ARTICLE: Outcomes of Acute Myocardial Infarction Hospitalizations During the COVID-19 Pandemic
JOURNAL: JACC. 2020 Aug 24.
The 2019 novel coronavirus (COVID-19) pandemic is the greatest public health crisis of this century, with both the case rate and death toll continuing to rise.1 The pandemic has strained healthcare systems and exacerbated known healthcare disparities related to race, sex, and underlying co-morbidity status.2,3 In addition, men are more likely to be infected and die from COVID-19 than women.3 These sex disparities may be related to different rates of underlying pre-existing disease, variable behaviors, and biological differences particularly related to angiotensin-converting enzyme 2 (ACE2) receptors.4 COVID-19 also disproportionately affects patients with underlying health problems. A national study found that 90% of patients hospitalized with COVID-19 have at least one underlying co-morbidity.5 It is important for healthcare providers, and the healthcare system at large, to be aware of the incommensurate impact of the pandemic on these high-risk populations in order to provide optimal care as the pandemic continues.
In addition to bringing increased visibility to longstanding healthcare disparities, the COVID-19 pandemic has greatly impacted healthcare delivery across the world. Many hospitals and health systems cancelled non-urgent procedures and closed clinics, and governments messaged to the public to stay home and avoid going to hospitals for non-urgent care. While hospitalization rates related to COVID-19 infection have surged, there is clear evidence that patients in the United States and around the world have less commonly sought medical attention for a number medical emergencies such as acute myocardial infarction (AMI) than they were prior to the pandemic.6 The characteristics of patients most affected by this phenomenon and its impact on complication rates and patient outcomes are yet to be elucidated.
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