#COVID19 pandemic & admission rates for & management of acute coronary syndromes in #England @TheLancet #heartattack #Covid19UK thelancet.com/journals/lance…
By the end of March, 2020, the average weekly number of acute coronary syndrome admissions fell by 40% compared with the average weekly number observed during 2019.
Measured against this baseline, from January, 2020, until the end of May, 2020, there had been around 8000 fewer admissions for acute coronary syndromes than would be expected.
... it seems likely that fear of contagion has been a major factor underlying the observed reduction in admissions for acute coronary syndrome in our study.
... environmental changes (eg, reduced air pollution), decreased physical activity, or diminished stress because of lockdown are unlikely to be major contributors to the noted trends in acute coronary syndrome admissions in the current pandemic.
There was a 23% reduction in STEMI admissions compared with the 42% reduction of NSTEMI admissions.
As STEMI is generally associated with severe and unremitting symptoms, patients could be less reluctant to seek help irrespective of any fears they might have about attending a hospital, whereas those with NSTEMI might be able to tolerate less severe symptoms & so remain at home.
The reduction in admissions for acute coronary syndrome during the #COVID19 pandemic is a concern, because patients with symptoms indicative of acute myocardial ischaemia benefit from rapid in-hospital assessment & treatment.
The failure of patients with #heartattack to be admitted to hospital so they can receive early reperfusion therapy & / or other appropriate treatments is likely to have resulted in avoidable deaths & complications, such as fatal arrhythmias & #heartfailure
Whilst SUSAPC data are timely they are incomplete, with some #NHS trusts having recorded admissions without a diagnostic code.
A further potential limitation of our analysis is that the coding of STEMI & NSTEMI was inferred from ICD-10 codes, which can be inaccurate.
In essence, the reduced number o #heartattack admissions during this period is likely to have resulted in increases in out-of-hospital deaths, long-term complications of myocardial infarctions & missed opportunities to provide secondary prevention medications.
If you think you may be having a #heartattack, then do go to hospital, using the emergency medical services.
