The following is a summary of “Impact of COVID-19 pandemic on sex and racial disparities in chest pain presentation and management through the emergency department,” published in the April 2024 issue of Cardiology by Hu et al.

Sex and racial disparities in chest pain management exist, but COVID-19’s impact on these is unknown.

Researchers conducted a retrospective study investigating the impact of the COVID-19 pandemic on sex and racial disparities in chest pain presentation, management, and outcomes in the emergency department. 

They used data from a single academic center from January 1, 2016, to May 1, 2022. Patients with complaints of chest pain and equivalent symptoms were categorized by sex, race, ethnicity (Asian, Black, Hispanic, White, and other) and age (18-40, 41-65, >65), and diagnostic evaluations, treatments, and outcomes before, during, and after the pandemic were compared. 

The results studied 95,764 chest pain cases. During the early pandemic, ED visits for chest pain dropped by about 38%. Females presented less than males (48% vs. 52%, P<0.001) in the early pandemic, especially Asian females. Despite increased troponin and echocardiogram orders during peak COVID-19, females still had fewer tests. Coronary angiograms didn’t increase; females were less likely to undergo that. Females were less diagnosed with AMI, but in-hospital deaths were similar. 

Investigators concluded that during a pandemic, fewer females, especially Non-White ones, sought ED care for chest pain. Management disparities persisted, with females receiving fewer cardiac evaluations and AMI diagnoses than males, but in-hospital mortality stayed similar. 

Source: cardiologyres.org/index.php/Cardiologyres/article/view/1586/1561