Pattern of acute MI admissions in India during COVID-19 era: a Cardiological Society of India study - Rationale and Design

Ramakrishnan, Sivasubramanian; Jabir, Abdullakutty; Jayagopal, Pathiyil Balagopalan; Mohanan, Padinhare Purayil; Nair, Venugopal Krishnan; Das, Mrinal Kanti; Mandal, Manoranjan; Roy, Debabrata; Reddy, Seemala Saikrishna; Malviya, Amit; Singh, Bateshwar Prasad; Bharti, Bishwa Bhushan; Majumder, Biswajit; Karunadas, Chakkalakkal Prabhakaran; Meena, Chandra Bhan; Girish, Meennahalli Palleda; Ezhilan, Janakiraman; Tummala, Karthik; Katyal, Virender Kumar; Subramanyam, Kodangala; Goyal, Krishna Kishore; Kenchappa, Kumar; Gupta, Mohit Dayal; Hanumanthappa, Natesh Bangalore; Bardoloi, Neil; Modi, Nitin; Bhattacharyya, Pranab Jyoti; Gadkari, Pushkraj; Patil, Rahul Raosaheb; Murty, Rambhatla Suryanarayana; Baruah, Rituparna; Krishnappa, Santhosh; Kumar, Satish; Routray, Satyanarayan; Tewari, Satyendra; Gupta, Shashi Bhushan; Maduramuthu, Sivabalan; Yerram, Sreekanth; Kumar, Sudeep; Jadhav, Uday; Manjunath, Cholenahally Nanjappa; Prabhakaran, Dorairaj; Kerker, Prafulla; Yadav, Rakesh; Guha, Santanu; Deb, Pradip Kumar; Zachariah, Geevar

BACKGROUND: COVID-19 pandemic has affected around 20million patients worldwide and 2.0 million cases from India. The lockdown was employed to delay the pandemic. However, it had an unintentional impact on acute cardiovascular care, especially acute myocardial infarction (AMI). Observational studies have shown a decrease in hospital admissions for AMI in several developed countries during the pandemic period.We aimed to evaluate the impact of COVID-19 on the AMI admissions patterns across India. METHODS: In this multicentric, retrospective, cross-sectional study, we included all AMI cases admitted to participating hospitals during the study period 15(th) March to 15(th) June 2020 and compared them using a historical control of all cases of AMI admitted during the corresponding period in the year 2019. Major objective of the study is to analyze the changes inthe number of hospital admissions for AMI in hospitals across India. In addition, we intend to evaluate the impact of COVID-19 on the weekly AMI admission rates, and other performance measures like rates of thrombolysis/primary percutaneous interventions (PCI), window period, door to balloon time, and door to needle time. Other objectives include evaluation of changes in the major complications and mortality rates of AMI and its predictors during COVID-19 pandemic. CONCLUSIONS: This CSI-AMI study will provide scientific evidence about the impact of COVID-19 on AMI care in India. Based on this study, we may be able to suggest appropriate changes to the existing MI guidelines and to educate the public regarding emergency care for AMI during COVID-19 pandemic.