Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Continuous Decline in Myocardial Infarction and Heart Failure Hospitalizations During the First 12 Months of the COVID-19 Pandemic in Israel

Version 1 : Received: 8 February 2022 / Approved: 10 February 2022 / Online: 10 February 2022 (02:47:49 CET)

A peer-reviewed article of this Preprint also exists.

Lavie, G.; Wolff Sagy, Y.; Hoshen, M.; Saliba, W.; Flugelman, M.Y. Continuous Decline in Myocardial Infarction and Heart Failure Hospitalizations during the First 12 Months of the COVID-19 Pandemic in Israel. J. Clin. Med. 2022, 11, 1577. Lavie, G.; Wolff Sagy, Y.; Hoshen, M.; Saliba, W.; Flugelman, M.Y. Continuous Decline in Myocardial Infarction and Heart Failure Hospitalizations during the First 12 Months of the COVID-19 Pandemic in Israel. J. Clin. Med. 2022, 11, 1577.

Abstract

Background A decline in cardiovascular hospitalizations was observed during the initial phases of the COVID-19 pandemic. We examine the continued effect of the pandemic on cardiovascular hospitalizations and the associated mortality rates during the first year of the pandemic in Israel. Methods We conduct a retrospective cohort study using the data of Clalit Health Services, the largest healthcare organization in Israel. We divide the Corona year into six periods (three lockdowns and three post-lockdowns) and compare the incidence rates of cardiovascular hospitalizations and their 30-day mortality during each period to the previous three years. Results The number of non-STEMI hospitalizations during the first year of the pandemic was 13.7% lower than the average of the previous three years (95% CI 11%-17%); STEMI hospitalizations were 15.7% lower (95% CI 13%-19%); and CHF hospitalizations were 23.9% lower (95%, CI 21%-27%). No significant differences in 30-day mortality rates were observed for AMI patients during most of the periods, whereas the annual 30-day all-cause mortality rate of CHF was 23% higher. Conclusions Hospitalizations for AMI and CHF were significantly lower during the first year of the pandemic relative to 2017–9. Mortality rates were higher in the case of CHF patients but not in the case of AMI patients, possibly due a change in the clinical acuity of patients arriving at the hospitals. We conclude that targeted public health messaging should be implemented, together with proactive monitoring in order to identify residual disability in patients that may have received non-optimal treatment during the pandemic.

Keywords

COVID-19 pandemic; Acute myocardial infarction; Congestive heart failure; Cardiovascular hospitalizations

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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