Methods: The investigators analyzed data on hospital admissions in Gaza for types of ACS from August 25- 2019, to October 1, 2019 that were recorded in the Alshifa Hospital Cardiology Department Service Admitted Patient Care database. Admissions were classified as ST-elevation myocardial infarction (STEMI) and non- ST elevation ACS (non-STEACS) and we calculate the diagnostic and percutaneous coronary intervention (PCI) rate and we compared to the same time period in 2020 and 2021. 

Results: Hospital admissions for ACS in 2019 was 99 patients declined to 40 patient's admission in 2020 and increased to 175 patients in 2021 in this time period. In 2020 a reduction of total ACS admission was 60%. During the period of declining admissions, there were reductions in the number of admissions for all types of ACS, including both STEMI and NON-STEACS, with a percent reduction of 64 % NON-STEACS in parallel, reductions were recorded in the STEMI percent reduction by 46 %, the mortality rate for STEMI patient was 4% in 2019 and 21% in 2020. The total ACS admission in 2021 was 175 patients, increases compared with 2019 by 77% . The increase rate in non-STEMI patient was 68 and increases rate in STEMI was 100% compared with 2019. The mortality rate for STEMI patient was 4% in 2019 and 2021. 

Conclusions: We found that significant reduction in the number of patients with ACS who were admitted to the hospital but increase in mortality rate in STEMI in 2020 (during the first month of pandemic) , and significant increases of ACS admission rate with the same mortality rate of STEMI patients in 2021 ( one year after pandemic) compared with 2019 in Gaza.