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Hospitalization Rates for AMI Dropped During Early COVID-19

MONDAY, Aug. 10, 2020 -- During the early COVID-19 period, there was a decrease in hospitalization rates for acute myocardial infarction (AMI), according to a brief report published online Aug. 7 in JAMA Cardiology.

Ty J. Gluckman, M.D., from Providence St Joseph Health in Portland, Oregon, and colleagues conducted a cross-sectional study analyzing AMI hospitalizations that occurred between Dec. 30, 2018, and May 16, 2020, in hospitals located in six states. Patients with a principal discharge diagnosis of AMI (ST-segment elevation myocardial infarction [STEMI] or non-STEMI) were included. Cases were categorized into three periods: before COVID-19 (Dec. 30, 2018, to Feb. 22, 2020), early COVID-19 (Feb. 23, 2020, to March 28, 2020), and later COVID-19 (March 29, 2020, to May 16, 2020).

Data were included for 15,244 AMI hospitalizations involving 14,724 patients. The researchers found that AMI-associated hospitalizations decreased at a rate of −19.0 cases per week for five weeks beginning Feb. 23, 2020. Thereafter, in the later COVID-19 period, there was an increase in AMI-associated hospitalization at a rate of +10.5 cases per week. Across periods, there were no appreciable differences in patient demographics, cardiovascular comorbidities, and treatment approaches. During the early period, the observed/expected mortality ratio for AMI increased (1.27) and was disproportionately associated with patients with STEMI.

"Results of this cross-sectional study appear to validate previous concerns that large numbers of patients with AMI initially avoided hospitalization during the COVID-19 pandemic," the authors write.

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Posted: August 2020

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