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June 12, 2026European Journal of Preventive CardiologyOpen Access

The 2020 COVID-19 lockdown was associated with significantly higher in-hospital mortality among ACS patients ≥70 years compared to the 2019 pre-pandemic period (13.8% vs 7.0%; RR 1.97, p=0.04).

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Why the study?

Does the COVID-19 pandemic affect ACS admissions and in-hospital mortality differently across age groups?

Population

1539 consecutive patients diagnosed with acute coronary syndrome in Albania, admitted between March 9th and…

Comparison

Admission during the COVID-19 lockdown or… vs Admission during the pre-pandemic control period

Design

Cohort

Follow-up

in-hospital

Key result

The 2020 COVID-19 lockdown was associated with significantly higher in-hospital mortality among ACS patients ≥70 years compared to the 2019 pre-pandemic period (13.8% vs 7.0%; RR 1.97, p=0.04).

Authors

LSL SimoniACA CekaMGM Gina

Discussion

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Member takes

Overview

Reduced ACS admissions during lockdown may signal care avoidance; leaves open true incidence shifts and outcome impacts.

Key Points

  • This study investigates age differences in acute coronary syndrome (ACS) admissions and in-hospital outcomes during and after the COVID-19 lockdown.
  • Conducted a retrospective single-center study
  • Included patients diagnosed with ACS from March 9, 2020, to April 30, 2021
  • Grouped patients by age: <70 and ≥70 years old
  • Total of 1539 ACS patients included: 550 in 2019, 321 in 2020, and 668 in 2021
  • Mortality for patients ≥70 years increased from 7.0% to 13.8% during lockdown (RR=1.97; p=0.04)
  • Mortality rates in 2021 were similar to 2019 for both age groups.

Study Design

Type

Observational (n=1,539)

Multicenter

No

Structured PICO

Does the COVID-19 pandemic affect ACS admissions and in-hospital mortality differently across age groups?

P
Population
1,539 consecutive patients diagnosed with acute coronary syndrome in Albania, evaluated for admissions and in-hospital outcomes across pre-pandemic, lockdown, and ongoing pandemic periods.
E
Exposure
Admission during the COVID-19 lockdown (2020) or ongoing pandemic (2021)
C
Comparator
Admission during the pre-pandemic control period (2019)
O
Outcome
ACS admissions (incidence rate ratio) and in-hospital mortalityhard clinical

Main Result

Relative Risk: 1.97

Absolute Event Rate: 13.8% vs 7%

p-value: p=0.04

The COVID-19 lockdown was associated with a significant reduction in ACS admissions and a near-doubling of in-hospital mortality among patients aged ≥70 years.

Cite This Study

Simoni et al. (2026) conducted an observational in Acute coronary syndrome (n=1,539). COVID-19 lockdown (2020) vs. Pre-pandemic period (2019) was evaluated on In-hospital mortality for ACS patients ≥70 years (RR 1.97, p=0.04). The 2020 COVID-19 lockdown was associated with significantly higher in-hospital mortality among ACS patients ≥70 years compared to the 2019 pre-pandemic period (13.8% vs 7.0%; RR 1.97, p=0.04).

synapsesocial.com/papers/6a2bd1056550ea4541ffe856https://doi.org/10.1093/eurjpc/zwag249.420
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The impact of aging on acute coronary syndromes: an EHR-based analysis2025
  2. 2Impact of the COVID-19 pandemic on admission trends, diagnosis patterns, and demographics of ischemic heart disease patients: a retrospective study2025
  3. 3Clinical Outcomes After Immediate Coronary Angiography in Elderly Versus Younger Patients Suffering from Acute Coronary Syndrome2025
  4. 4Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage2020 · 644 citations
  5. 51420-P: Temporal Trends and Sociodemographic Disparities in Acute Myocardial Infarction Outcomes among Hospitalized Patients with Diabetes Mellitus: Impact of the COVID-19 Pandemic in California, 2016–20222026