Alexander Kagan, Donna R Zwas, Ziona Haklai, Hagai Levine
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Acute coronary syndrome rates by age and sex before and during the COVID-19 pandemic in Israel: nationwide study
Background There have been reports of sharp declines in acute coronary syndrome (ACS) during the COVID-19 pandemic. The study aims to assess nationwide ACS emergency department (ED) visit rates across age and sex subgroups and the general population, with a comparison before and throughout the pandemic’s various phases. Methods A multiple interrupted time series analysis was used to assess 61 349 ACS nationwide hospital visits from January 2018 to December 2021 at monthly intervals. The study period was divided into three periods: January 2018–February 2020 (pre-pandemic period); March 2020–January 2021 (early-pandemic period); February 2021–December 2021 (late-pandemic period). Segmented regression with a seasonally adjusted autoregressive moving average structure was used to build predictive models with an estimated reference trendline (counterfactual). Results Over 11 months of the early-pandemic period (lockdowns), the largest decrease in visits was seen in women aged 65 and above, of 18.4% [incidence rate ratio (IRR) 0.82; 95% confidence interval (CI) 0.77–0.86]. The lowest decrease was observed in men aged 25–64, of 7.2% (IRR 0.93; 0.91–0.94). During the late-pandemic period, which included high vaccination coverage and no lockdowns, the largest further decrease was in women aged 25–64 of 20.1% (IRR 0.80; 0.75–0.84) on average. Conclusions The pandemic influenced ACS ED visits variably, with substantial declines during phases of high COVID-19 morbidity and mortality. Older individuals, particularly women, demonstrated the largest decrease in ACS ED visits, highlighting the need for tailored public health strategies to maintain public confidence in access to critical care during future health emergencies.
期刊介绍:
The International Journal of Epidemiology is a vital resource for individuals seeking to stay updated on the latest advancements and emerging trends in the field of epidemiology worldwide.
The journal fosters communication among researchers, educators, and practitioners involved in the study, teaching, and application of epidemiology pertaining to both communicable and non-communicable diseases. It also includes research on health services and medical care.
Furthermore, the journal presents new methodologies in epidemiology and statistics, catering to professionals working in social and preventive medicine. Published six times a year, the International Journal of Epidemiology provides a comprehensive platform for the analysis of data.
Overall, this journal is an indispensable tool for staying informed and connected within the dynamic realm of epidemiology.