@article{discovery10116853,
            year = {2020},
          volume = {9},
           month = {November},
         journal = {Journal of the American Heart Association},
          number = {22},
           title = {Impact of Coronavirus Disease 2019 Pandemic on the Incidence and Management of Out-of-Hospital Cardiac Arrest in Patients Presenting With Acute Myocardial Infarction in England},
            note = {Copyright {\copyright} 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.},
             url = {https://doi.org/10.1161/JAHA.120.018379},
          author = {Rashid, M and Gale, CP and Curzen, N and Ludman, P and De Belder, M and Timmis, A and Mohamed, MO and L{\"u}scher, TF and Hains, J and Wu, J and Shoaib, A and Kontopantelis, E and Roebuck, C and Denwood, T and Deanfield, J and Mamas, MA},
        abstract = {Background: Studies have reported significant reduction in acute myocardial infarction-related hospitalizations during the coronavirus disease 2019 (COVID-19) pandemic. However, whether these trends are associated with increased incidence of out-of-hospital cardiac arrest (OHCA) in this population is unknown. /

Methods and Results: Acute myocardial infarction hospitalizations with OHCA during the COVID-19 period (February 1-May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre-COVID-19 period (February 1-May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID-19 period were reduced by {\ensuremath{>}}50\% (n=20 310 versus n=9325). OHCA was more prevalent during the COVID-19 period compared with the pre-COVID-19 period (5.6\% versus 3.6\%), with a 56\% increase in the incidence of OHCA (incidence rate ratio, 1.56; 95\% CI, 1.39-1.74). Patients experiencing OHCA during COVID-19 period were likely to be older, likely to be women, likely to be of Asian ethnicity, and more likely to present with ST-segment-elevation myocardial infarction. The overall rates of invasive coronary angiography (58.4\% versus 71.6\%; P{\ensuremath{<}}0.001) were significantly lower among the OHCA group during COVID-19 period with increased time to reperfusion (mean, 2.1 versus 1.1 hours; P=0.05) in those with ST-segment-elevation myocardial infarction. The adjusted in-hospital mortality probability increased from 27.7\% in February 2020 to 35.8\% in May 2020 in the COVID-19 group (P{\ensuremath{<}}.001). /

Conclusions: In this national cohort of hospitalized patients with acute myocardial infarction, we observed a significant increase in incidence of OHCA during COVID-19 period paralleled with reduced access to guideline-recommended care and increased in-hospital mortality.},
        keywords = {acute myocardial infarction, coronavirus disease 2019, incidence, mortality, out-of-hospital cardiac arrest}
}