The number of heart attack patients seeking urgent hospital care has dropped by more than 50% worldwide during the COVID-19 outbreak, according to a survey by the European Society of Cardiology (ESC).
The survey of 3,101 healthcare professionals in 141 countries was conducted in mid-April.The findings are published in European Heart Journal — Quality of Care and Clinical Outcomes.
“This is the strongest evidence yet of the collateral damage caused by the pandemic. Fear of catching the coronavirus means even people in the midst of a life-threatening heart attack are too afraid to go to hospital for life-saving treatment,” said ESC president Barbara Casadei in a news release. “There has been a lack of public reassurance that every effort has been made to provide clean hospital areas for non-COVID-19 patients.
“Yet the risk of dying of a heart attack is much greater than that of dying of COVID-19,” Casadei added. “Moreover, cardiac death is largely preventable if patients with a heart attack come to hospital in time to get treatment. What we are witnessing is an unnecessary loss of life. Our priority must be to stop this from happening. We must continue to save the lives we know how to save.”
Ischemic stroke patients are also delaying hospital treatment, according to another recent study. That study, by the Society of NeuroInterventional Surgery, found that these patients were showing up to the hospital an average of 160 minutes later during the COVID-19 pandemic than during a similar timeframe in 2019. The delay is affecting both stroke survival and recovery, according to stroke surgeons from the group.
In the most severe heart attacks, known as ST-elevation myocardial infarctions (STEMIs), a major artery to the heart becomes blocked. Urgent treatment — either with a stent or clot busting drugs — restores blood flow. Delay causes irreversible damage to the heart muscle, substantially increasing the risk of heart failure and death.
The vast majority of hospital physicians and nurses answering the ESC survey reported a drop in the number of patients with these severe heart attacks coming to hospital, compared to before the COVID-19 crisis. On average, there was a 50% decrease. In addition, most respondents said that of those patients who did go to hospital, 48% arrived later than usual and beyond the optimal window for urgent treatment.
A separate survey of interventional cardiologists found a 28% increase in life-threatening complications among patients with heart attacks during the pandemic.
Conducted by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the second poll surveyed more than 600 interventional cardiologists from 84 countries during the first two weeks of April. Nearly half of respondents said restoration of blood flow was delayed due to COVID-19 fears, a situation likely to lead to premature death and disability.