Impact of COVID-19 pandemic on ST-elevation myocardial infarction in a non-COVID-19 epicenter.

ABSTRACT: OBJECTIVES:We sought to study the impact of COVID-19 pandemic on the presentation delay, severity, patterns of care, and reasons for delay among patients with ST-elevation myocardial infarction (STEMI) in a non-hot-spot region. BACKGROUND:COVID-19 pandemic has significantly reduced the activations for STEMI in epicenters like Spain. METHODS:From January 1, 2020, to April 15, 2020, 143 STEMIs were identified across our integrated 18-hospital system. Pre- and post-COVID-19 cohorts were based on March 23rd, 2020, whenstay-at-home orders were initiated in Ohio. We used presenting heart rate, blood pressure, troponin, new Q-wave, and left ventricle ejection fraction (LVEF) to assess severity. Duration of intensive care unit stay, total length of stay, door-to-balloon (D2B) time, and radial versus femoral access were used to assess patterns of care. RESULTS:Post-COVID-19 presentation was associated with a lower admission LVEF (45 vs. 50%, p =?.015), new Q-wave, and higher initial troponin; however, these did not reach statistical significance. Among post-COVID-19 patients, those with >12-hr delay in presentation 31(%) had a longer average D2B time (88 vs. 53?min, p =?.033) and higher peak troponin (58 vs. 8.5?ng/ml, p =?.03). Of these, 27% avoided the hospital due to fear of COVID-19, 18% believed symptoms were COVID-19 related, and 9% did not want to burden the hospital during the pandemic. CONCLUSIONS:COVID-19 has remarkably affected STEMI presentation and care. Patients' fear and confusion about symptoms are integral parts of this emerging public health crisis.

SUBMITTER: Hammad TA 

PROVIDER: S-EPMC7300525 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature