Department of Internal Medicine, Ryhov County Hospital, Region Jönköping County, Jönköping, Sweden.
Department of Internal Medicine, Ryhov County Hospital, Region Jönköping County, Jönköping, Sweden; Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Lancet Healthy Longev. 2021 May;2(5):e283-e289. doi: 10.1016/S2666-7568(21)00085-4.
The incidence of acute myocardial infarction has decreased during the COVID-19 pandemic, but sex and age differences in this change in incidence have not been tested. Thus, we aimed to compare the incidence of acute myocardial infarction in a health-care region in Sweden during the COVID-19 pandemic with previous years and to evaluate sex and age differences.
We did a retrospective, observational cohort study using data from a national registry of patients admitted to coronary care units in Sweden. All patients admitted to one of three hospitals in Region Jönköping County with a diagnosis of acute myocardial infarction during the COVID-19 pandemic (March 1 to July 31, 2020) or reference period (March 1 to July 31, 2017-19) were included. The incidence of acute myocardial infarction (ST-elevation and non-ST-elevation) was calculated for both study periods. Participants were grouped according to sex and age (<70 years vs ≥70 years). The incidence and the incidence rate ratio (IRR) between the two study periods was calculated for each group and compared between groups using the Breslow-Day test.
The study included 1088 participants, 846 who were admitted for acute myocardial infarction during the reference period and 242 who were admitted during the COVID-19 pandemic period. The IRR of acute myocardial infarction for the COVID-19 period compared with the reference period was 0·85 (95% CI 0·73-0·98). The IRR for acute myocardial infarction was significantly lower among women aged 70 years or older (0·56 [0·40-0·78]) than among men aged 70 years or older (0·97 [0·77-1·23]; p=0·0074).
The incidence of acute myocardial infarction decreased predominantly among women aged 70 years or older during the COVID-19 pandemic. This highlights potential sex differences in health effects of the COVID-19 pandemic, which should be further elucidated.
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在 COVID-19 大流行期间，急性心肌梗死的发病率有所下降，但这种发病率变化在性别和年龄方面的差异尚未得到检验。因此，我们旨在比较瑞典一个医疗保健区域在 COVID-19 大流行期间与前几年的急性心肌梗死发病率，并评估性别和年龄差异。
我们使用来自瑞典冠状动脉护理病房患者全国登记处的数据进行了一项回顾性、观察性队列研究。所有在 COVID-19 大流行期间（2020 年 3 月 1 日至 7 月 31 日）或参考期（2017-19 年 3 月 1 日至 7 月 31 日）因急性心肌梗死（ST 段抬高和非 ST 段抬高）被收治到延雪平省三个医院之一的患者均纳入研究。计算了两个研究期间的急性心肌梗死（ST 段抬高和非 ST 段抬高）发病率。根据性别和年龄（<70 岁与≥70 岁）将参与者分为不同组。计算了每个组在两个研究期间的发病率和发病率比值（IRR），并使用 Breslow-Day 检验比较组间差异。
本研究共纳入 1088 名参与者，其中 846 名在参考期因急性心肌梗死入院，242 名在 COVID-19 大流行期间入院。与参考期相比，COVID-19 期间急性心肌梗死的 IRR 为 0.85（95%CI 0.73-0.98）。70 岁及以上女性的急性心肌梗死 IRR 明显低于 70 岁及以上男性（0.56 [0.40-0.78] 比 0.97 [0.77-1.23]；p=0.0074）。
COVID-19 大流行期间，70 岁及以上女性的急性心肌梗死发病率显著下降。这突出了 COVID-19 大流行对健康影响方面的潜在性别差异，需要进一步阐明。
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