Article

Hospitals See Fewer Heart Attacks During Covid-19

Over the last several months during the pandemic, emergency room physicians have seen a curious phenomenon – far fewer patients presenting with myocardial infarction (MI), stroke, and other emergency conditions.

Over the last several months during the pandemic, emergency room physicians have seen a curious phenomenon – far fewer patients presenting with myocardial infarction (MI) and other emergency conditions.

This drop – reported anecdotally over the last several weeks by frontline health care workers, has been noted in various news stories, pre-print journal articles, and reports from 911 operators in various states have also confirmed a precipitous drop in emergency calls. 

In a letter to the editor of the New England Journal of Medicine, physicians in the Kaiser Permanente system in the San Francisco Bay Area provide data comparing the number of hospitalizations for MI prior to the first reported case of COVID-19 to those hospitalizations during the COVID-19 period.

The authors wrote “data from 43,017,810 person-weeks from January 1 through April 14, 2020, were evaluated. The weekly rates of hospitalization for acute myocardial infarction decreased by up to 48% during the Covid-19 period. From January 1 through March 3, 2020, a total of 1051 hospitalization events occurred (incidence rate, 4.1 per 100,000 person-weeks), and from April 8 through April 14, 2020, a total of 61 hospitalization events occurred (incidence rate, 2.1 per 100,000 person-weeks) (incidence rate ratio, 0.52; 95% confidence interval [CI], 0.40 to 0.68; P<0.001).”

This shift is particularly interesting given that a significant number of COVID-19 patients present with cardiovascular symptoms, and that the coronavirus is known to disproportionately effect those patients with pre-existing cardiovascular disease, begging the obvious question: what do these statistics tell us about the disease?  And why is this happening? Are patients who might otherwise be admitted with MI being admitted as COVID-19 patients instead?  Or are patients simply reluctant to come to the hospital and delaying crucial treatment?  The latter has caused a number of organizations like the American College of Cardiology and the American Heart Association to sound the alarm and attempt to raise awareness among patients that it is still safe to call 911, and not to delay potentially lifesaving treatments. 

While the authors do not offer any explanation for their findings, they note that similar trends have been observed elsewhere including Italy, and Spain

Solomon MD, McNulty EJ, Rana JS, et al. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction [published online ahead of print, 2020 May 19]. N Engl J Med. 2020;10.1056/NEJMc2015630. doi:10.1056/NEJMc2015630

Related Videos
The APAC Recap: Peripheral Artery Disease at CAPP Live 2024 with Bob Ross, PA-C | Image Credit: APAC
AMG0001 Advances Healing in CLTI with David G. Armstrong, DPM, PhD, and Michael S. Conte, MD | Image Credit: Canva
Brigit Vogel, MD: Exploring Geographical Disparities in PAD Care Across US| Image Credit: LinkedIn
| Image Credit: X
Ahmad Masri, MD, MS | Credit: Oregon Health and Science University
Ahmad Masri, MD, MS | Credit: Oregon Health and Science University
Stephen Nicholls, MBBS, PhD | Credit: Monash University
Marianna Fontana, MD, PhD: Nex-Z Shows Promise in ATTR-CM Phase 1 Trial | Image Credit: Radcliffe Cardiology
Zerlasiran Achieves Durable Lp(a) Reductions at 60 Weeks, with Stephen J. Nicholls, MD, PhD | Image Credit: Monash University
Muthiah Vaduganathan, MD, MPH | Credit: Brigham and Women's Hospital
© 2024 MJH Life Sciences

All rights reserved.