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Author
DOI
Article Type
Special Issue
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Impact of COVID-19 outbreak on patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention in a regional emergency center in Seoul, Korea
1Department of Emergency Medicine, College of Medicine, Korea University, 02841 Seoul, Republic of Korea
2Department of Emergency Medicine, Korea University Guro Hospital, 08308 Seoul, Republic of Korea
DOI: 10.22514/sv.2023.008 Vol.19,Issue 3,May 2023 pp.165-172
Submitted: 08 June 2022 Accepted: 26 July 2022
Published: 08 May 2023
*Corresponding Author(s): Sung-Joon Park E-mail: kuedpsj@hanmail.net
The corona virus disease 2019 (COVID-19) outbreak may have delayed the treatment of patients with ST-segment elevated myocardial infarction (STEMI) in the emergency department (ED). This study aimed to determine the causes for treatment delay and evaluate the outcomes of such delays in STEMI patients undergoing primary percutaneous coronary intervention. This was a single-center retrospective observational study. Hospital records of STEMI patients who received primary percutaneous coronary intervention from 01 January 2019, to 31 December 2020, were assessed. The pre-COVID-19 period was set before 01 January 2020, and the COVID-19 period was set after 01 January 2020, following which the data between these two periods were compared. During the COVID-19 period, there was a decrease in the reported incidence of STEMI patients compared with during the pre-COVID-19 period (incidence rate ratio, 0.74; 95% confidence interval, 0.55–0.99; p = 0.04). After arrival at ED, the time from door to balloon significantly differed between the pre-COVID-19 and COVID-19 period (78.0 min vs. 102.0 min, p < 0.001). Also, the time to alert a cardiologist (16 min vs. 9 min), puncture time after cardiologist arrival (57 min vs. 42 min), and puncture to balloon time (19 min vs. 14 min) were significantly longer during the COVID period. However, the time from alert to cardiologist arrival was similar. Compared to the pre-COVID 19 period, more patients suffered from major adverse cardiac events during the COVID-19 period (n = 20 (25.3%) vs. n = 12 (11.2%), p = 0.012). In both periods, the number of patients admitted to the intensive care unit and died (106 vs. 79, 9 vs. 10, respectively) and the number of days spent in the ICU were similar. Early recognition of critically ill patients and appropriate response in the ED can lower misdiagnosis rates and increase prompt and correct treatments, thereby improving patient prognosis.
COVID-19; ST-segment elevated myocardial infarction; Acute myocardial infarct; Percutaneous coronary intervention
Ha Eun Bae,Young-Hoon Yoon,Jung-Youn Kim,Young-Duck Cho,Sung-Hyuk Choi,Sung-Joon Park. Impact of COVID-19 outbreak on patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention in a regional emergency center in Seoul, Korea. Signa Vitae. 2023. 19(3);165-172.
[1] Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomedica. 2020; 91: 157–160.
[2] Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine. 2020; 382: 1708–1720.
[3] WHO. Infection prevention and control in the context of coronavirus disease (COVID-19): A living guideline, 2022. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-ipc-guideline-2022.2 (Accessed: 13 July 2022).
[4] Coronavirus (COVID-19) status, Republic of Korea. Available at: http: //ncov.mohw.go.kr/en/ (Accessed: 13 July 2022).
[5] WHO Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ (Accessed: 13 July 2022).
[6] De Luca G, Suryapranata H, Ottervanger JP, Antman EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction. Circulation. 2004; 109: 1223–1225.
[7] Wijns W, Naber CK. Reperfusion delay in patients with high-risk ST-segment elevation myocardial infarction: every minute counts, much more than suspected. European Heart Journal. 2018; 39: 1075–1077.
[8] Park J, Choi KH, Lee JM, Kim HK, Hwang D, Rhee T, et al. Prognostic implications of door-to-balloon time and onset-to-door time on mortality in patients with ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention. Journal of the American Heart Association. 2019; 8: e012188.
[9] Mayol J, Artucio C, Batista I, Puentes A, Villegas J, Quizpe R, et al. An international survey in Latin America on the practice of interventional cardiology during the COVID-19 pandemic, with a particular focus on myocardial infarction. Netherlands Heart Journal. 2020; 28: 424-430.
[10] Rodríguez-Leor O, Cid-Álvarez B, Ojeda S, Martín-Moreiras J, Ramón Rumoroso J, López-Palop R, et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC: Interventional Cardiology. 2020; 2: 82–89.
[11] Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, et al. Impact of coronavirus disease 2019 (COVID-19) outbreak on outcome of myocardial infarction in Hong Kong, China. Catheterization and Cardiovascular Interventions. 2021; 97: E194–E197.
[12] Chew NW, Sia C, Wee H, Benedict LJ, Rastogi S, Kojodjojo P, et al. Impact of the COVID-19 pandemic on door-to-balloon time for primary percutaneous coronary intervention—results from the Singapore western STEMI network—. Circulation Journal. 2021; 85: 139–149.
[13] Li Y, Huang W, Hwang J. No reduction of ST-segment elevation myocardial infarction admission in Taiwan during coronavirus pandemic. The American Journal of Cardiology. 2020; 131: 133–134.
[14] Sofi F, Dinu M, Reboldi G, Stracci F, Pedretti RFE, Valente S, et al. Worldwide differences of hospitalization for ST-segment elevation myocardial infarction during COVID-19: a systematic review and meta-analysis. International Journal of Cardiology. 2022; 347: 89–96.
[15] Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, et al. Impact of coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circulation. Cardiovascular Quality and Outcomes. 2020; 13: e006631.
[16] Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung S, et al. The Covid-19 pandemic and the incidence of acute myocardial infarction. New England Journal of Medicine. 2020; 383: 691–693.
[17] Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. Journal of the American College of Cardiology. 2020; 75: 2871–2872.
[18] Bhatt AS, Moscone A, McElrath EE, Varshney AS, Claggett BL, Bhatt DL, et al. Fewer hospitalizations for acute cardiovascular conditions during the COVID-19 pandemic. Journal of the American College of Cardiology. 2020; 76: 280–288.
[19] Roffi M, Guagliumi G, Ibanez B. The obstacle course of reperfusion for ST-segment-elevation myocardial infarction in the COVID-19 pandemic. Circulation. 2020; 141: 1951–1953.
[20] Hammad TA, Parikh M, Tashtish N, Lowry CM, Gorbey D, Forouzandeh F, et al. Impact of COVID-19 pandemic on ST-elevation myocardial infarction in a non-COVID-19 epicenter. Catheterization and Cardiovascular Interventions. 2021; 97: 208–214.
[21] Yu IT, Xie ZH, Tsoi KK, Chiu YL, Lok SW, Tang XP, et al. Why did outbreaks of severe acute respiratory syndrome occur in some hospital wards but not in others? Clinical Infectious Diseases. 2007; 44: 1017–1025.
[22] Kim SW, Park JW, Jung HD, Yang JS, Park YS, Lee C, et al. Risk factors for transmission of middle east respiratory syndrome coronavirus infection during the 2015 outbreak in South Korea. Clinical Infectious Diseases. 2017; 64: 551-–557.
[23] Sorci G, Faivre B, Morand S. Why does COVID-19 case fatality rate vary among countries? To be published in medRxiv. 2020. [Preprint].
[24] Sorci G, Faivre B, Morand S. Explaining among-country variation in COVID-19 case fatality rate. Scientific Reports. 2020; 10: 18909.
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