Observational Study on Chest Pain During the Covid-19 Pandemic: Changes and Characteristics of Visits to a Norwegian Emergency Department During the Lockdown.

Abstract Background: As the Covid-19 pandemic spread during 2020, reports emerged on a decline in emergency department (ED) visits, including patients with chest pain. The current study aimed to describe the consequences of the Covid-19 pandemic and the subsequent national lockdown for the chest pain population in a Norwegian ED. Methods: Data were collected retrospectively in all patients presenting to the ED with chest pain from January 6th to August 30th 2020. Variations in the number of ED visits, severity, gender and age were assessed and compared to the corresponding period in 2019.Results: Following the national lockdown, fewer patients presented to the ED compared to the corresponding weeks in 2019 (week 13: down 38%; weeks 11-27: down 16%). Numbers normalized by week 28 compared to 2019 levels. There were relatively fewer moderate acuity patients in this period, while there was an increase in lower acuity patients during the same period. The median age was lower in the first weeks following lockdown compared to the same period in 2019 (58 years (IQR 25) vs 62 years (IQR 24), respectively). The proportion of patients admitted with acute coronary syndromes (ACS) remained stable. Conclusions: Fewer patients presented to the ED after the Covid-19 outbreak and the subsequent national lockdown in Norway. The patients were on average younger, and seemed paradoxically to be less severely ill. The proportion of patients with ACS was however stable, implying that some patients with myocardial infarctions may have failed to seek medical advice.