Table 1. Relative changes in Acute Coronary Syndrome diagnoses and in-hospital mortality before and during initial period of Covid-19 outbreak in the current analysis and in the international literature (North Italy⁴, Kaiser Permanente⁵, Italian Registry⁶).

	Total ACS^a	STEMI	NSTEMI	In-hospital mortality
North Italy^b	28% reduction	24% reduction	43% reduction	Not available
Kaiser Permanente^c	48% reduction	40% reduction	49% reduction	Not available
Italian Registry^d	48.4% reduction	26.5% reduction	65.1% reduction	RR_overall= 3.6 (2.0–6.4) RR_STEMI= 3.3 (1.7–6.6)
Brazilian Network^e	36.5% reduction^e	28.9% reduction^e	39.5% reduction^e	RR_overall= 0.85 (0.4-1.7)^e RR_STEMI= 1.2 (0.3-4.0)^e

ACS: Acute Coronary Syndrome; STEMI: ST-Elevation Myocardial Infarction; NSTEMI: Non-ST-Elevation Myocardial infarction; RR: Risk Ratio.

In the reports from Kaiser Permanente and Italian Registry, only acute myocardial infarction was evaluated.

Retrospective analysis of consecutive patients who were admitted for acute coronary syndrome at 15 hospitals in northern Italy, comparing February and March to two control periods: a corresponding period in the previous year (2019) and an earlier period in the same year (2020)⁴. We reported the average from both analyses.

The comparison reported was based on a database of a health care delivery system from January through March 2020, compared to data from April 2020⁵.

Data based on a nationwide survey regarding admissions for acute myocardial infarction at Italian coronary care units in a one-week period during the Covid-19 outbreak, and compared with the equivalent week in 2019⁶.

Comparison between the average of the first three months of the Covid-19 pandemic (94 ACS per month; 21 STEMI per month; 53.3 NSTEMI per month) and the average of the previous 12 months (148.1 ACS per month; 29.5 STEMI per month; 88.1 NSTEMI per month). Overall, the mortality rate was 3.4% (61/1777) in the previous 12 months and 2.9% in the first three months of the pandemic (9/306). The mortality was 3.9% among STEMI patients (14/354) in the previous 12 months and 4.7% (3/63) in the first three months of the pandemic.

Table 1. Relative changes in Acute Coronary Syndrome diagnoses and in-hospital mortality before and during initial period of Covid-19 outbreak in the current analysis and in the international literature (North Italy4, Kaiser Permanente5, Italian Registry6).

Table 1. Relative changes in Acute Coronary Syndrome diagnoses and in-hospital mortality before and during initial period of Covid-19 outbreak in the current analysis and in the international literature (North Italy⁴, Kaiser Permanente⁵, Italian Registry⁶).