{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:27:22Z","timestamp":1772252842763,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T00:00:00Z","timestamp":1647129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: A decline in cardiovascular hospitalizations was observed during the initial phases of the COVID-19 pandemic. We examine the continuous effect of the COVID-19 pandemic in reducing cardiovascular hospitalization and associated mortality rates during the first year of the pandemic in Israel. Methods: We conduct a retrospective cohort study using the data of Clalit Health Services, the largest healthcare organization in Israel. We divide the Corona year into six periods (three lockdowns and three post-lockdowns) and compare the incidence rates of cardiovascular hospitalizations and 30-day all-cause mortality during each period to the previous three years. Results: The number of non-STEMI hospitalizations during the first year of the pandemic was 13.7% lower than the average of the previous three years (95% CI 11\u201317%); STEMI hospitalizations were 15.7% lower (95% CI 13\u201319%); CHF (Congestive heart failure) hospitalizations were 23.9% lower (95%, CI 21\u201327%). No significant differences in 30-day all-cause mortality rates were observed among AMI (acute myocardial infarction) patients during most of the periods, whereas the annual 30-day all-cause mortality rate among CHF patients was 23% higher. Conclusions: AMI and CHF hospitalizations were significantly lower during the first year of the pandemic relative to 2017\u20139. Mortality rates were higher in the case of CHF patients but not in the case of AMI patients, possibly due to a change in the clinical acuity of patients arriving at the hospitals. We conclude that targeted public health messaging should be implemented together with proactive monitoring, in order to identify residual disability in patients who may have received non-optimal treatment during the pandemic.<\/jats:p>","DOI":"10.3390\/jcm11061577","type":"journal-article","created":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T22:29:43Z","timestamp":1647210583000},"page":"1577","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Continuous Decline in Myocardial Infarction and Heart Failure Hospitalizations during the First 12 Months of the COVID-19 Pandemic in Israel"],"prefix":"10.3390","volume":"11","author":[{"given":"Gil","family":"Lavie","sequence":"first","affiliation":[{"name":"Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine, Technion\u2014Israel Institute of Technology, Haifa 31096, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Wolff Sagy","sequence":"additional","affiliation":[{"name":"Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moshe","family":"Hoshen","sequence":"additional","affiliation":[{"name":"Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid","family":"Saliba","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine, Technion\u2014Israel Institute of Technology, Haifa 31096, Israel"},{"name":"Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa 3436212, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moshe Y.","family":"Flugelman","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine, Technion\u2014Israel Institute of Technology, Haifa 31096, Israel"},{"name":"Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa 3436212, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1056\/NEJMc2015630","article-title":"The COVID-19 Pandemic and the Incidence of Acute Myocardial infarction","volume":"383","author":"Solomon","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","unstructured":"(2022, March 10). Infarction. Available online: https:\/\/www.who.int\/news\/item\/01-06-2020-covid-19-significantly-impacts-health-services-for-noncommunicable-diseases."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1093\/ehjqcco\/qcaa046","article-title":"Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: A survey by the European Society of Cardiology","volume":"6","author":"Camm","year":"2020","journal-title":"Guilherme Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1056\/NEJMc2009166","article-title":"Reduced Rate of Hospital Admissions for ACS during COVID-19 Outbreak in Northern Italy","volume":"383","author":"Angelini","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4182","DOI":"10.1002\/ehf2.13043","article-title":"Reduction in heart failure hospitalization rate during coronavirus disease 19 pandemic outbreak","volume":"7","author":"Severino","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lavie, G., Battat, E., Saliba, W., and Flugelman, M.Y. (2021). Change in hospitalizations and 30-day mortality of patients with acute myocardial infarction during the first COVID-19 lockdown\u2014A pure social isolation effect?. Cardiovasc. Revasc. Med.","DOI":"10.1016\/j.carrev.2021.08.025"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S0140-6736(20)31356-8","article-title":"COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England","volume":"396","author":"Mafham","year":"2020","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1016\/j.jacc.2020.12.039","article-title":"Second Decline in Admissions With Heart Failure and Myocardial Infarction During the COVID-19 Pandemic","volume":"77","author":"Wu","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1001\/jama.2021.8414","article-title":"Changes in Patterns of Hospital Visits for Acute Myocardial Infarction or Ischemic Stroke During COVID-19 Surges","volume":"326","author":"Solomon","year":"2021","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ahj.2021.07.001","article-title":"Nationwide cardiovascular disease admission rates during a second COVID-19 lockdown","volume":"241","author":"Christensen","year":"2021","journal-title":"Am. