The Lancet Regional Health. Europe (Mar 2021)

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

  • Eric Van Belle,
  • Thibault Manigold,
  • Adeline Piérache,
  • Alain Furber,
  • Nicolas Debry,
  • Anne Luycx-Bore,
  • Jean-Jacques Bauchart,
  • Olivier Nugue,
  • François Huchet,
  • Mathieu Bic,
  • François Vinchon,
  • Smaïn Sayah,
  • Alexandre Fournier,
  • Eric Decoulx,
  • Usman Mouhammad,
  • Jérôme Clerc,
  • Aurélie Manchuelle,
  • Tahar Lazizi,
  • Akram Chmait,
  • Julien Jeannetteau,
  • Pierre Hénon,
  • Mickael Bonin,
  • Marie Dupret-Minet,
  • Ashok Tirouvanziam,
  • David Molcard,
  • Fabien Arabucki,
  • Antoine Py,
  • Fabrice Prunier,
  • Cédric Delhaye,
  • Gilles Lemesle,
  • Guillaume Schurtz,
  • Alessandro Cosenza,
  • Hugues Spillemaeker,
  • Basile Verdier,
  • Tom Denimal,
  • Thibault Pamart,
  • Habib Sylla,
  • Dany Janah,
  • David Aouate,
  • Sina Porouchani,
  • Valérie Guillez,
  • Guillaume Bonnet,
  • Julien Ternacle,
  • Julien Labreuche,
  • Guillaume Cayla,
  • Flavien Vincent

Journal volume & issue
Vol. 2
p. 100030

Abstract

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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.

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