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

• Published in: The Lancet regional health. Europe Vol. 2; p. 100030
• Main Authors: Van Belle, Eric, Manigold, Thibault, Piérache, Adeline, Furber, Alain, Debry, Nicolas, Luycx-Bore, Anne, Bauchart, Jean-Jacques, Nugue, Olivier, Huchet, François, Bic, Mathieu, Vinchon, François, Sayah, Smaïn, Fournier, Alexandre, Decoulx, Eric, Mouhammad, Usman, Clerc, Jérôme, Manchuelle, Aurélie, Lazizi, Tahar, Chmait, Akram, Jeannetteau, Julien, Hénon, Pierre, Bonin, Mickael, Dupret-Minet, Marie, Tirouvanziam, Ashok, Molcard, David, Arabucki, Fabien, Py, Antoine, Prunier, Fabrice, Delhaye, Cédric, Lemesle, Gilles, Schurtz, Guillaume, Cosenza, Alessandro, Spillemaeker, Hugues, Verdier, Basile, Denimal, Tom, Pamart, Thibault, Sylla, Habib, Janah, Dany, Aouate, David, Porouchani, Sina, Guillez, Valérie, Bonnet, Guillaume, Ternacle, Julien, Labreuche, Julien, Cayla, Guillaume, Vincent, Flavien
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2021; Elsevier
• Subjects: Cardiology and cardiovascular system; Clinical outcome; COVID-19 outbreak; Emerging diseases; Human health and pathology; Infectious diseases; Life Sciences; Mortality; Myocardial Infarction; Research Paper; Santé publique et épidémiologie; COVID-19; NSTEMI; Clinical outcome; Myocardial Infarction; Mortality; STEMI; COVID-19 outbreak; MI; MI, Myocardial Infarction; STEMI, ST-segment elevation myocardial infarction; COVID-19, Coronavirus disease 2019; NSTEMI, non ST-segment elevation myocardial infarction
• ISSN: 2666-7762; 2666-7762
• DOI: 10.1016/j.lanepe.2021.100030

A reduction of admission for MI has been reported in most countries affected by COVID-19. No clear explanation has been provided. 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. 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). 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. The study was conducted without external funding.