Key result
Following the Covid-19 outbreak and national lockdown in Norway, emergency department visits for chest pain decreased by 16% compared to 2019, with patients presenting being younger and less severely ill.
Why the study?
Following the Covid-19 outbreak, reports emerged on decreasing ED visits, including patients experiencing chest pain; the study aimed to describe the impact of the pandemic and lockdown on the chest pain population in a Norwegian ED.
Does the Covid-19 pandemic and national lockdown reduce the number and alter the characteristics of emergency department visits for chest pain?
Observational (n=3,368)
No
Does the Covid-19 pandemic and national lockdown reduce the number and alter the characteristics of emergency department visits for chest pain?
Effect estimate: 16% reduction
Absolute Event Rate: 753% vs 893%
The Covid-19 lockdown in Norway led to a significant decrease in emergency department visits for chest pain, particularly among older and higher-acuity patients, though the proportion of true acute coronary syndrome admissions remained stable.
Chest pain ED visits fell during lockdown among younger, lower-acuity patients; observational data leaves open effects on true ACS incidence or delayed care.
BACKGROUND: Following the spread of the Covid-19 pandemic in 2020, reports emerged on decreasing emergency department (ED) visits in many countries. Patients experiencing chest pain was no exception. The aim of the current study was to describe how the Covid-19 pandemic and the subsequential lockdown impacted the chest pain population in a Norwegian ED. METHODS: , 2020, and compared to the corresponding period in 2019, assessing variations in the number of ED visits, severity, gender, and age. RESULTS: Fewer patients with chest pain were seen in the ED following the national lockdown in Norway, compared to the corresponding 2019 period (week 13: 38% fewer; weeks 11-27: 16% fewer). By week 28, the rate normalized compared to 2019 levels. There was a relative increase in lower acuity patients among these patients, while fewer moderate acuity patients were seen. During the initial period following lockdown, the median age was lower compared to the corresponding 2019 period (58 years (IQR 25) vs 62 years (IQR 24), respectively). Admissions due to acute coronary syndromes (ACS) remained proportionally stable. CONCLUSIONS: Succeeding the Covid-19 outbreak and the subsequent national lockdown in Norway, fewer chest pain patients presented to the ED. Paradoxically, the patients seemed to be less severely ill and were on average younger compared to 2019 data. However, the proportion of patients admitted with ACS was stable during this period. This could imply that some patients may have failed to seek medical advice despite experiencing a myocardial infarction.
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Grande et al. (2022) conducted an observational in Chest pain (n=3,368). Covid-19 pandemic and national lockdown vs. Corresponding period in 2019 was evaluated on Number of ED visits due to chest pain (weeks 11-27) (16% reduction). Following the Covid-19 outbreak and national lockdown in Norway, emergency department visits for chest pain decreased by 16% compared to 2019, with patients presenting being younger and less severely ill.
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