Myocardial Infarction incidence during national lockdown in two French provinces unevenly affected by COVID-19 outbreak: an observational study

Background A reduction of admission for MI has been reported in most countries affected by COVID-19 No clear explanation has been provided Methods To report the incidence of myocardial infarction(MI) admission during COVID-19 pandemic and in particular during national lockdown in two unequally affected French provinces (10-million inhabitants) with a different media strategy, and to describe the magnitude of MI incidence changes relative to the incidence of COVID-19-related deaths A longitudinal study to collect all MIs from January 1 until May 17, 2020 (study period) and from the identical time period in 2019(control period) was conducted in all centers with PCI-facilities in northern “Hauts-de-France”(H-de-F) province and western “Pays-de-la-Loire” Province(PDL) The incidence of COVID-19 fatalities was also collected Findings In H-de-F, during lockdown(March18-May10), 1500 COVID-19-related deaths were observed A 23% decrease in MI-IR(IRR=0 77;95%CI:0 71-0 84, p<0 001) was observed for a loss of 272 MIs (95%CI:-363,-181), representing 18% of COVID-19-related deaths In PDL, 382 COVID-19-related deaths were observed A 19% decrease in MI-IR(IRR=0 81;95%CI=0 73-0 90, p<0 001) was observed for a loss of 138 MIs (95%CI:-210,-66), representing 36% of COVID-19-related deaths While in H-de-F the MI decline started before lockdown and recovered 3 weeks before its end, in PDL, it started after lockdown and recovered only by its end In-hospital mortality of MI patients was increased during lockdown in both provinces(5 0% vs 3 4%, p=0 02) Interpretation It highlights one of the potential collateral damages of COVID-19 outbreak on cardiovascular health with a dramatic reduction of MI incidence It advocates for a careful and weighted communication strategy in pandemic crises