Return towards normality in admissions for myocardial infarction after the lockdown removal for COVID-19 outbreak in Italy

Andrea Rognoni, Fabrizio D'Ascenzo, Martina Solli, Marco G. Mennuni, Vincenzo Galiffa, Roberta Rosso, Chiara Cavallino, Fabrizio Ugo, Ovidio De Filippo, Andrea Borin, Italo Porto, Francesco Fedele, Massimo Mancone, Gennaro Sardella, Daniela Trabattoni, Umberto Barbero, Cinzia Moncalvo, Roberto Verardi, Gianni Casella, Claudio MontaltoSergio Leonardi, Danila Azzolina, Gaetano Maria De Ferrari, Giuseppe Patti

Research output: Contribution to journalArticlepeer-review


Background: Investigations demonstrated a decrease of admissions for myocardial infarction (MI) during the CoronaVirus Disease-19 (COVID-19) outbreak. No study has evaluated the time required to reverse this downward curve of MI admissions. Methods: This is a retrospective analysis on patients (N = 2415) admitted to the Emergency Departments for acute MI in nine Italian centers. Primary endpoint was the incidence rates (IRs) of MI admissions in the post-lockdown COVID-19 period (case-period: from May 4 to July 12, 2020) vs. the following control periods: January 1–February 19, 2020 (pre-lockdown period); February 20–May 3, 2020 (intra-lockdown period); May 4–July 12, 2019 (inter-year non-COVID-19 period). Results: IR of admissions for MI in the post-lockdown period was higher than the intra-lockdown period (IR ratio, IRR: 1.60, 95% CI 1.42–1.81; p = 0.0001), was lower than the pre-lockdown period (IRR: 0.86, 0.77–0.96; p = 0.009) and similar to the inter-year non-COVID-19 period (IRR: 0.96, 0.87–1.07; p = 0.47). Within the case period, the increase in MI admissions was more pronounced in earlier vs later weeks (IRR 1.19, 95% CI 1.02–1.38, p = 0.024) and, compared to the inter-year control period, was significant for non ST-segment elevation MI (IRR: 1.25, 95% CI 1.08–1.46, p = 0.004), but was not observed for ST-segment elevation MI (STEMI), where hospitalizations were reduced (IRR 0.76, 95% CI 0.65–0.88, p = 0.0001). Conclusions: Our study first indicates an increase in the number of admissions for MI after the removal of the national lockdown for COVID-19 in Italy. This increase was prevalent in the first weeks following the lockdown removal, but was under-represented in STEMI patients.

Original languageEnglish
Pages (from-to)235-237
Number of pages3
JournalInternational Journal of Cardiology
Publication statusPublished - Jun 1 2021


  • COVID-19
  • Hospitalizations
  • Myocardial infarction
  • Viral pandemic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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