Influence of age and gender on arrival of patients with ST-segment elevation acute myocardial infarction to tertiary centers during COVID-19 pandemic. Experience of Madrid, Spain, STEMI network (Codigo Infarto Madrid).

Potential explanations may include reduction of STEMI due to physical inactivity, reluctance of patients for seeking medical assistance due to the possibility of SARS-CoV-2 contamination, attribution of symptoms to COVID-19 infection, health system failures and diagnostic errors in attending patients with chest pain, delay in diagnosis losing the benefit of early coronary reperfusion, increased use of thrombolysis, and cardiac death before medical attendance Mean age was not statistically different in both periods (63 4 ± 13 4 before, and 65 1 ± 13 1 during pandemic, p = 0 3769) [ ]the reduction in the number of patients with STEMI attended in tertiary hospitals only was found in men [ ]men have higher treatment-seeking threshold than women, some studies having pointed towards men's sense of stoicism and self-reliance Because of these reasons, COVID-19 pandemic might have impacted clearly on STEMI treatment only in male patients, and counterbalanced the classical advantage of more typical symptoms in male gender