Impact of the COVID-19 outbreak on the incidence of severe chest pain:a single-center study

Luo Yuanyuan; Li Jian; Gong Jie; Wang Qiang

doi:10.3969/j.issn.1674-4055.2024.03.19

Abstract：Objective To explore the impact of the COVID-19 outbreak on the incidence of Acute Chest Pain(ACP)by analyzing changes in the number of patients and mortality rates of severe ACP at the Department of Clinical Research Center,the Affiliated Wuxi People's Hospital of Nanjing Medical University during the early outbreak of COVID-19 in 2020.Methods Patients diagnosed with three types of ACP diseases:Acute Myocardial Infarction(AMI),Aortic Dissection(AD),and Pulmonary Embolism(PE)who visited the Emergency Center of Wuxi People's Hospital from January 1,2020,to April 29,2020,were selected.Based on the COVID-19 outbreak and the corresponding work suspension and resumption,ACP patients were divided into:①Lockdown Period(LP)group,covering the suspension period from January 23,2020(when Wuhan announced lockdown and other cities followed)to March 22,2020(when the epidemic was completely controlled in the city and work resumed the next day),a total of 60 days;②Unlocked Period(ULP)group,reflecting the normal living and working state,including the period before the outbreak from January 1,2020,to January 22,2020,and after work resumption from March 23,2020,to April 29,2020,also a total of 60 days.Age,gender,and other characteristics of the enrolled patients were recorded,and the number of patients and mortality rates during hospitalization in each group were compared.Results The number of ACP patients in the LP group(n=63)decreased by 41.1%compared to the ULP group(n=107),with a 46.2%decrease in AMI patients(LP:42 vs.ULP:78)and an increase in mortality rate(LP:16.7%vs.ULP:6.4%,P=0.074).This was mainly reflected in the decrease in STEMI patients(LP:33 vs.ULP:70,a decrease of 52.9%)and an increase in mortality rate(LP:21.2%vs.ULP:7.1%,P=0.038).The number of AD patients in the LP group(n=7)decreased by 65.0%compared to the ULP group(n=20),while the number of PE patients increased by 55.6%(LP:14 vs.ULP:9).The proportion of PE patients among all ACP cases was statistically different between the two groups(LP:22.2%vs.ULP:8.4%,P=0.011).There was no statistical difference in the proportion of AMI and AD patients among ACP cases between the two groups(P=0.389,P=0.192).Conclusion During the COVID-19 outbreak,there was a decrease in the number of AMI and AD patients,an increase in PE patients,and a significant rise in the mortality rate of STEMI patients.These changes may be related to lifestyle changes triggered by the outbreak.