The Impact of a National COVID-19 Lockdown on Acute Coronary Syndrome Hospitalisations in New Zealand: an ANZACS-QI study
Section snippets
Background
Countries with a high incidence of coronavirus-2019 (COVID-19) reported reduced hospitalisations for acute coronary syndromes (ACS) during the pandemic. This study describes the impact of a nationwide lockdown on ACS hospitalisations in New Zealand (NZ), a country with a low incidence of COVID-19.
Method
All patients admitted to a NZ hospital with ACS who underwent coronary angiography in the All NZ ACS Quality Improvement (ANZACS-QI) registry during the lockdown (23 March 2020–26 April 2020) were compared with equivalent weeks in 2015-2019. Ambulance attendances and regional community troponin testing were compared for lockdown and non-lockdown (1 July 2019–16 February 2020) periods.
Results
Hospitalisation for ACS was lower during the 5-week lockdown (105 vs 146 per-week, rate ratio 0.72 [95% CI, 0.61–0.83], p=0.003). This was explained by fewer admissions for non-ST-segment elevation ACS (NSTE-ACS; p=0.002) but not ST-segment elevation myocardial infarction (STEMI; p=0.31). Patient characteristics and in-hospital mortality were similar. For STEMI, door-to-balloon times were similar (70 vs 72 min, p=0.52). For NSTE-ACS, there was an increase in percutaneous revascularisation (59%
Conclusion
Despite the low incidence of COVID-19, there was a nationwide decrease in ACS hospitalisations during the lockdown. These findings have important implications for future pandemic planning.