Sex-stratified patterns of emergency cardiovascular admissions prior and during the COVID-19 pandemic

Piotr Gajewski*, Mikołaj Błaziak, Szymon Urban, Mateusz Garus, Frieder Braunschweig, Daniel Caldeira, Antoni Gawor, John P. Greenwood, Mateusz Guzik, Frank R. Halfwerk, Gracjan Iwanek, Michał Jarocki, Maksym Jura, Małgorzata Krzystek-Korpacka, Łukasz Lewandowski, Lars H. Lund, Michał Matysiak, Fausto Pinto, Jakub Sleziak, Weronika WietrzykMateusz Sokolski, Jan Biegus, Piotr Ponikowski, Robert Zymliński

*Corresponding author for this work

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The COVID-19 pandemic has had a significant impact on global public health, with long-term consequences that are still largely unknown. This study aimed to assess the data regarding acute cardiovascular hospital admissions in five European centers before and during the pandemic. A multicenter, multinational observational registry was created, comparing admissions to the emergency departments during a 3-months period in 2020 (during the pandemic) with the corresponding period in 2019 (pre-pandemic). Data on patient demographics, COVID-19 test results, primary diagnosis, comorbidities, heart failure profile, medication use, and laboratory results were collected. A total of 8778 patients were included in the analysis, with 4447 patients in 2019 and 4331 patients in 2020. The results showed significant differences in the distribution of cardiovascular diseases between the two years. The frequency of pulmonary embolism (PE) increased in 2020 compared to 2019, while acute heart failure (AHF) and other cardiovascular diseases decreased. The odds of PE incidence among hospitalized patients in 2020 were 1.316-fold greater than in 2019. The incidence of AHF was 50.83% less likely to be observed in 2020, and the odds for other cardiovascular diseases increased by 17.42% between the 2 years. Regarding acute coronary syndrome (ACS), the distribution of its types differed between 2019 and 2020, with an increase in the odds of ST-segment elevation myocardial infarction (STEMI) in 2020. Stratification based on sex revealed further insights. Among men, the incidence of AHF decreased in 2020, while other cardiovascular diseases increased. In women, only the incidence of STEMI showed a significant increase. When analyzing the influence of SARS-CoV-2 infection, COVID-positive patients had a higher incidence of PE compared to COVID-negative patients. COVID-positive patients with ACS also exhibited symptoms of heart failure more frequently than COVID-negative patients. These findings provide valuable information on the impact of the COVID-19 pandemic on acute cardiovascular hospital admissions. The increased incidence of PE and changes in the distribution of other cardiovascular diseases highlight the importance of monitoring and managing cardiovascular health during and post pandemic period. The differences observed between sexes emphasize the need for further research to understand potential sex-specific effects of COVID-19 on cardiovascular outcomes.

Original languageEnglish
Article number17924
Number of pages14
JournalScientific reports
Issue number1
Publication statusE-pub ahead of print/First online - 20 Oct 2023
Externally publishedYes


  • Acute coronary syndromes
  • Cardiology
  • Heart failure
  • Medical research


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  • Impact of coronavirus disease 2019 (COVID-19) outbreak on acute admissions at the emergency and cardiology departments across Europe

    Sokolski, M., Gajewski, P., Zymliński, R., Biegus, J., Berg, J. M. T., Bor, W., Braunschweig, F., Caldeira, D., Cuculi, F., D'elia, E., Edes, I. F., Garus, M., Greenwood, J. P., Halfwerk, F. R., Hindricks, G., Knuuti, J., Kristensen, S. D., Landmesser, U., Lund, L. H., Lyon, A., & 20 othersMebazaa, A., Merkely, B., Nawrocka-Millward, S., Pinto, F. J., Ruschitzka, F., Semedo, E., Senni, M., Sepehri Shamloo, A., Sorensen, J., Stengaard, C., Thiele, H., Toggweiler, S., Tukiendorf, A., Verhorst, P. M. J., Wright, D. J., Zamorano, P., Zuber, M., Narula, J., Bax, J. J. & Ponikowski, P., 1 Apr 2021, In: American Journal of Medicine. 134, 4, p. 482-489 8 p.

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