scholarly journals Stent-Save a Life international survey on the practice of primary coronary angioplasty during the COVID-19 pandemic

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H Pereira ◽  
S S L On Behalf Of Stent Save A Life Initative ◽  
Keyword(s):  
Coronary Angioplasty ◽  
Hospital Admissions ◽  
Related Factors ◽  
Funding Sources ◽  
Patient Admissions ◽  
Primary Coronary Angioplasty ◽  
Coronary Syndromes ◽  
Global Initiative ◽  
The Impact ◽  
Global Reduction

Abstract Aims To evaluate the impact of the COVID-19 pandemic on patient admissions with acute coronary syndromes (ACS) and primary coronary angioplasty (PPCI) in countries participating in the Stent-Save a Life (SSL) global initiative. Methods and results We conducted a multicenter, observational survey to collect data on patient admissions for ACS, STEMI and PPCI in the SSL participating countries throughout a period during the COVID-19 outbreak (March and April 2020) compared with the equivalent period in 2019. From the 32 member countries of the SSL global initiative, 17 accepted to participate in the survey (3 from Africa, 5 from Asia, 6 from Europe and 3 from Latin America (LATAM)). We observed a global reduction of 27,5% and 20,0% in admissions with ACS and STEMI respectively. The decrease in PPCI was 26,7% (Figure 1). This trend was observed in all countries except two. In these two countries, the pandemic peaked later than in the other countries. Conclusions This survey shows that the COVID-19 outbreak was associated with a significant reduction of hospital admissions for ACS and STEMI as well as a reduction of PPCI, which can be explained by both patient and system related factors. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

Does climate change affect the chronobiological trends in occurrence of acute coronary syndromes?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
L Kuzma ◽  
A Kurasz ◽  
M Niwinska ◽  
EJ Dabrowski ◽  
M Swieczkowski ◽  
...  
Keyword(s):  
Climate Change ◽  
Acute Coronary Syndromes ◽  
Hospital Admissions ◽  
Global Climate ◽  
Weather Conditions ◽  
Temperature Changes ◽  
Funding Sources ◽  
Relative Risks ◽  
Coronary Syndromes ◽  
Atmospheric Changes

Abstract Funding Acknowledgements Type of funding sources: None. Background Acute coronary syndromes (ACS) are the leading cause of death all over the world, in the last years chronobiology of their occurrence has been changing. Purpose The aim of this study was to assess the influence of climate change on hospital admissions due to ACS. Methods Medical records of 10,529 patients hospitalized for ACS in 2008–2017 were examined. Weather conditions data were obtained from the Institute of Meteorology. Results Among the patients, 3537 (33.6%) were hospitalized for STEMI, 3947 (37.5%) for NSTEMI, and 3045 (28.9%) for UA. The highest seasonal mean for ACS was recorded in spring (N = 2782, mean = 2.52, SD = 1.7; OR 1.07; 95% CI 1.0-1.2; P = 0.049) and it was a season with the highest temperature changes day to day (Δ temp.=11.7). On the other hand, every 10ºC change in temperature was associated with an increased admission due to ACS by 13% (RR 1.13; 95% CI 1.04-1.3; P = 0.008). Analysis of weekly changes showed that the highest frequency of ACS occurred on Thursday (N = 1703, mean = 2.7, SD = 1.9; OR 1.16; 95% CI 1.0-1.23; P = 0.004), in STEMI subgroup it was Monday (N = 592, mean = 0.9, SD = 1.6, OR 1.2; 95% CI 1.1-1.4; P = 0.002). Sunday was associated with decreased admissions due to all types of ACS (N = 1098, mean = 1.7, SD = 1.4; OR 0.69; 95% CI 0.6-0.8, P < 0.001). In the second half of the study period (2013-2018) the relative risks of hospital admissions due to ACS were 1.043 (95%CI: 1.009-1.079, P = 0.014, lag 0) and 0.957 (95%CI: 0.925-0.990, P = 0.010, lag 1) for each 10ºC decrease in temperature; 1.049 (95% CI: 1.015-1.084, P = 0.004, lag 0) and 1.045 (95%CI: 1.011-1.080, P = 0.008, lag 1) for each 10 hPa decrease in atmospheric pressure and 1.180 (95% CI: 1.078-1.324, P = 0.007, lag 0) for every 10ºC change in temperature. For the first half of the study the risk was significantly lower. Conclusion We observed a shift in the seasonal peak of ACS occurrence from winter to spring which may be related to temperature fluctuation associated with climate change in this season. The lowest frequency of ACS took place on weekends. Atmospheric changes had a much more pronounced effect on admissions due to ACS in the second half of the analyzed period, which is in line with the dynamics of global climate change.