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/joim.13206","article-title":"The association of mode of location activity and mobility with acute coronary syndrome: A nationwide ecological study","volume":"289","author":"Mohammad","year":"2021","journal-title":"J. Int. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.ijcard.2021.10.156","article-title":"Worldwide differences of hospitalization for ST-segment elevation myocardial infarction during COVID-19: A systematic review and meta-analysis","volume":"347","author":"Sofi","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Wong, E., Rosamond, W., Patel, M.D., and Waller, A.E. (2021). Statewide declines in myocardial infarction and stroke emergency department visits during COVID-19 restrictions in North Carolina. Am. J. Emerg. Med.","DOI":"10.1161\/circ.143.suppl_1.045"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jacc.2020.05.038","article-title":"Fewer Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic","volume":"76","author":"Bhatt","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1001\/jamainternmed.2020.3288","article-title":"Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US","volume":"180","author":"Jeffery","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ahj.2020.09.005","article-title":"Internet search volume for chest pain during the COVID-19 pandemic","volume":"231","author":"Ciofani","year":"2021","journal-title":"Am. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.15585\/mmwr.mm6936a4","article-title":"Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns\u2014United States, June 2020","volume":"69","author":"Czeisler","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ijcard.2021.12.042","article-title":"Patients hospitalised with heart failure across different waves of the COVID-19 pandemic show consistent clinical characteristics and outcomes","volume":"350","author":"Rind","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ijcard.2021.03.063","article-title":"Impact of COVID-19 pandemic and infection on in hospital survival for patients presenting with acute coronary syndromes: A multicenter registry","volume":"332","author":"Borin","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/ehjqcco\/qcab021","article-title":"The association between cardiovascular disease admission rates and the coronavirus disease 2019 lockdown and reopening of a nation: A Danish nationwide cohort study","volume":"8","author":"Butt","year":"2022","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1093\/ehjqcco\/qcab040","article-title":"Substantial decline in hospital admissions for heart failure accompanied by increased community mortality during COVID-19 pandemic","volume":"7","author":"Shoaib","year":"2021","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1002\/clc.23590","article-title":"Acute cardiovascular hospitalizations and illness severity before and during the COVID-19 pandemic","volume":"44","author":"Rao","year":"2021","journal-title":"Clin. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1002\/ejhf.1925","article-title":"Temporal trends in decompensated heart failure and outcomes during COVID-19: A multisite report from heart failure referral centres in London","volume":"22","author":"Bromage","year":"2020","journal-title":"Eur. J. Heart Fail"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1007\/s00392-020-01703-z","article-title":"Impact of COVID-19 outbreak on regional STEMI care in Germany","volume":"109","author":"Scholz","year":"2020","journal-title":"Clin. Res. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Cannata, A., Watson, S.A., Daniel, A., Giacca, M., Shah, A.M., McDonagh, T.A., Scott, P.A., and Bromage, D.I. (2021). Impact of the COVID-19 pandemic on in-hospital mortality in cardiovascular disease: A meta-analysis. Eur. J. Prev. Cardiol., zwab119.","DOI":"10.1093\/eurjpc\/zwab119"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1002\/ejhf.2044","article-title":"In-hospital care in acute heart failure during the COVID-19 pandemic: Insights from the German-wide Helios hospital network","volume":"22","author":"Hohenstein","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1093\/eurpub\/ckab047","article-title":"Assessing the indirect effects of COVID-19 on healthcare delivery, utilization and health outcomes: A scoping review","volume":"31","author":"Roy","year":"2021","journal-title":"Eur. J. Public Health"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/6\/1577\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:35:45Z","timestamp":1760135745000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/6\/1577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,13]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jcm11061577"],"URL":"https:\/\/doi.org\/10.3390\/jcm11061577","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202202.0144.v1","asserted-by":"object"}]},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,13]]}}}