key: cord-0816095-2dcqr6hr
authors: .Kapelios, Chris J.; Siafarikas, Christos; Bonou, Maria; Liatis, Stavros; Barbetseas, John
title: The effect of the COVID-19 pandemic on acute coronary syndrome hospitalizations and out-of-hospital cardiac arrest in Greece
date: 2020-12-16
journal: Public Health
DOI: 10.1016/j.puhe.2020.12.006
sha: 08b46330c3842ece770c49c7a2851ff8af934004
doc_id: 816095
cord_uid: 2dcqr6hr

Objectives After COVID-19 outbreak, striking decreases in the number of hospital admissions for acute coronary syndromes (ACS) and rises in rates of out-of-hospital cardiac arrest (OHCA) have been noted. Study Design This is an analysis of prospectively collected data from a cardiology department in a single, large volume hospital of the National Health System of the Metropolitan area of Athens. Methods We investigated the numbers of OHCA and hospital admissions for ACS during a 1-year and made comparisons between the pre-COVID-19 and the COVID-19 outbreak periods. Results One hundred and eighty five patients were admitted during the total period of observation with the diagnosis of ACS. The mean monthly number of admissions for ACS for the pre-COVID-19 era was significantly higher compared with the post-COVID-19 era (20.1±7.8 vs. 8.8±6.5 admissions, Ρ=0.024). The cases of OHCA which were transferred to our emergency room department by EMS during the same period were nominally lower in the pre-pandemic compared with the post-pandemic era (1.9 ± 1.7 vs. 4.0 ± 4.6, P=0.28). Conclusions The present study provides hints on the potential unintended consequences of the pandemic in countries characterized by fewer COVID-19 cases and fatalities but prompt measures of social contact restrictions and lock-down.

To face the coronavirus (COVID-19) pandemic [1] , strict social containment measures have been implemented worldwide, and healthcare systems have been reorganized to cope with the expected surge in the numbers of critically ill patients [2] . However, Greek authorities adopted strict and timely social distancing policies to contain COVID-19 spread [3] . These policies were proven highly efficient as Greece reported one of the lowest incidence and fatality rates worldwide during the first pandemic wave [4]. After COVID-19 outbreak, striking decreases in the number of hospital admissions for acute coronary syndromes (ACS) have been noted [5, 6] .

Similarly, early studies from regions severely affected by the pandemic have supported that the rates of out-of-hospital cardiac arrest (OHCA) have significantly risen during this period [7] . Furthermore, mechanical complications of ACS, which have been rendered infrequent in the era of timely coronary reperfusion, have resurfaced during the pandemic [8] . Lock-down measures which hinder access to health care services, and/or fear of SARS-CoV-2 contraction, which deters patients from seeking healthcare, could be advocated as potential explanations for aforementioned trends. Nonetheless, data from countries, which have been least 

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