scholarly journals Impact of COVID-19 pandemic on stroke admissions in Qatar

2021 ◽  
Vol 3 (1) ◽  
pp. e000084
Author(s):  
Naveed Akhtar ◽  
Salman Al Jerdi ◽  
Ziyad Mahfoud ◽  
Yahia Imam ◽  
Saadat Kamran ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Small Vessel Disease ◽  
Tertiary Care ◽  
Relative Increase ◽  
Large Vessel ◽  
Tertiary Care Centre ◽  
Transient Ischaemic Attacks ◽  
Stroke Mimics ◽  
Coronary Syndromes ◽  
The Impact

IntroductionThe COVID-19 pandemic has resulted in a dramatic unexplained decline in hospital admissions due to acute coronary syndromes and stroke. Several theories have emerged aiming to explain this decline, mostly revolving around the fear of contracting the disease and thus avoiding hospital visits.AimsIn this study, we aim to examine the impact of the COVID-19 pandemic on stroke admissions to a tertiary care centre in Qatar.MethodsThe Hamad General Hospital stroke database was interrogated for stroke admissions between September 2019 and May 2020. The number of stroke admissions, stroke subtypes and short-term outcomes was compared between the ‘pre-COVID-19’ period (September 2019 to February 2020) and the COVID-19 pandemic period (March to May 2020).ResultsWe observed a significant decline in monthly admissions in March (157), April (128) and May (135) compared with the pre-COVID-19 6-month average (229) (p=0.024). The reduction in admissions was most evident in functional stroke mimics. The average admissions decreased from 87 to 34 per month (p=0.0001). Although there were no significant differences in admissions due to ischaemic stroke (IS), intracranial haemorrhage or transient ischaemic attacks between the two periods, we noted a relative decrease in IS due to small vessel disease and an increase in those due to large vessel atherosclerosis in March to May 2020.ConclusionsThe decline in overall stroke admissions during the COVID-19 pandemic is most likely related to concerns of contracting the infection, evidenced mainly by a decline in admissions of stroke mimics. However, a relative increase in large vessel occlusions raises suspicion of pathophysiological effects of the virus, and requires further investigation.

scholarly journals Smoking Ban: A Long-term Analysis of the Malta Paradox in a Population of over 400,000 Subjects

2015 ◽  
Vol 1 (4) ◽  
pp. 184 ◽  
Author(s):  
Caroline Magri ◽  
Robert Xuereb ◽  
Sandra Distefano ◽  
Neville Calleja ◽  
Victor Grech
Keyword(s):  
Hospital Admissions ◽  
Public Awareness ◽  
Age Groups ◽  
Admission Rate ◽  
Coronary Heart Disease Mortality ◽  
Smoking Ban ◽  
Annual Data ◽  
Public Areas ◽  
Coronary Syndromes ◽  
The Impact

Objectives: The introduction of laws that make indoor public areas and workplaces smoke-free has resulted in a significant<br />reduction in the incidence of acute coronary syndromes (ACS). Malta was the second European country to introduce the<br />smoking ban legislation in April 2004. The purpose of the study was to investigate the impact of the smoking ban in Malta on<br />ACS morbidity and mortality.<br />Methods: The number of ACS hospital admissions and the number of cardiovascular deaths were retrospectively analysed.<br />The annual data for 5 years prior to and following the introduction of the Tobacco Act were obtained according to age-groups<br />for both genders. Poisson regression analyses were performed to assess for decline in ACS admission and cardiovascular<br />death.<br />Results: The ACS admission rate increased throughout the 5 years following the introduction of the smoking ban. There was<br />no change in mortality rate in the 5 years following the legislation, except in 2007 when a small but significant decline was<br />noted.<br />Conclusions: The Malta smoking ban did not have a significant impact on cardiovascular mortality and ACS admissions<br />rates, indicating the need for proper enforcement of the public smoking ban and increase in public awareness regarding the<br />adverse effects of smoking.<br />Key words: Coronary heart disease; Mortality; Prevention; Smoking.

