Department of Cardiology, Hôpital Universitaire de Montpellier, 34295 Montpellier, France; PhyMedExp, Université de Montpellier, Inserm U1046, CNRS UMR 9214, 34295 Montpellier, France.
Department of Cardiology, Hôpital Cardiologique Louis Pradel, 69500 Bron, France.
Arch Cardiovasc Dis. 2020 May;113(5):303-307. doi: 10.1016/j.acvd.2020.04.002. Epub 2020 Apr 28.
Coronavirus disease 2019 (COVID-19) is likely to have significant implications for the cardiovascular care of patients. In most countries, containment has already started (on 17 March 2020 in France), and self-quarantine and social distancing are reducing viral contamination and saving lives. However, these considerations may only be the tip of the iceberg; most resources are dedicated to the struggle against COVID-19, and this unprecedented situation may compromise the management of patients admitted with cardiovascular conditions.
We aimed to assess the effect of COVID-19 containment measures on cardiovascular admissions in France.
We asked nine major cardiology centres to give us an overview of admissions to their nine intensive cardiac care units for acute myocardial infarction or acute heart failure, before and after containment measures.
Before containment (02-16 March 2020), the nine participating intensive cardiac care units admitted 4.8±1.6 patients per day, versus 2.6±1.5 after containment (17-22 March 2020) (rank-sum test P=0.0006).
We confirm here, for the first time, a dramatic drop in the number of cardiovascular admissions after the establishment of containment. Many hypotheses might explain this phenomenon, but we feel it is time raise the alarm about the risk for patients presenting with acute cardiovascular disease, who may suffer from lack of attention, leading to severe consequences (an increase in the number of ambulatory myocardial infarctions, mechanical complications of myocardial infarction leading to an increase in the number of cardiac arrests, unexplained deaths, heart failure, etc.). Similar consequences can be feared for all acute situations, beyond the cardiovascular disease setting.
2019 年冠状病毒病（COVID-19）可能对患者的心血管护理产生重大影响。在大多数国家，遏制措施已经开始（2020 年 3 月 17 日在法国），自我隔离和社会隔离正在减少病毒污染并挽救生命。然而，这些考虑因素可能只是冰山一角；大多数资源都致力于对抗 COVID-19，这种前所未有的情况可能会影响心血管疾病患者的管理。
我们旨在评估 COVID-19 遏制措施对法国心血管入院的影响。
我们要求九家主要心脏病学中心在遏制措施前后，向我们介绍其九家急性心肌梗死或急性心力衰竭重症监护病房的入院情况。
在遏制措施之前（2020 年 3 月 2 日至 16 日），九家参与的重症监护病房每天收治 4.8±1.6 名患者，而在遏制措施之后（2020 年 3 月 17 日至 22 日）为 2.6±1.5 名患者（秩和检验 P=0.0006）。
我们在此首次确认，在实施遏制措施后，心血管入院人数急剧下降。许多假设可以解释这种现象，但我们认为现在应该警惕急性心血管疾病患者的风险，他们可能因缺乏关注而遭受严重后果（门诊心肌梗死增加，心肌梗死的机械并发症导致心脏骤停增加，不明原因死亡，心力衰竭等）。在心血管疾病以外的所有急性情况下，可能会出现类似的后果。
