Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France.
Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France.
Arch Cardiovasc Dis. 2021 May;114(5):371-380. doi: 10.1016/j.acvd.2021.01.006. Epub 2021 Apr 14.
The coronavirus disease 2019 (COVID-19) pandemic and the national lockdown have led to significant changes in the use of emergency care by the French population.
To describe the national and regional temporal trends in emergency department (ED) admissions for myocardial infarction (MI) and stroke, before, during and after the first national lockdown.
The weekly numbers of ED admissions for MI and stroke were collected from the OSCOUR® network, which covers 93.3% of all ED admissions in France. National and regional incidence rate ratios from 02 February until 31 May (2020 versus 2017-2019) were estimated using Poisson regression for MI and stroke, before, during and after lockdown.
A decrease in ED admissions was observed for MI (-20% for ST-segment elevation MI and-25% for non-ST-segment elevation MI) and stroke (-18% for ischaemic and-22% for haemorrhagic) during the lockdown. The decrease became significant earlier for stroke than for MI. No compensatory increase in ED admissions was observed at the end of the lockdown for these diseases. Important regional disparities in ED admissions were observed, without correlation with the regional levels of COVID-19 cases. The impact of lockdown on ED admissions was particularly significant in six regions (Ile-de France, Occitanie, Provence-Alpes-Côte d'Azur, Nouvelle Aquitaine, Hauts-de-France and Bretagne).
The decrease in ED admissions for MI and stroke observed during the lockdown was probably caused by fear of COVID-19 and augmented by the lockdown, and was heterogeneous across the French territory. ED admissions were slow to return to the usual levels from previous years, without a compensatory increase. These results underline the need to reinforce messages directed at the population to encourage them to seek care without delay in case of cardiovascular symptoms.
2019 年冠状病毒病（COVID-19）大流行和全国封锁导致法国人口对急救护理的使用发生了重大变化。
描述第一次全国封锁前后，急诊部（ED）因心肌梗死（MI）和中风入院的全国和地区时间趋势。
从 OSCOUR®网络收集每周因 MI 和中风到 ED 就诊的人数，该网络覆盖了法国所有 ED 就诊的 93.3%。使用泊松回归法，在封锁前后，估计 02 月 2 日至 5 月 31 日（2020 年与 2017-2019 年）期间 MI 和中风的全国和地区发病率比值。
在封锁期间，ED 因 MI（ST 段抬高型 MI 下降 20%，非 ST 段抬高型 MI 下降 25%）和中风（缺血性中风下降 18%，出血性中风下降 22%）入院人数减少。中风的下降比 MI 更早变得显著。封锁结束后，这些疾病的 ED 就诊人数没有出现补偿性增加。观察到 ED 就诊人数存在重要的地区差异，与 COVID-19 病例的地区水平无关。封锁对 ED 就诊人数的影响在六个地区（法兰西岛、奥克西塔尼、普罗旺斯-阿尔卑斯-蓝色海岸、新阿基坦、上法兰西和布列塔尼）特别显著。
封锁期间因 MI 和中风观察到的 ED 就诊人数减少，可能是由于对 COVID-19 的恐惧所致，并因封锁而加剧，且在法国各地存在异质性。ED 就诊人数从往年的正常水平恢复缓慢，没有补偿性增加。这些结果强调需要加强向公众传达信息，鼓励他们在出现心血管症状时毫不拖延地寻求医疗。
