Impact of coronavirus cisease 2019 pandemic on the incidence and management of out-of-hospital cardiac arrest in patients presenting with acute myocardial infarction in England
Impact of coronavirus cisease 2019 pandemic on the incidence and management of out-of-hospital cardiac arrest in patients presenting with acute myocardial infarction in England
Background: studies have reported significant reduction in acute myocardial infarction-related hospitalizations during the coronavirus disease 2019 (COVID-19) pandemic. However, whether these trends are associated with increased incidence of out-of-hospital cardiac arrest (OHCA) in this population is unknown.
Methods and results: acute myocardial infarction hospitalizations with OHCA during the COVID-19 period (February 1-May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre-COVID-19 period (February 1-May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID-19 period were reduced by >50% (n=20 310 versus n=9325). OHCA was more prevalent during the COVID-19 period compared with the pre-COVID-19 period (5.6% versus 3.6%), with a 56% increase in the incidence of OHCA (incidence rate ratio, 1.56; 95% CI, 1.39-1.74). Patients experiencing OHCA during COVID-19 period were likely to be older, likely to be women, likely to be of Asian ethnicity, and more likely to present with ST-segment-elevation myocardial infarction. The overall rates of invasive coronary angiography (58.4% versus 71.6%; P<0.001) were significantly lower among the OHCA group during COVID-19 period with increased time to reperfusion (mean, 2.1 versus 1.1 hours; P=0.05) in those with ST-segment-elevation myocardial infarction. The adjusted in-hospital mortality probability increased from 27.7% in February 2020 to 35.8% in May 2020 in the COVID-19 group (P<.001).
Conclusions: in this national cohort of hospitalized patients with acute myocardial infarction, we observed a significant increase in incidence of OHCA during COVID-19 period paralleled with reduced access to guideline-recommended care and increased in-hospital mortality.
acute myocardial infarction, coronavirus disease 2019, incidence, mortality, out‐of‐hospital cardiac arrest
e018379
Rashid Hons, Muhammad
5c88c841-5961-4ece-bcd1-79e20c99a268
Gale Hons, Chris P.
a32f0dd7-94f7-484f-aba9-fa8a9a69313f
Curzen Hons, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Ludman Hons, Peter
08685513-938d-4f80-82bb-839cb3a25afd
De Belder Hons, Mark
cb6b6e01-a3b6-41de-8ba9-31b098b3653f
Timmis Hons, Adam
8d34df89-9cb7-4965-8a17-6f764b20f0cb
Mohamed Hons, Mohamed O.
bcf535d4-7e3c-4db1-9008-53b6cc7ca72d
Lüscher Hons, Thomas F.
9e165092-dc5e-45d7-b884-1e5cf65bea2a
Hains Hons, Julian
bdee3374-4d35-40ae-9612-c85a1b153c19
Wu, Jianhua
d1e83015-b7d2-4404-847e-c6f73e281759
Shoaib, Ahmad
87d9fdcb-a5ce-4379-8280-3115040dc364
Kontopantelis, Evangelos
80980bf2-f5d8-4cb4-a348-02250af00915
Roebuck, Chris
f978a109-73c6-4e7e-b0af-17932a532c20
Denwood, Tom
ebadd107-476e-4390-8829-3c96c917bfe1
Deanfield, John
3ffa04cf-a239-4dd7-8d77-dfc9cfe716fd
Mamas, Mamas A.
41515b72-75ff-4922-bb9f-8f9c63f9f5af
7 October 2020
Rashid Hons, Muhammad
5c88c841-5961-4ece-bcd1-79e20c99a268
Gale Hons, Chris P.
a32f0dd7-94f7-484f-aba9-fa8a9a69313f
Curzen Hons, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Ludman Hons, Peter
08685513-938d-4f80-82bb-839cb3a25afd
De Belder Hons, Mark
cb6b6e01-a3b6-41de-8ba9-31b098b3653f
Timmis Hons, Adam
8d34df89-9cb7-4965-8a17-6f764b20f0cb
Mohamed Hons, Mohamed O.
bcf535d4-7e3c-4db1-9008-53b6cc7ca72d
Lüscher Hons, Thomas F.
