Key result
A nationwide COVID-19 lockdown in New Zealand was associated with fewer hospitalisations for acute coronary syndromes compared to previous years (rate ratio 0.72; 95% CI 0.61-0.83; p=0.003).
Why the study?
Countries with a high incidence of COVID-19 reported reduced ACS hospitalisations, but the impact of a nationwide lockdown in a low-incidence country was unknown.
Does a national COVID-19 lockdown reduce hospitalizations for acute coronary syndromes in a country with a low incidence of COVID-19?
Observational
Yes
Does a national COVID-19 lockdown reduce hospitalizations for acute coronary syndromes in a country with a low incidence of COVID-19?
A national COVID-19 lockdown in a low-incidence country was associated with a significant decrease in hospitalizations for NSTE-ACS, but not STEMI, highlighting the collateral healthcare impacts of pandemic restrictions.
ACS hospitalizations fell 28% during NZ lockdown despite low COVID-19; leaves open behavioral factors versus true incidence changes for pandemic planning.
Background Countries with a high incidence of coronavirus 2019 (COVID-19) reported reduced hospitalisations for acute coronary syndromes (ACS) during the pandemic. This study describes the impact of a nationwide lockdown on ACS hospitalisations in New Zealand (NZ), a country with a low incidence of COVID-19. Methods All patients admitted to a NZ Hospital with ACS who underwent coronary angiography in the All NZ ACS Quality Improvement registry during the lockdown (23 March – 26 April 2020) were compared with equivalent weeks in 2015–2019. Ambulance attendances and regional community troponin-I testing were compared for lockdown and non-lockdown (1 July 2019 to 16 February 2020) periods. Findings Hospitalisation for ACS was lower during the 5-week lockdown (105 vs. 146 per-week, rate ratio 0•72 [95% CI 0•61–0•83], p = 0.003). This was explained by fewer admissions for non-ST-segment elevation ACS (NSTE-ACS; p = 0•002) but not ST-segment elevation myocardial infarction (STEMI; p = 0•31). Patient characteristics and in-hospital mortality were similar. For STEMI, door-to-balloon times were similar (70 vs. 72 min, p = 0•52). For NSTE-ACS, there was an increase in percutaneous revascularisation (59% vs. 49%, p <0•001) and reduction in surgical revascularisation (9% vs. 15%, p = 0•005). There were fewer ambulance attendances for cardiac arrests (98 vs. 110 per-week, p = 0•04) but no difference for suspected ACS (408 vs. 420 per-week, p = 0•44). Community troponin testing was lower throughout the lockdown (182 vs. 394 per-week, p <0•001). Interpretation Despite the low incidence of COVID-19, there was a nationwide decrease in ACS hospitalisations during the lockdown. These findings have important implications for future pandemic planning.
No takes yet. Share an insight, caveat, or question.
Chan et al. (2020) conducted an observational in Acute coronary syndromes. COVID-19 lockdown vs. Equivalent weeks in 2015-2019 was evaluated on Hospitalisation for ACS (rate ratio 0.72, 95% CI 0.61-0.83, p=0.003). A nationwide COVID-19 lockdown in New Zealand was associated with fewer hospitalisations for acute coronary syndromes compared to previous years (rate ratio 0.72; 95% CI 0.61-0.83; p=0.003).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: