Fewer heart attacks in early lockdown

Date: 5 August 2020

Introduction: During the lockdown, 26% fewer patients were admitted to Belgian hospitals following a heart attack.

"Patients were more reluctant to go to the hospital, but on the upside, people got to unwind and relax more, resulting in fewer heart problem", says cardiologist Marc Claeys (UZA/UAntwerp).

With the coronavirus pandemic in full swing, many physicians sounded the alarm in the media: they feared that people with problems unrelated to COVID-19 would put off going to their doctor or even the emergency room out of fear of becoming infected with the virus. These physicians urged people not to postpone consultations, as this might increase the severity of their medical problems. Hard data to support this warning were not yet available at the time, however.

Prof. Marc Claeys, a cardiologist associated with UZA and the University of Antwerp, has now collected data on classic heart attacks (ST-elevation myocardial infarctions, or STEMIs) from Belgian hospitals in collaboration with the Belgian Society of Cardiology. He compared the situation in the first three weeks of lockdown (13 March – 4 April) with the same periods in 2017, 2018 and 2019.

Approperiate  care was always available

"In those three weeks, 26% fewer patients (188 compared to 254) were admitted to our hospitals following a heart attack compared to previous years", Claeys explains. "Furthermore, the number of patients who waited more than twelve hours to come to the hospital after the onset of pain doubled. About 6% did not survive the heart attack, which is comparable to the mortality rate before the COVID-19 outbreak. Some countries failed to provide approperiate care for people with serious heart problems in the midst of the crisis, but this was not the case in Belgium."

Claeys sees two reasons for the decrease. "For one thing, people may have been afraid to come to the hospital. But that fear was unjustified, as hospitals separate COVID-19 patients from other patients. Our research also shows that continuity of care was maintained, even at the peak of the crisis."

Positive effect of relaxation

A second aspect highlighted by the Antwerp-based cardiologist is the fact that patients were less exposed to triggers during the lockdown because they had to stay at home. After all, factors such as air pollution, cold and stress can provoke heart attacks. Claeys: "There was significantly less road traffic and the air was cleaner: measurements indicate that pollution was 30% lower. In particular, there was less nitrogen dioxide in the air. And we also know that relaxation and lower stress levels have positive effects on the functioning of the heart. Those are aspects we have to keep in mind, even after this crisis."

Claeys and his team are continuing to monitor the situation and aim to track the number of heart attacks throughout the course of the pandemic. The results of the research covering the first three weeks of the lockdown have been published in the peer-reviewed journal Acta Cardiologica.