Pôle Anesthésie-Réanimation, CHU Grenoble Alpes, CS 10217, CEDEX 9, Grenoble, France; Centre Hospitalier Territorial Gaston-Bourret, Service de Réanimation, Dumbea-Sur-Mer 98835, New Caledonia; Institut Pasteur de Nouvelle-Calédonie, Unité d'Epidémiologie, 98845 Nouméa Cedex, New Caledonia; Grenoble Alpes University, HP2 Laboratory, U1042, INSERM, CS 10217, CEDEX 9, Grenoble, France.
Institut Pasteur de Nouvelle-Calédonie, URE Dengue et Arboviroses, 98845 Nouméa Cedex, New Caledonia; Institut de Recherche pour le Développement, UMR ENTROPIE 9220, IRD, CNRS, UR, Noumea 98800, New Caledonia.
Public Health. 2023 Apr;217:98-104. doi: 10.1016/j.puhe.2023.01.029. Epub 2023 Feb 3.
There are concerns about the potential effect of social distancing used to control COVID-19 on the incidence of cardiovascular diseases (CVD).
Retrospective cohort study.
We examined the association between lockdown and CVD incidence in a Zero-COVID country, New Caledonia. Inclusion criteria were defined by a positive troponin sample during hospitalization. The study period lasted for 2 months, starting March 20, 2020 (strict lockdown: first month; loose lockdown: second month) compared with the same period of the three previous years to calculate incidence ratio (IR). Demographic characteristics and main CVD diagnoses were collected. The primary endpoint was the change in incidence of hospital admission with CVD during lockdown compared with the historical counterpart. The secondary endpoint included influence of strict lockdown, change in incidence of the primary endpoint by disease, and outcome incidences (intubation or death) analyzed with inverse probability weighting method.
A total of 1215 patients were included: 264 in 2020 vs 317 (average of the historical period). CVD hospitalizations were reduced during strict lockdown (IR 0.71 [0.58-0.88]), but not during loose lockdown (IR 0.94 [0.78-1.12]). The incidence of acute coronary syndromes was similar in both periods. The incidence of acute decompensated heart failure was reduced during strict lockdown (IR 0.42 [0.24-0.73]), followed by a rebound (IR 1.42 [1-1.98]). There was no association between lockdown and short-term outcomes.
Our study showed that lockdown was associated with a striking reduction in CVD hospitalizations, independently from viral spread, and a rebound of acute decompensated heart failure hospitalizations during looser lockdown.
人们对用于控制 COVID-19 的社交距离措施对心血管疾病 (CVD) 发病率的潜在影响表示担忧。
回顾性队列研究。
我们研究了在一个零新冠国家新喀里多尼亚，封锁与 CVD 发病率之间的关系。纳入标准是住院期间肌钙蛋白样本呈阳性。研究期间持续 2 个月，从 2020 年 3 月 20 日开始（严格封锁：第一个月；宽松封锁：第二个月），与前三年同期相比计算发病率比 (IR)。收集人口统计学特征和主要 CVD 诊断。主要终点是与历史同期相比，封锁期间 CVD 住院人数的变化。次要终点包括严格封锁的影响、主要终点按疾病分类的发病率变化以及通过逆概率加权法分析的结果发病率（插管或死亡）。
共纳入 1215 例患者：2020 年 264 例，前 3 年平均 317 例。严格封锁期间 CVD 住院人数减少（IR0.71 [0.58-0.88]），但宽松封锁期间未减少（IR0.94 [0.78-1.12]）。两个时期急性冠状动脉综合征的发病率相似。急性失代偿性心力衰竭的发病率在严格封锁期间降低（IR0.42 [0.24-0.73]），随后反弹（IR1.42 [1-1.98]）。封锁与短期结果之间没有关联。
我们的研究表明，封锁与 CVD 住院人数的显著减少有关，与病毒传播无关，在更宽松的封锁期间，急性失代偿性心力衰竭的住院人数出现反弹。
