Minnesota COVID-19 Lockdowns: The Effect on Acute Myocardial Infarctions and Revascularizations in the Community

Guilherme S Lopes; Sheila M Manemann; Susan A Weston; Ruoxiang Jiang; Nicholas B Larson; Ethan D Moser; Véronique L Roger; Paul Y Takahashi; Yader Sandoval; Malcolm R Bell; Alanna M Chamberlain; LaPrincess C Brewer; Mandeep Singh; Jennifer L St Sauver; Suzette J Bielinski

doi:10.1016/j.mayocpiqo.2021.12.002

Minnesota COVID-19 Lockdowns: The Effect on Acute Myocardial Infarctions and Revascularizations in the Community

Mayo Clin Proc Innov Qual Outcomes. 2022 Feb;6(1):77-85. doi: 10.1016/j.mayocpiqo.2021.12.002. Epub 2021 Dec 13.

Authors

Guilherme S Lopes¹, Sheila M Manemann², Susan A Weston¹, Ruoxiang Jiang¹, Nicholas B Larson¹, Ethan D Moser², Véronique L Roger^{2

3

4}, Paul Y Takahashi⁵, Yader Sandoval³, Malcolm R Bell³, Alanna M Chamberlain², LaPrincess C Brewer³, Mandeep Singh³, Jennifer L St Sauver², Suzette J Bielinski²

Affiliations

¹ Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
² Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
³ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
⁴ Epidemiology and Community Health Branch National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD.
⁵ Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.

Abstract

Objective: To study associations between the Minnesota coronavirus disease 2019 (COVID-19) mitigation strategies on incidence rates of acute myocardial infarction (MI) or revascularization among residents of Southeast Minnesota.

Methods: Using the Rochester Epidemiology Project, all adult residents of a nine-county region of Southeast Minnesota who had an incident MI or revascularization between January 1, 2015, and December 31, 2020, were identified. Events were defined as primary in-patient diagnosis of MI or undergoing revascularization. We estimated age- and sex-standardized incidence rates and incidence rate ratios (IRRs) stratified by key factors, comparing 2020 to 2015-2019. We also calculated IRRs by periods corresponding to Minnesota's COVID-19 mitigation timeline: "Pre-lockdown" (January 1-March 11, 2020), "First lockdown" (March 12-May 31, 2020), "Between lockdowns" (June 1-November 20, 2020), and "Second lockdown" (November 21-December 31, 2020).

Results: The incidence rate in 2020 was 32% lower than in 2015-2019 (24 vs 36 events/100,000 person-months; IRR, 0.68; 95% CI, 0.62-0.74). Incidence rates were lower in 2020 versus 2015-2019 during the first lockdown (IRR, 0.54; 95% CI, 0.44-0.66), in between lockdowns (IRR, 0.70; 95% CI, 0.61-0.79), and during the second lockdown (IRR, 0.54; 95% CI, 0.41-0.72). April had the lowest IRR (IRR 0.48; 95% CI, 0.34-0.68), followed by August (IRR, 0.55; 95% CI, 0.40-0.76) and December (IRR, 0.56; 95% CI, 0.41-0.77). Similar declines were observed across sex and all age groups, and in both urban and rural residents.

Conclusion: Mitigation measures for COVID-19 were associated with a reduction in hospitalizations for acute MI and revascularization in Southeast Minnesota. The reduction was most pronounced during the lockdown periods but persisted between lockdowns.

Keywords: CABG, coronary artery bypass graft; COVID-19, coronavirus disease 2019; IRR, incidence rate ratio; MI, myocardial infarction; PCI, percutaneous coronary intervention; REP, Rochester Epidemiology Project.

Abstract

Grants and funding