Impact of coronavirus disease 2019 (COVID-19) outbreak on acute admissions at the emergency and cardiology departments across Europe.

PURPOSE: We evaluated whether the severe acute respiratory syndrome coronavirus 2 pandemic was associated with changes in the pattern of acute cardiovascular admissions across European centres METHODS: We set-up a multi-centre, multi-national, pan-European observational registry in 15 centres from 12 countries All consecutive acute admissions to emergency departments and cardiology departments throughout a 1-month period during the COVID-19 outbreak were compared with an equivalent 1-month period in 2019 The acute admissions to cardiology departments were classified into 5 major categories: acute coronary syndrome, acute heart failure, arrhythmia, pulmonary embolism and other RESULTS: Data from 54331 patients were collected and analysed Nine centres provided data on acute admissions to emergency departments comprising 50384 patients: 20226 in 2020 vs 30158 in 2019 - incidence rate ratio (IRR) with 95% confidence interval (95%CI): 0 66(0 58-0 76) The risk of death at the emergency departments was higher in 2020 vs 2019: odds ratio (OR) with 95%CI: 4 1(3 0-5 8), P<0 0001 All 15 centers provided data on acute cardiology departments admissions: 3007 patients in 2020 vs 4452 in 2019, respectively, IRR(95%CI): 0 68(0 64-0 71) In 2020, there were less admissions with IRR(95%CI): acute coronary syndrome: 0 68(0 63-0 73), acute heart failure: 0 65(0 58-0 74), arrhythmia: 0 66(0 60-0 72), other: 0 68(0 62-0 76);we found a relatively higher percentage of pulmonary embolism admissions in 2020: OR(95%CI): 1 5(1 1-2 1), P=0 02 Among patients with acute coronary syndrome there were fewer admissions with unstable angina: 0 79(0 66-0 94), non-ST segment elevation myocardial infarction: 0 56(0 50-0 64) and ST-segment elevation myocardial infarction: 0 78(0 68-0 89) CONCLUSION: In the European centres during the COVID-19 outbreak, there were fewer acute cardiovascular admissions Also, fewer patients were admitted to the emergency departments with 4-times higher death risk at the emergency departments