scholarly journals The impact of COVID-19 on eating disorder referrals and admissions in Waikato, New Zealand

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sara J. Hansen ◽  
Alice Stephan ◽  
David B. Menkes
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
New Zealand ◽  
Hospital Admissions ◽  
Resource Constraints ◽  
English Summary ◽  
Outpatient Services ◽  
Patient Admissions ◽  
Clinical Records ◽  
The Impact

Abstract Background Several countries have reported increased demand for eating disorder services during the COVID-19 pandemic, particularly for adolescents. Within New Zealand, anecdotal and media reports suggest similar changes but are limited in scope and detail. We assessed eating disorder service demand in the Waikato district in relation to the COVID-19 pandemic. Methods We retrospectively analysed records of eating disorder admissions and referrals for both children (< 18 years) and adults (≥ 18 years) during 2019 and 2020 in the Waikato, a mixed urban–rural province in northern New Zealand (population 435,000). We analysed medical admission and outpatient referral rates, and referral acuity, in relation to the COVID-19 pandemic using Welch’s t- and chi-square tests. Results 106 medical admissions met inclusion criteria (n = 37 in 2019; 69 in 2020). Admissions for eating disorders increased markedly following nationwide lockdown in March 2020 (RR = 1.7, p = 0.01), largely driven by increases in adult admissions (RR 2.0, p = 0.005). The proportion of ‘new patient’ admissions showed comparable increases for both children (RR = 2.0, p = 0.02) and adults (RR = 2.3, p = 0.03). Following lockdown, outpatient referrals increased in acuity (RR = 1.8, p = 0.047) and volume (RR = 1.6, p = 0.076) for children but not for adults. Conclusions Our study confirms a pandemic-related increase in demand for eating disorder services in the Waikato region of New Zealand, consistent with findings reported overseas. We observed contrasting increases in admissions for adults and outpatient referrals for children, exacerbating resource constraints for already stretched services and compromising provision of timely care. Plain English summary The COVID-19 pandemic has been linked to increased numbers and worsening severity of eating disorders in several settings. In New Zealand, similar trends have been noted anecdotally. We assessed clinical records to calculate rates of eating disorder-related hospital admissions and outpatient referrals during 2019 and 2020. We found significant increases in hospital admissions related to COVID-19, particularly for adults, and greater proportions of both children and adults having a first-ever eating disorder-related admission. In outpatient services, young people were referred more frequently during the pandemic and were more physically unwell when referred. These results indicate increased demand for eating disorder services as a result of the pandemic and complement findings reported overseas.

scholarly journals Long-term trends of hospital admissions among patients with cancer following the 2015 earthquake: a single institution observational study in Kathmandu, Nepal

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026746 ◽  
Author(s):  
Anup Uprety ◽  
Akihiko Ozaki ◽  
Asaka Higuchi ◽  
Bikal Ghimire ◽  
Toyoaki Sawano ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Low Income ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Patients With Cancer ◽  
Nepal Earthquake ◽  
Patient Admissions ◽  
The Impact ◽  
2015 Nepal Earthquake

ObjectivesLittle is known regarding how natural disasters affect patients with cancer in low-income and middle-income countries. The objective of the present study was to assess the impact of the 2015 Nepal earthquake on the admission of patients with cancer at a core medical institution in Kathmandu.Design, setting and participantsWe considered all 3520 cancer patient admissions to Tribhuvan University Teaching Hospital, from 25 April 2013 to 24 April 2017 (2 years before and 2 years after the earthquake).Outcome measuresThe number of cancer patient admissions was calculated for each month. Using a negative binomial model, we estimated the incidence rate ratio (IRR) for admission numbers each month after the earthquake compared with the pre-earthquake baseline and investigated chronological change.ResultsThe total admission number in the first month after the earthquake was decreased compared with that of the predisaster baseline (IRR=0.66, 95% CI 0.43 to 1.00), which largely reflected decreased admissions of patients from outside of the most disaster-affected districts. From the second month, the admission number consistently exceeded the predisaster baseline for the remaining postdisaster period. In contrast to the month of the disaster, the continuation of increased admissions was most prominent among those from outside of the most affected districts.ConclusionsAfter a transient decrease immediately following the 2015 Nepal earthquake, there was a long-term increase in cancer patient admissions in a core hospital in Kathmandu. These changes were seen most prominently in patients from outside the most disaster affected areas.

