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Trends in Acute MI and Stroke in the ED During COVID-19

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Update: On July 7, we published an update to this article that found the weekly incidence of acute myocardial infarctions and stroke have returned to their near average historical trends.

As the COVID-19 pandemic continues, there are growing concerns that patients with urgent conditions are not seeking the care they need for fear of exposure to COVID-19.

Recent EHR data show that the weekly incidence of acute myocardial infarctions (AMI), commonly known as heart attacks, has decreased by 45% since the United States declared a national emergency for COVID-19 on March 13, 2020. Similarly, the weekly incidence of strokes decreased by 38% relative to the average number of strokes prior to March 13, 2020.

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This sample includes data aggregated from electronic medical records at 22 health systems in the United States, spanning 17 states and covering 7 million patients. These data were used to examine the yearly trend in emergency department (ED) visits from April 2, 2019 – April 7, 2020.

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Further investigation is necessary to determine the expected number of AMI and stroke events that occurred during COVID-19, given the large-scale lifestyle changes associated with social distancing.

It is not yet clear whether there are actually fewer people experiencing AMIs and strokes, or whether fewer patients are seeking care due to fear of COVID-19 exposure. Policy makers and clinicians may find this information useful as they continue working to understand the broader impact of the pandemic.

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