9e165092-dc5e-45d7-b884-1e5cf65bea2a
Hains Hons, Julian
bdee3374-4d35-40ae-9612-c85a1b153c19
Wu, Jianhua
d1e83015-b7d2-4404-847e-c6f73e281759
Shoaib, Ahmad
87d9fdcb-a5ce-4379-8280-3115040dc364
Kontopantelis, Evangelos
80980bf2-f5d8-4cb4-a348-02250af00915
Roebuck, Chris
f978a109-73c6-4e7e-b0af-17932a532c20
Denwood, Tom
ebadd107-476e-4390-8829-3c96c917bfe1
Deanfield, John
3ffa04cf-a239-4dd7-8d77-dfc9cfe716fd
Mamas, Mamas A.
41515b72-75ff-4922-bb9f-8f9c63f9f5af
Rashid Hons, Muhammad, Gale Hons, Chris P., Curzen Hons, Nick, Ludman Hons, Peter, De Belder Hons, Mark, Timmis Hons, Adam, Mohamed Hons, Mohamed O., Lüscher Hons, Thomas F., Hains Hons, Julian, Wu, Jianhua, Shoaib, Ahmad, Kontopantelis, Evangelos, Roebuck, Chris, Denwood, Tom, Deanfield, John and Mamas, Mamas A.
(2020)
Impact of coronavirus cisease 2019 pandemic on the incidence and management of out-of-hospital cardiac arrest in patients presenting with acute myocardial infarction in England.
Journal of the American Heart Association, 9 (22), .
(doi:10.1161/JAHA.120.018379).
Abstract
Background: studies have reported significant reduction in acute myocardial infarction-related hospitalizations during the coronavirus disease 2019 (COVID-19) pandemic. However, whether these trends are associated with increased incidence of out-of-hospital cardiac arrest (OHCA) in this population is unknown.
Methods and results: acute myocardial infarction hospitalizations with OHCA during the COVID-19 period (February 1-May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre-COVID-19 period (February 1-May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID-19 period were reduced by >50% (n=20 310 versus n=9325). OHCA was more prevalent during the COVID-19 period compared with the pre-COVID-19 period (5.6% versus 3.6%), with a 56% increase in the incidence of OHCA (incidence rate ratio, 1.56; 95% CI, 1.39-1.74). Patients experiencing OHCA during COVID-19 period were likely to be older, likely to be women, likely to be of Asian ethnicity, and more likely to present with ST-segment-elevation myocardial infarction. The overall rates of invasive coronary angiography (58.4% versus 71.6%; P<0.001) were significantly lower among the OHCA group during COVID-19 period with increased time to reperfusion (mean, 2.1 versus 1.1 hours; P=0.05) in those with ST-segment-elevation myocardial infarction. The adjusted in-hospital mortality probability increased from 27.7% in February 2020 to 35.8% in May 2020 in the COVID-19 group (P<.001).
Conclusions: in this national cohort of hospitalized patients with acute myocardial infarction, we observed a significant increase in incidence of OHCA during COVID-19 period paralleled with reduced access to guideline-recommended care and increased in-hospital mortality.
Text
Impact of Coronavirus Disease 2019
- Version of Record
More information
Accepted/In Press date: 21 September 2020
Published date: 7 October 2020
Keywords:
acute myocardial infarction, coronavirus disease 2019, incidence, mortality, out‐of‐hospital cardiac arrest
Identifiers
Local EPrints ID: 446348
URI: http://eprints.soton.ac.uk/id/eprint/446348
PURE UUID: 506455ce-b0f6-424c-9228-565cb4c717a7
Catalogue record
Date deposited: 05 Feb 2021 17:30
Last modified: 17 Mar 2024 03:02
Export record
Altmetrics
Contributors
Author:
Muhammad Rashid Hons
Author:
Chris P. Gale Hons
Author:
Peter Ludman Hons
Author:
Mark De Belder Hons
Author:
Adam Timmis Hons
Author:
Mohamed O. Mohamed Hons
Author:
Thomas F. Lüscher Hons
Author:
Julian Hains Hons
Author:
Jianhua Wu
Author:
Ahmad Shoaib
Author:
Evangelos Kontopantelis
Author:
Chris Roebuck
Author:
Tom Denwood
Author:
John Deanfield
Author:
Mamas A. Mamas
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