scholarly journals Unpredictable Fall of Severe Emergent Cardiovascular Diseases Hospital Admissions During the COVID‐19 Pandemic: Experience of a Single Large Center in Northern Italy

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Mauro Toniolo ◽  
Francesco Negri ◽  
Marco Antonutti ◽  
Marco Masè ◽  
Domenico Facchin
Keyword(s):  
Cardiovascular Diseases ◽  
Acute Coronary Syndromes ◽  
Hospital Admissions ◽  
Early Recognition ◽  
Time Frame ◽  
Northern Italy ◽  
University Hospital ◽  
Tertiary Referral Center ◽  
Coronary Syndromes ◽  
The Impact

Background Northern Italy is one of the epicenters of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV 2) pandemic in Europe. The impact of the pandemic and the consequent lockdown on medical emergencies other than those SARS‐CoV 2 pandemic related is largely unknown. The aim of this study was to analyze the epidemiologic impact of coronavirus disease 2019 pandemic on hospital admission for severe emergent cardiovascular diseases ( SECD s) in a single Northern Italy large tertiary referral center. Methods and Results We quantified SECD s admissions to the Cardiology Division of Udine University Hospital between March 1, 2020 and March 31, 2020 and compared them with those of the same time frame during 2019. Compared with March 2019, we observed a significant reduction in all SECD s admissions: −30% for ST ‐segment–elevation acute coronary syndromes, −66% for non‐ ST ‐segment–elevation acute coronary syndromes and −50% for severe bradyarrhythmia. Conclusions A significant decrease in all SECD s admissions has been observed during the SARS‐CoV 2. pandemic and was unlikely caused by a reduction in the incidence of cardiovascular diseases. Fear of contagion may have contributed to the unpredictable drop of SECD s. Social education about early recognition of symptoms of life‐threatening cardiac conditions requiring appropriate care in a timely fashion may help to reduce this counterproductive phenomenon.

scholarly journals The bimodal rise and fall acute coronary syndromes curves paralleling COVID-19 outbreaks

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Trabattoni ◽  
G Teruzzi ◽  
P M Ravagnani ◽  
G Santagostino Baldi ◽  
P Montorsi ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Acute Coronary Syndromes ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Nasopharyngeal Swab ◽  
Admission Rates ◽  
Coronary Syndromes ◽  
The Impact

Abstract Introduction Preliminary reports from the early phase of COVID-19 epidemic in Italy reported a dramatic reduction in hospital admission rates for acute coronary syndromes (ACS) coupled with longer times from symptoms onset to hospital presentation. Purpose To assess the impact of COVID-19 on hospital admission rates and ACS patterns, as well as time to presentation and clinical outcomes, following the acute pandemic phase in 2020 compared to previous year. Methods We conducted a single institution retrospective analysis conducted in a cardiovascular hub serving a large metropolitan area in Italy. Number and monthly distribution of hospital admissions for ACS from January 1 to December 31, 2020 were compared to the respective figures in 2019. Baseline clinical features, time from symptoms onset to hospital admission and main clinical outcomes were collected. Results A total of 599 ACS cases were recorded in 2020 vs. 386 cases in 2019, with a net 55% increase. ACS presentation rate in 2020 showed a bimodal pattern, paralleling the most contagious outbreak periods (Figure 1). SARS-CoB-2 nasopharyngeal swab or specific antibody tests were positive in 34 (5.7%) patients. Time from symptoms onset to hospital presentation tended to be longer in 2020 than in 2019, being two-fold longer during the peak epidemic phase (February 21-May 3, 2020; median time 2.0 vs. 5.0 hours, p=0.030). The proportion of late-presenting STEMI (&gt;8 hrs from symptoms onset) was higher in 2020 compared to 2019 (30% vs. 18%, p=0.003),as well as higher was in-hospital mortality (15% in 2020 vs 6% in 2019, p=0.001), partly due to a three-fold increase in cardiogenic shock on ACS presentation. Conclusions ACS admission rate significantly increased during the 2020 COVID-19 epidemic outbreak for several reasons only partially explained by a SARS-CoV-2 infection trigger effect on ACS. Longer presentation times and higher rates of cardiogenic shock and mortality were observed, urging the need health-care systems to keep a high priority on cardiovascular emergencies response networks. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

