Reduction of Hospitalization for Acute Myocardial Infarction in Research Institute of Cardiology(Ric), Baku, Azerbaijan in Covid-19 Pandemic

Aims: To study the impact of quarantine during COVID-19 pandemic on admission of patients with myocardial infarction to the intensive cardiac care unit (ICCU) of Research Institute of Cardiology (RIC). Methods and Results: We conducted a single-centre,observational survey to collect data on admissions for acute myocardial infarction(AMI) at ICCU RIC during strict quarantine in April-May 2020,in Baku,Azerbaijan,compared with April-May 2019. We observe 10% reduction in admission rate for AMI’s patients admitted at ICCU RIC in April-May 2020 in comparison to April-May 2019.We observed significant 40% reduction in admissions for AMI in April 2020 compared with April 2019, it also turned out to be the lowest number of ICCU admissions for AMI among all months of the last 5 years. Fatality cases of patients admitted in April-May 2020, was 70% higher than in the equivalent period of 2019. The month of May, following the month of April 2020, had the mortality rate of 26.6% among AMI patients admitted to the intensive cardiac care unit, and it was the highest mortality rate among all months in the last 5 years. During the April 2020, the first month of strict quarantine, in 86,6% (13 out of 15)of AMI patients admitted to ICCU used narcotic analgesics to relieve pain. In May, narcotic analgesics for pain relief were used in 36.6% or in 11 out of 30 patients.86,6%, the percentage of patients with AMI who received narcotic analgesics for pain relief in April 2020 was the highest among 15 months, from April 2019 to June 2020.(see table 2) Conclusion: During strict quarantine for to prevent spread of COVID-19 in April-May2020 in Azerbaijan, admissions in April for AMI at intensive care unit of Research Institute of Cardiology in Baku, Azerbaijan, were significantly reduced, fatality cases among patients admitted with AMI increased in May 2020. Perhaps some of the "missing AMIs" missed among patients with less severe pain who stay at home, who postpone seeking medical attention. This is a serious social problem, demanding attention by the scientific and healthcare communities and public regulatory system. The stringent quarantine measures required to slow the spread of coronavirus infection may increase the number of untreated patients with acute myocardial infarction and lead to increased mortality. For such patients, during a pandemic, it is necessary to develop measures to deliver of fast and high-quality medical care in full, in accordance with modern recommendations.