新冠肺炎大流行期间急性心肌梗死的发生率。

Rates of Acute Myocardial Infarction During the COVID-19 Pandemic.

机构信息

Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.

Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.

出版信息

Perm J. 2021 Dec 13;25:21.074. doi: 10.7812/TPP/21.074.

DOI:10.7812/TPP/21.074

PMID:35348103

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8784080/

Abstract

BACKGROUND

During the early phases of the COVID-19 pandemic pandemic, stay-at-home orders and fear of acquiring COVID-19 may have led to an avoidance of care for medical emergencies, including acute myocardial infarction (AMI). We evaluated whether a decline in rates of AMI occurred during the COVID-19 stay-at-home order.

METHODS

Rates of AMI per 100,000 member-weeks were calculated for Kaiser Permanente Southern California patients from January 1 to March 3, 2020 (prepandemic period) and from March 20 to July 31, 2020 (pandemic period), and during the same periods in 2019. Rate ratios (RRs) were calculated comparing the time periods using Poisson regression. Case fatality rates (CFRs) were also compared.

RESULTS

Rates of AMI were lower during the pandemic period of 2020 compared to the same period of 2019 [3.20 vs 3.76/100,000 member-weeks; RR, 0.85; 95% confidence interval (CI) 0.80-0.90]. There was no evidence that rates of AMI differed during the 2020 prepandemic period compared to the same period in 2019 (4.45 vs 4.24/100,000 member-weeks; RR, 0.95; 95% CI, 0.88-1.03). AMI rates were lower during the early pandemic period (March 20-May 7: RR, 0.70; 95% CI, 0.66-0.77), but not during the later pandemic period (May 8-July 31: RR, 0.95; 95% CI, 0.88-1.02) compared to 2019. In-hospital and 30-day case fatality rates were higher during the pandemic period of 2020 compared to 2019 (8.8% vs 6.1% and 6.5% vs 5.0%, respectively).

CONCLUSION

AMI rates were lower during the COVID-19 pandemic compared to the same period in 2019. During stay-at-home orders, public health campaigns that encourage people to seek care for medical emergencies are warranted.

摘要

背景

在 COVID-19 大流行的早期阶段，居家令和对感染 COVID-19 的恐惧可能导致人们避免因医疗紧急情况（包括急性心肌梗死 (AMI)）而就医。我们评估了 COVID-19 居家令期间 AMI 发生率是否下降。

方法

计算了 Kaiser Permanente Southern California 患者从 2020 年 1 月 1 日至 3 月 3 日（大流行前时期）和 2020 年 3 月 20 日至 7 月 31 日（大流行时期）的每 100,000 人周 AMI 发生率，以及 2019 年同期的发生率。使用泊松回归比较时间段计算率比 (RR)。还比较了病死率 (CFR)。

结果

与 2019 年同期相比，2020 年大流行期间 AMI 发生率较低[3.20 与 3.76/100,000 人周；RR，0.85；95%置信区间（CI）0.80-0.90]。没有证据表明 2020 年大流行前时期与 2019 年同期的 AMI 发生率不同[4.45 与 4.24/100,000 人周；RR，0.95；95%CI，0.88-1.03]。在大流行早期（3 月 20 日至 5 月 7 日），AMI 发生率较低（RR，0.70；95%CI，0.66-0.77），但在大流行后期（5 月 8 日至 7 月 31 日）并非如此（RR，0.95；95%CI，0.88-1.02）与 2019 年相比。与 2019 年相比，2020 年大流行期间住院和 30 天病死率更高（分别为 8.8%、6.1%和 6.5%、5.0%）。