Abstract 14881: Impact of a Large-scale Telemedicine Network on Emergency Visits and Hospital Admissions During the Covid-19 Pandemic in Brazil: Data From the UNIMED-BH System

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bruno R Nascimento ◽  
Ana Cristina T Castro ◽  
Luiz Eduardo V Fróes ◽  
Antonio L Ribeiro ◽  
Cynthia B Araújo ◽  
...  
Keyword(s):  
Large Scale ◽  
Hospital Admissions ◽  
Positive Impact ◽  
Diagnosis Related Groups ◽  
Mobile App ◽  
Multiple Systems ◽  
Phone Calls ◽  
Surge Control ◽  
Coronary Syndromes ◽  
The Impact

Introduction: A strategy for healthcare surge control in the Covid-19 pandemic is forward triage by on-demand telemedicine (TM), implemented by several providers. We aimed to evaluate the impact of a large-scale Covid-19 TM system on visits to emergency medical services (EMS) and all-cause and cardiovascular (CV) hospital admissions during the pandemic in Brazil. Methods: From March 18 - May 18, 2020 we evaluated the database of UNIMED-BH, a cooperative Brazilian private health insurance, with over 1.25 million clients. The Covid-19 TM system consisted of: a) online mobile app with questions about Covid-19 symptoms, which redirects to teleconsultations in case of moderate/severe manifestations; b) telemonitoring system, with regular phone calls to all clients with reported flu-like symptoms or Covid-19 diagnosis, to monitor disease progression; c) 24/7 emergency call and ambulance system (GMOV), with VOIP triage and counselling by 2 physicians: calls with suspected Covid-19 or respiratory abnormalities were computed. EMS visits and admissions in all accredited hospitals were recorded, with diagnoses assessed by the Diagnosis Related Groups (DRG) method. Covid-19 lab diagnosis and deaths were identified from the patients’ registries, and outcomes assessed until June 1 st . Results: In 60 days, 24,351 patients (1.9% of clients) accessed one of the TM systems, 59% women, median age was 35±18 years. The most frequently utilized system was telemonitoring (16,717, 69%), followed by teleconsultation (13,350, 55%) and GMOV (683, 3%); 6,330 patients accessed multiple systems. The rates of EMS and hospital admissions for each system were: telemonitoring 19.7% (3,296) and 4.6% (774); teleconsultation 17.3% (2,312) and 2.3% (311) and GMOV: 55.9% (382) and 56.2% (384) patients. At total 4.1% (996) had at least 1 hospital admission, 32% (321) with respiratory diseases (41 requiring mechanical ventilation) and 5.6% (56) with CV diagnoses (12 acute coronary syndromes). Overall, 277 (1.1%) patients had confirmed Covid-19 diagnosis, and 160 (0.7%) died, 9 with Covid-19. Conclusion: The TM system resulted in low rates of EMS visits and hospital admissions, suggesting a positive impact on healthcare utilization. The percent of admissions due to CV causes was low.

scholarly journals Reduction of Emergency Calls and Hospitalizations for Cardiac Causes: Effects of Covid-19 Pandemic and Lockdown in Tuscany Region

2021 ◽  
Vol 8 ◽  
Author(s):  
Flavio D'Ascenzi ◽  
Matteo Cameli ◽  
Silvia Forni ◽  
Fabrizio Gemmi ◽  
Claudia Szasz ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Public Information ◽  
First Trimester ◽  
Medical System ◽  
Maximum Difference ◽  
Information Strategies ◽  
Relevant Role ◽  
Containment Measures ◽  
Coronary Syndromes ◽  
The Impact

