U.K. hospital admissions for heart attacks and heart failure were reduced by more than 50 percent in the spring of 2020 and by more than a third in the second wave of COVID-19 as people fear going to hospitals and ignore serious symptoms. Getty Images
February 24, 2021 — A study of admissions for acute myocardial infarction (AMI) and heart failure (HF) in the U.K. decreased by 41% and 34% respectively during the second wave of the COVID-19 panademic in the fall of 2020. The first wave in March 2020 saw a 54% decrease in admissions.
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.
The authors wrote that despite an initial recovery in admissions with HF and MI, the latter part of 2020 has witnessed a second decline in people hospitalized with these conditions, which pre-dated the onset of the second national lockdown in the United Kingdom. The second dip appears of similar magnitude to that of the first and signals that the public are fearful of attending hospitals despite having medical emergencies, and that this varies over time, possibly relating to numbers of cases and social mandates. This is important because earlier work from the United Kingdom described how delays to seeking help were temporally related to an inflation in deaths from a range of acute cardiovascular diseases. The authors said the decline in admissions requires clear public messaging to prevent further unintended consequences with increased deaths and poor outcomes due to delays in cardiac care.
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1. Jianhua Wu, Mamas A. Mamas, Mar A. de Belder, John E.Deanfield, Chris P.Gale. Second decline in admissions with heart failure and myocardial infarction during the COVID-19 pandemic. J Am Coll Cardiol. Published online 2021 Jan 12. https://doi.org/10.1016/j.jacc.2020.12.039.