Characteristics and hospital course of patients admitted for acute cardiovascular diseases during the coronavirus disease-19 outbreak

• Published in: Journal of cardiovascular medicine (Hagerstown, Md.) Vol. 22; no. 1; p. 29
• Main Authors: Zorzi, Alessandro, Vio, Riccardo, Rivezzi, Francesco, Falzone, Pasquale V, Giordani, Andrea S, Condello, Chiara, Dellino, Carlo M, Deola, Petra, Gallucci, Marco, Giannattasio, Alessia, Licchelli, Luca, Lupasco, Diana, Montonati, Carolina, Ravagnin, Alberto, Sinigiani, Giulio, Torreggiani, Gianpaolo, Vianello, Riccardo, Migliore, Federico, Famoso, Giulia, Babuin, Luciano, Cacciavillani, Luisa, Iliceto, Sabino
• Format: Journal Article
• Language: English
• Published: United States 01.01.2021
• Subjects: Acute Disease; Aged; Aged, 80 and over; Arrhythmias, Cardiac - epidemiology; COVID-19 - epidemiology; Female; Heart Failure - epidemiology; Hospitalization - statistics & numerical data; Hospitals, Teaching; Humans; Italy - epidemiology; Male; Middle Aged; Pandemics; ST Elevation Myocardial Infarction - epidemiology; Italy
• ISSN: 1558-2035
• DOI: 10.2459/JCM.0000000000001129

During the coronavirus disease-19 (COVID-19) outbreak in spring 2020, people may have been reluctant to seek medical care fearing infection. We aimed to assess the number, characteristics and in-hospital course of patients admitted for acute cardiovascular diseases during the COVID-19 outbreak. We enrolled all consecutive patients admitted urgently for acute myocardial infarction, heart failure or arrhythmias from 1 March to 31 May 2020 (outbreak period) and 2019 (control period). We evaluated the time from symptoms onset to presentation, clinical conditions at admission, length of hospitalization, in-hospital medical procedures and outcome. The combined primary end point included in-hospital death for cardiovascular causes, urgent heart transplant or discharge with a ventricular assist device. A similar number of admissions were observed in 2020 (N = 210) compared with 2019 (N = 207). Baseline characteristics of patients were also similar. In 2020, a significantly higher number of patients presented more than 6 h after symptoms onset (57 versus 38%, P < 0.001) and with signs of heart failure (33 versus 20%, P = 0.018), required urgent surgery (13 versus 5%, P = 0.004) and ventilatory support (26 versus 13%, P < 0.001). Hospitalization duration was longer in 2020 (median 10 versus 8 days, P = 0.03). The primary end point was met by 19 (9.0%) patients in 2020 versus 10 (4.8%) in 2019 (P = 0.09). Despite the similar number and types of unplanned admissions for acute cardiac conditions during the 2020 COVID-19 outbreak compared with the same period in 2019, we observed a higher number of patients presenting late after symptoms onset as well as longer and more complicated clinical courses.