Introduction: Containment measures were established to flatten the curve of COVID-19 contagion in order to avoid a crash of the healthcare system. However, these measures influenced the rate of hospitalization of cardiac patients. In this study, we aimed to analyse the impact of COVID-19 and the effects of lockdown measures on hospital admissions and alerts of emergency medical system (EMS) for cardiac causes in the Tuscany region.Methods: An observational, retrospective analysis from Italian Tuscany region was conducted. We evaluated consecutive patients contacting EMS or admitted to the 39 Emergency Departments (EDs) in Tuscany for cardiac causes in the first trimester of 2020. Data were compared with the same period in 2018/19.Results: The alerts of EMS for cardiac causes significantly decrease in 2020 and the highest difference between 2018/19 and 2020 was found immediately after national lockdown (Δ = −47.4%, p &lt; 0.001). The number of admissions for chest pain in the EDs also decreased, with a maximum difference of −67.6% (p &lt; 0.001) vs. 2018/19. The number of hospital accesses for acute coronary syndromes, atrial fibrillation, and heart failure in the EDs significantly decreased in 2020 as compared to 2018/19 (maximum Δ = −58.9%, p &lt; 0.001; maximum Δ = −63.0%, p &lt; 0.001; maximum Δ = −72.7%, p &lt; 0.001, respectively).Conclusions: A significant decrease in the contacts to EMS for cardiac causes and in cardiac diagnoses was observed during the first trimester of 2020. Fear of contagion has likely played a relevant role. The lesson learnt from first wave of COVID-19 pandemic suggests that appropriate public information strategies and re-education of people are essential.

scholarly journals Impact of coronavirus disease 19 (COVID 19) pandemic on acute coronary syndrome (ACS) hospitalizations, and related invasive procedures

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
L Simoni ◽  
I Alimehmeti ◽  
A Ceka ◽  
E Tafaj ◽  
M Gina ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Admissions ◽  
St Elevation Myocardial Infarction ◽  
Invasive Procedures ◽  
Coronary Syndrome ◽  
Funding Sources ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Revascularization Procedures ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background   Reports from countries affected by the COVID 19 pandemic demonstrate a reduction in ACS hospitalizations and invasive procedures. Purpose We aimed to investigate the impact of the COVID 19 pandemic on ACS patient hospitalizations and related invasive procedures in a country with low COVID 19 incidence and without changes in Cardiology hospital services. Methods We conducted a retrograde study collecting data for ACS hospitalizations including ST elevation myocardial infarction (STEMI), non- ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) and related invasive and revascularization procedures from March 9th 2020 (first COVID 19 case in our country) to April 30th (period of total lockdown) compared with the same period of 2019 in our center. Results Hospital admissions for ACS declined during 2020 (COVID 19 period) from a total of 550 patients in 2019 to 321 patients hospitalization in 2020 representing a 41.6% reduction (p &lt; 0.001). The reduction was observed for all types of ACS, the greatest reduction was for UA 58% (p &lt; 0.001) followed by NSTEMI 32% (p &lt; 0.001) and for STEMI 28% reduction (p &lt; 0.009). Compared to 2019 the proportion of patients presented with STEMI was higher in 2020 (48.6% vs 39.5% p = 0.01) and lower with UA (43.3% vs 31.5% p = 0.0002) Reduction was observed also in coronary angiography by 43% (p &lt; 0.001) and in percutaneous coronary interventions with 42% (p &lt; 0.001). Compared to 2019 the proportion of patients with 3 vessels coronary disease(CAD)and left main (LM) was higher during COVID 19 pandemic,  respectively 33% vs 40% p = 0.032 and 8% vs 13% p = 0.046 Conclusions Hospitalizations and related invasive procedures for ACS significantly dropped during COVID 19 pandemic.  Patients admitted to hospital during pandemic presented more with STEMI and had more 3 vessels CAD and LM. Measures should be taken to ensure patients for the safety of health services and encouraged not to neglect cardiac consultations and treatments.

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