Impact of coronavirus disease 2019 (COVID-19) outbreak on outcome of myocardial infarction in Hong Kong, China.
ACS/NSTEMI
acute myocardial infarction/STEMI
health care outcomes
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
11
04
2020
accepted:
14
04
2020
pubmed:
6
5
2020
medline:
25
2
2021
entrez:
6
5
2020
Statut:
ppublish
Résumé
To determine whether COVID-19 may adversely affect outcome of myocardial infarction (MI) patients in Hong Kong, China. The COVID-19 pandemic has infected thousands of people and placed enormous stress on healthcare system. Apart from being an infectious disease, it may affect human behavior and healthcare resource allocation which potentially cause treatment delay in MI. This was a single center cross-sectional observational study. From November 1, 2019 to March 31, 2020, we compared outcome of patients admitted for acute ST-elevation MI (STEMI) and non-ST elevation MI (NSTEMI) before (group 1) and after (group 2) January 25, 2020 which was the date when Hong Kong hospitals launched emergency response measures to combat COVID-19. There was a reduction in daily emergency room attendance since January 25, 2020 (group 1,327/day vs. group 2,231/day) and 149 patients with diagnosis of MI were included into analysis (group 1 N = 85 vs. group 2 N = 64). For STEMI, patients in group 2 tended to have longer symptom-to-first medical contact time and more presented out of revascularization window (group 1 27.8 vs. group 2 33%). The primary composite outcome of in-hospital death, cardiogenic shock, sustained ventricular tachycardia or fibrillation (VT/VF) and use of mechanical circulatory support (MCS) was significantly worse in group 2 (14.1 vs. 29.7%, p = .02). More MI patients during COVID-19 outbreak had complicated in-hospital course and worse outcomes. Besides direct infectious complications, cardiology community has to acknowledge the indirect effect of communicable disease on our patients and system of care.
Sections du résumé
OBJECTIVE
To determine whether COVID-19 may adversely affect outcome of myocardial infarction (MI) patients in Hong Kong, China.
BACKGROUND
The COVID-19 pandemic has infected thousands of people and placed enormous stress on healthcare system. Apart from being an infectious disease, it may affect human behavior and healthcare resource allocation which potentially cause treatment delay in MI.
METHODS
This was a single center cross-sectional observational study. From November 1, 2019 to March 31, 2020, we compared outcome of patients admitted for acute ST-elevation MI (STEMI) and non-ST elevation MI (NSTEMI) before (group 1) and after (group 2) January 25, 2020 which was the date when Hong Kong hospitals launched emergency response measures to combat COVID-19.
RESULTS
There was a reduction in daily emergency room attendance since January 25, 2020 (group 1,327/day vs. group 2,231/day) and 149 patients with diagnosis of MI were included into analysis (group 1 N = 85 vs. group 2 N = 64). For STEMI, patients in group 2 tended to have longer symptom-to-first medical contact time and more presented out of revascularization window (group 1 27.8 vs. group 2 33%). The primary composite outcome of in-hospital death, cardiogenic shock, sustained ventricular tachycardia or fibrillation (VT/VF) and use of mechanical circulatory support (MCS) was significantly worse in group 2 (14.1 vs. 29.7%, p = .02).
CONCLUSIONS
More MI patients during COVID-19 outbreak had complicated in-hospital course and worse outcomes. Besides direct infectious complications, cardiology community has to acknowledge the indirect effect of communicable disease on our patients and system of care.
Identifiants
pubmed: 32367683
doi: 10.1002/ccd.28943
pmc: PMC7267252
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
E194-E197Informations de copyright
© 2020 Wiley Periodicals, Inc.
Références
Eur Heart J. 2018 Jan 7;39(2):119-177
pubmed: 28886621
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Circulation. 2018 Nov 13;138(20):e618-e651
pubmed: 30571511
Eur Heart J. 2016 Jan 14;37(3):267-315
pubmed: 26320110
Catheter Cardiovasc Interv. 2021 Feb 1;97(2):E194-E197
pubmed: 32367683
Circulation. 2014 Dec 23;130(25):e344-426
pubmed: 25249585
Acta Biomed. 2020 Mar 19;91(1):157-160
pubmed: 32191675
Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006631
pubmed: 32182131