The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction

During the Covid-19 pandemic, there have been suggestions of a decrease in hospital presentations for emergency conditions like acute myocardial infarction (AMI). This study examined data from Kaiser Permanente Northern California, a large integrated healthcare system. Patient characteristics and weekly hospitalization rates for AMI (STEMI and NSTEMI) among adults were analyzed before and after the first reported Covid-19 death in Northern California on March 4, 2020, and compared to the same period in 2019. The study evaluated data from 43,017,810 person-weeks from January 1 through April 14, 2020. Weekly rates of hospitalization for AMI decreased by up to 48% during the Covid-19 period. From January 1 to March 3, 2020, there were 1051 hospitalization events (incidence rate, 4.1 per 100,000 person-weeks), which decreased to 61 events (incidence rate, 2.1 per 100,000 person-weeks) from April 8 to April 14, 2020 (incidence rate ratio, 0.52; 95% CI, 0.40 to 0.68;

$P<0.001$). Similar decreases were observed for both NSTEMI (incidence rate ratio, 0.51; 95% CI, 0.38 to 0.68) and STEMI (incidence rate ratio, 0.60; 95% CI, 0.33 to 1.08). The decline in AMI hospitalizations during the Covid-19 period in 2020 was consistent with the decrease seen when comparing the Covid-19 period to the same weekly periods in 2019. The prevalence of pre-existing coronary artery disease, previous AMI, and percutaneous coronary intervention was lower in patients presenting during the Covid-19 period compared to the pre-Covid-19 period in 2020 and the corresponding period in 2019. However, demographic characteristics, hemodynamic measures, tr

During the Covid-19 pandemic, there have been suggestions of a decrease in hospital presentations for emergency conditions like acute myocardial infarction (AMI). This study examined data from Kaiser Permanente Northern California, a large integrated healthcare system. Patient characteristics and weekly hospitalization rates for AMI (STEMI and NSTEMI) among adults were analyzed before and after the first reported Covid-19 death in Northern California on March 4, 2020, and compared to the same period in 2019. The study evaluated data from 43,017,810 person-weeks from January 1 through April 14, 2020. Weekly rates of hospitalization for AMI decreased by up to 48% during the Covid-19 period. From January 1 to March 3, 2020, there were 1051 hospitalization events (incidence rate, 4.1 per 100,000 person-weeks), which decreased to 61 events (incidence rate, 2.1 per 100,000 person-weeks) from April 8 to April 14, 2020 (incidence rate ratio, 0.52; 95% CI, 0.40 to 0.68;

$P<0.001$). Similar decreases were observed for both NSTEMI (incidence rate ratio, 0.51; 95% CI, 0.38 to 0.68) and STEMI (incidence rate ratio, 0.60; 95% CI, 0.33 to 1.08). The decline in AMI hospitalizations during the Covid-19 period in 2020 was consistent with the decrease seen when comparing the Covid-19 period to the same weekly periods in 2019. The prevalence of pre-existing coronary artery disease, previous AMI, and percutaneous coronary intervention was lower in patients presenting during the Covid-19 period compared to the pre-Covid-19 period in 2020 and the corresponding period in 2019. However, demographic characteristics, hemodynamic measures, tr