AU - Zuber, Michel
AU - Narula, Jagat
AU - Bax, Jeroen J.
AU - Ponikowski, Piotr
N1 - Publisher Copyright:
© 2020
PY - 2021/4
Y1 - 2021/4
N2 - Purpose: We evaluated whether the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic was associated with changes in the pattern of acute cardiovascular admissions across European centers. Methods: We set-up a multicenter, multinational, pan-European observational registry in 15 centers 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 54,331 patients were collected and analyzed. Nine centers provided data on acute admissions to emergency departments comprising 50,384 patients: 20,226 in 2020 compared with 30,158 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 compared to 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 and 4452 in 2019; IRR (95% CI): 0.68 (0.64-0.71). In 2020, there were fewer 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); and other: 0.68(0.62-0.76). We found a relatively higher percentage of pulmonary embolism admissions in 2020: odds ratio (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 centers 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.
AB - Purpose: We evaluated whether the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic was associated with changes in the pattern of acute cardiovascular admissions across European centers. Methods: We set-up a multicenter, multinational, pan-European observational registry in 15 centers 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 54,331 patients were collected and analyzed. Nine centers provided data on acute admissions to emergency departments comprising 50,384 patients: 20,226 in 2020 compared with 30,158 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 compared to 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 and 4452 in 2019; IRR (95% CI): 0.68 (0.64-0.71). In 2020, there were fewer 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); and other: 0.68(0.62-0.76). We found a relatively higher percentage of pulmonary embolism admissions in 2020: odds ratio (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 centers 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.
KW - Acute cardiovascular admissions
KW - Acute coronary syndrome
KW - COVID-19
KW - Outbreak
KW - SARS-CoV2
UR - https://www.scopus.com/pages/publications/85096867898
U2 - 10.1016/j.amjmed.2020.08.043
DO - 10.1016/j.amjmed.2020.08.043
M3 - Article
C2 - 33010226
AN - SCOPUS:85096867898
SN - 0002-9343
VL - 134
SP - 482
EP - 489
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 4
ER -