Impact of COVID-19 Pandemic on Hospital Admissions of Acute Coronary Syndrome: A Beijing Inpatient Database Study

Background: Consequences of reduced acute coronary syndrome (ACS) admissions during COVID-19 pandemic periods were reported by different countries. However, admissions, treatments, and prognosis of ACS during and after COVID-19 pandemic in Beijing, China was unknown. Methods: Information on ACS admissions and heart failure (HF) admission were identified from database of Beijing Municipal Health Commission Information Center. Study period was defined as December 1, 2019 to June 30, 2020, and control period was defined as December 1, 2018 to June 30, 2019. Numbers of admission for HF during the control period, the study period, and 5 months after study period were compared to evaluate the consequence of changed ACS care during the COVID-19 pandemic. Findings: Admissions for ST-elevation myocardial infarction (STEMI), Non-ST-elevation myocardial infarction (Non-STEMI), and unstable angina (UAP) reduced by 38·0%, 41·0%, and 63·3% in study period. Percutaneous coronary intervention performed within 24 hours were significantly more frequent during study period in patients with STEMI ( 37·9% vs. 31·7%, P<0·0001), but significantly less frequent in patients with Non-STEMI (7·9% vs. 9·5%, P=0·049), and in patients with UAP ( 1·7% vs. 3·5%, P<0·0001). In-hospital mortality rates in patients with ACS were similar during the study period and the control period (3·1% vs 2·5%, P=0·174 for STEMI; 2·7% vs 2·3%, P=0·429 for Non-STEMI; 0·2% vs 0·1%, P=0·222 for UAP). A fall by 26·3% for HF admissions was also observed during the five months following the study period than equivalent period in 2019. Interpretation: During COVID-19 pandemic, ACS admissions reduced significantly in Beijing; however, increase of HF admissions was not observed within five months post-pandemic period, implying the pandemic didn’t deteriorate the prognosis for ACS. Funding Information: This work was supported by the National Natural Science Foundation of China (82103904) and the National Key Research and Development Program of China (Grant number: 2020YFC2004803). Declaration of Interests: Chang-Sheng Ma has received honoraria from Bristol-Myers Squibb (BMS), Pfizer, Johnson & Johnson, Boehringer-Ingelheim (BI) and Bayer for giving lectures. Jian-Zeng Dong has received honoraria from Johnson & Johnson for giving lectures. The remaining authors have no disclosures to report. Ethics Approval Statement: Our research protocol was approved by the Medical Ethics Committee of Beijing Anzhen Hospital, Capital Medical University. Informed consent was waived in this study.