People with serious heart problems have been getting the wrong message about avoiding the hospital during the COVID-19 pandemic, and they are at greater risk of dying as a result, doctors say.

In Paris, researchers found that cardiac arrests outside of hospitals grew drastically in March and April, and the proportion of those patients admitted to the hospital alive dropped by almost half.

Santiago Garcia, an interventional cardiologist at the Minneapolis Heart Institute and corresponding author of the paper that included the Minnesota data on declining heart interventions, said researchers believe patients are either afraid of getting COVID-19 if they go to the hospital or are misunderstanding directives from state and federal officials about avoiding health care that can be delayed.

And since shortness of breath can be a symptom of both a heart attack and COVID-19, some patients with heart problems may be self-isolating at home hoping the virus will pass — not realizing that the heart attack they’re having may be damaging their heart by depriving it of oxygenated blood.

In March and April, the Minneapolis Heart Institute at Abbott Northwestern Hospital in south Minneapolis saw declines of at least 27% in patients who came to the hospital with serious attacks and patients getting angioplasties to reopen clogged arteries on the heart, compared with the first two months of 2020.

A preliminary version of the article published in the Journal of the American College of Cardiology reported a 38% decline in patients going to the emergency room for serious heart attack care in March at the nine hospitals, compared with monthly averages for the previous 14 months.

But in France, researchers with the long-running Paris Sudden Death Expertise Center found that fewer patients were arriving at the hospital alive after cardiac arrest.

The sudden-death research center in France looked at trends among 6.8 million inhabitants of the greater Paris area and found that while the overall number of cardiac arrests outside the hospital had grown, the proportion of those patients who were admitted to the hospital alive dropped significantly during the Paris lockdown.

Only 12.8% of people with out-of-hospital cardiac arrest in the study area were admitted to the hospital alive from March 16 to April 26, compared with a historical average of 22.8% over the previous eight years, the report in the Lancet Public Health journal says.

If the trends in avoiding hospital care continue, Garcia said he’s concerned about unraveling the progress that has been made in educating the public on the signs of heart attack.