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The first wave of the COVID-19 pandemic was associated with a decline in admissions for cardiovascular disease. Many cardiologists remain concerned that the decline was related to care-seeking behavior rather than a change in incidence. These investigators used national U.K. databases to determine whether the second lockdown in the U.K. was accompanied by a similar decline in admissions.
In a sample of “rapid reporting” hospitals, the researchers identified 62,683 admissions for heart failure and acute myocardial infarction (AMI) between November 1, 2018, and November 17, 2020. During the first lockdown, which began in March 2020, daily hospitalizations for heart failure and AMI declined by 54%. The rates began to increase during April and almost returned to baseline by June. Beginning with the second lockdown in October 2020, admissions again declined, with decreases of 41% in hospitalizations for heart failure and 34% for AMI. For context, the admission rates for 2018 varied little from the 2019 rates.
Wu J et al. Second decline in admissions with heart failure and myocardial infarction during the COVID-19 pandemic. J Am Coll Cardiol 2021 Jan 12; [e-pub]. (https://doi.org/10.1016/j.jacc.2020.12.039)
Comment
The public health interventions to prevent the transmission of the virus are associated with marked declines in cardiovascular hospitalizations. This study shows the temporal association of the lockdown with admissions in the U.K. How this will affect downstream mortality rates is not known, but we must promote public health measures while ensuring that people feel safe to receive needed services. As the authors note, we need to continue our strong messaging that pandemic measures should not impede people from seeking acute care.