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Return to Near Average Number of ED Visits for Acute MI and Strokes 12 Weeks Post COVID-19 Emergency Declaration

  • Jeff Trinkl, MD
  • J. Owen Sizemore, PhD
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When the COVID-19 outbreak first emerged, there was concern that patients with urgent conditions would not seek care in emergency departments for fear of exposure to COVID-19. On May 14, 2020, we published a study1 showing that the weekly incidence of AMIs, commonly known as heart attacks, and strokes decreased by 45% and 38% respectively when compared to historical averages prior to March 13, 2020, the day a national emergency for COVID-19 was issued. In this brief, we tracked the incidence of these two conditions in the ED for an additional 9 weeks and found a dramatic return to near normal levels.


EHR data from ED visits occurring between the weeks of April 7, 2020 and May 31, 2020 show the weekly incidence of acute myocardial infarctions has returned to approximately 92% of the historical trend prior to March 13, 2020. Similarly, the incidence of stroke has returned to approximately 87% of the historical trend.

Our previous report showed a drastic decrease in the number of ED visits for AMI and stroke. At the lowest point, in late March to early April, the incidence of these conditions was down by 45% for AMIs and 38% for strokes. In this brief, we see a dramatic increase back toward their historical trends. We previously speculated that the decreased incidence could reflect fewer people experiencing AMIs and strokes, or it may represent fewer patients seeking care due to fear of COVID-19 exposure. The current data seems to indicate that patients were not seeking care for AMI and stroke initially, but have returned to seek care for such conditions now.

This sample includes data aggregated from electronic medical records at 27 health systems in the United States, spanning 16 states and covering 3.2 million patients. These data were used to examine the yearly trend in emergency department (ED) visits between the weeks of April 7, 2019 and May 31, 2020.

1. Trends In Acute MI And Stroke In The ED During COVID-19. Epic Health Research Network. May 14, 2020. https://ehrn.org/trends-in-acute-mi-and-stroke-in-the-ed-during-covid-19

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