Background

The coronavirus disease 2019 (COVID-19) pandemic and the national lockdown have led to significant changes in the use of emergency care by the French population.

Aims

To describe the national and regional temporal trends in emergency department (ED) admissions for myocardial infarction (MI) and stroke, before, during and after the first national lockdown.

Methods

The weekly numbers of ED admissions for MI and stroke were collected from the OSCOUR® network, which covers 93.3% of all ED admissions in France. National and regional incidence rate ratios from 02 February until 31 May (2020 versus 2017–2019) were estimated using Poisson regression for MI and stroke, before, during and after lockdown.

Results

A decrease in ED admissions was observed for MI (–20% for ST-segment elevation MI and–25% for non-ST-segment elevation MI) and stroke (–18% for ischaemic and–22% for haemorrhagic) during the lockdown. The decrease became significant earlier for stroke than for MI. No compensatory increase in ED admissions was observed at the end of the lockdown for these diseases. Important regional disparities in ED admissions were observed, without correlation with the regional levels of COVID-19 cases. The impact of lockdown on ED admissions was particularly significant in six regions (Ile-de France, Occitanie, Provence-Alpes-Côte d’Azur, Nouvelle Aquitaine, Hauts-de-France and Bretagne).

Conclusions

The decrease in ED admissions for MI and stroke observed during the lockdown was probably caused by fear of COVID-19 and augmented by the lockdown, and was heterogeneous across the French territory. ED admissions were slow to return to the usual levels from previous years, without a compensatory increase. These results underline the need to reinforce messages directed at the population to encourage them to seek care without delay in case of cardiovascular symptoms.

中文翻译：

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第一波 COVID-19 大流行期间法国因心肌梗死和中风急诊入院：国家时间趋势和地区差异

背景

2019 年冠状病毒病 (COVID-19) 大流行和全国封锁导致法国民众对急救服务的使用发生重大变化。

宗旨

描述第一次全国封锁之前、期间和之后急诊科 (ED) 因心肌梗死 (MI) 和中风而入院的国家和地区时间趋势。

方法

从 OSCOUR® 网络收集每周因 MI 和中风入院的 ED 人数，该网络覆盖法国所有 ED 入院人数的 93.3%。2 月 2 日至 5 月 31 日（2020 年与 2017-2019 年）的国家和地区发病率比率是使用泊松回归估计锁定前、锁定期间和锁定后的 MI 和中风的。

结果

在锁定期间观察到 MI（ST 段抬高 MI 为 –20%，非 ST 段抬高 MI 为 –25%）和中风（缺血性为 –18%，出血性为 –22%）的急诊入院率下降. 中风的下降比 MI 更早。在这些疾病的封锁结束时，没有观察到急诊室入院人数的补偿性增加。观察到急诊室入院的重要区域差异，与 COVID-19 病例的区域水平无关。封锁对 ED 入学的影响在六个地区（法兰西岛、奥克西塔尼、普罗旺斯-阿尔卑斯-蓝色海岸、新阿基坦、上法兰西和布列塔尼）尤为显着。

结论

在封锁期间观察到的 MI 和中风的 ED 入院人数减少可能是由于对 COVID-19 的恐惧引起的，并因封锁而加剧，并且在法国境内是异质的。急诊室收治率缓慢恢复到前几年的正常水平，没有补偿性增加。这些结果强调需要加强针对人群的信息，以鼓励他们在出现心血管症状时立即就医。