Myocardial Infarction incidence during national lockdown in two French provinces unevenly affected by COVID-19 outbreak: An observational study

• Main Authors: Eric Van Belle (Author), Thibault Manigold (Author), Adeline Piérache (Author), Alain Furber (Author), Nicolas Debry (Author), Anne Luycx-Bore (Author), Jean-Jacques Bauchart (Author), Olivier Nugue (Author), François Huchet (Author), Mathieu Bic (Author), François Vinchon (Author), Smaïn Sayah (Author), Alexandre Fournier (Author), Eric Decoulx (Author), Usman Mouhammad (Author), Jérôme Clerc (Author), Aurélie Manchuelle (Author), Tahar Lazizi (Author), Akram Chmait (Author), Julien Jeannetteau (Author), Pierre Hénon (Author), Mickael Bonin (Author), Marie Dupret-Minet (Author), Ashok Tirouvanziam (Author), David Molcard (Author), Fabien Arabucki (Author), Antoine Py (Author), Fabrice Prunier (Author), Cédric Delhaye (Author), Gilles Lemesle (Author), Guillaume Schurtz (Author), Alessandro Cosenza (Author), Hugues Spillemaeker (Author), Basile Verdier (Author), Tom Denimal (Author), Thibault Pamart (Author), Habib Sylla (Author), Dany Janah (Author), David Aouate (Author), Sina Porouchani (Author), Valérie Guillez (Author), Guillaume Bonnet (Author), Julien Ternacle (Author), Julien Labreuche (Author), Guillaume Cayla (Author), Flavien Vincent (Author)
• Format: Book
• Published: Elsevier, 2021-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background: A reduction of admission for MI has been reported in most countries affected by COVID-19. No clear explanation has been provided. Methods: To report the incidence of myocardial infarction (MI) admission during COVID-19 pandemic and in particular during national lockdown in two unequally affected French provinces (10-million inhabitants) with a different media strategy, and to describe the magnitude of MI incidence changes relative to the incidence of COVID-19-related deaths. A longitudinal study to collect all MIs from January 1 until May 17, 2020 (study period) and from the identical time period in 2019 (control period) was conducted in all centers with PCI-facilities in northern "Hauts-de-France" province and western "Pays-de-la-Loire" Province. The incidence of COVID-19 fatalities was also collected. Findings: In "Hauts-de-France", during lockdown (March 18-May 10), 1500 COVID-19-related deaths were observed. A 23% decrease in MI-IR (IRR=0.77;95%CI:0.71-0.84, p<0.001) was observed for a loss of 272 MIs (95%CI:−363,−181), representing 18% of COVID-19-related deaths. In "Pays-de-la-Loire", 382 COVID-19-related deaths were observed. A 19% decrease in MI-IR (IRR=0.81; 95%CI=0.73-0.90, p<0.001) was observed for a loss of 138 MIs (95%CI:−210,−66), representing 36% of COVID-19-related deaths. While in "Hauts-de-France" the MI decline started before lockdown and recovered 3 weeks before its end, in "Pays-de-la-Loire", it started after lockdown and recovered only by its end. In-hospital mortality of MI patients was increased during lockdown in both provinces (5.0% vs 3.4%, p=0.02). Interpretation: It highlights one of the potential collateral damages of COVID-19 outbreak on cardiovascular health with a dramatic reduction of MI incidence. It advocates for a careful and weighted communication strategy in pandemic crises. Funding: The study was conducted without external funding.

Item Description

2666-7762
10.1016/j.lanepe.2021.100030