The coronavirus disease 2019 (COVID-19) pandemic, which began in late 2019, significantly impacted acute cardiac care, particularly in intensive cardiac care units (ICCUs), but extensive details about these changes remain scarce.

By comparing data from the pandemic era (2020) with the postpandemic era (2022), we aimed to understand the extent of changes in intensive cardiac care units as a result of COVID-19.

This observational study included all patients admitted to intensive cardiac care units in France during 2020 and 2022. Data were extracted from the French national hospital discharge database (PMSI), encompassing diagnoses, procedures, demographics and deaths. Multivariable logistic regression was used to assess in-hospital all-cause deaths.

Our analysis reveals that patient characteristics, treatments and deaths remained largely stable, with only minor shifts in non-surgical interventions. The overall impact of COVID-19 on intensive cardiac care unit care was limited, contrasting with some literature suggesting more pronounced changes. Smaller centres treated a higher proportion of older patients with heart failure, but had fewer admissions for coronary artery disease, leading to longer hospital stays. The in-hospital death rate remained steady at around 4%, with age and co-morbidities as significant predictors.

This study underscores the resilience of intensive cardiac care unit care in France throughout the COVID-19 pandemic, and emphasizes the need for continuous evaluations of resource allocation and care strategies aimed at high-risk populations.