COVID-19 sends STEMI to quarantine!?

Abdi, Seifollah; Salarifar, Mojtaba; Mortazavi, Seyedeh Hamideh; Sadeghipour, Parham; Geraiely, Babak

doi:10.1007/s00392-020-01664-3

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…We found an “atypical” low number of cardiovascular events compared with the weeks before the regional outbreak of the pandemic and compared with the same period of the previous year. A similar trend was observed in cardiovascular centers in Austria [ 14 ], the severely affected Northern Italy [ 3 ] and Iran [ 15 ]. It can be assumed by a stable incidence of patients having an ACS that patients abstain from seeing a doctor despite symptoms of acute myocardial ischemia.…”

Section: Discussionsupporting

confidence: 76%

Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

et al. 2020

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Background The spread of the novel coronavirus SARS-CoV-2 and the guidance from authorities for social distancing and media reporting lead to significant uncertainty in Germany. Concerns have been expressed regarding the underdiagnosing of harmful diseases. We explored the rates of emergency presentations for acute coronary syndrome (ACS) and acute cerebrovascular events (ACVE) before and after spread of SARS-CoV-2. Methods We analyzed all-cause visits at a tertiary university emergency department and admissions for ACS and ACVE before (calendar weeks 1–9, 2020) and after (calendar weeks 10–16, 2020) the first coronavirus disease (COVID-19) case in the region of the Saarland, Germany. The data were compared with the same period of the previous year. Results In 2020 an average of 346 patients per week presented at the emergency department whereas in 2019 an average of 400 patients presented up to calendar week 16 ( p = 0.018; whole year 2019 = 395 patients per week). After the first COVID-19 diagnosis in the region, emergency department visit volume decreased by 30% compared with the same period in 2019 ( p = 0.0012). Admissions due to ACS decreased by 41% ( p = 0.0023 for all; Δ − 71% ( p = 0.007) for unstable angina, Δ − 25% ( p = 0.42) for myocardial infarction with ST-elevation and Δ − 17% ( p = 0.28) without ST-elevation) compared with the same period in 2019 and decreased from 142 patients in calendar weeks 1–9 to 62 patients in calendar weeks 10–16. ACVE decreased numerically by 20% [ p = 0.25 for all; transient ischemic attack: Δ − 32% ( p = 0.18), ischemic stroke: Δ − 23% ( p = 0.48), intracerebral haemorrhage: Δ + 57% ( p = 0.4)]. There was no significant change in ACVE per week ( p = 0.7) comparing calendar weeks 1–9 (213 patients) and weeks 10–16 (147 patients). Testing of 3756 samples was performed to detect 58 SARS-CoV-2 positive patients (prevalence 1,54%, thereof one patient with myocardial and two with cerebral ischemia) up to calendar week 16 in 2020. Conclusions The COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.

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Section: Discussionsupporting

confidence: 76%

Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

et al. 2020

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“… 1 Due to its highly contagious features, necessary quarantine and social distance is important in preventing cross-infection. 2 Health-care facilities, as high-risk regions, applied screening protocols to avoid nosocomial infection. 3 Not only the patients with chronic conditions are affected, but patients with acute conditions are also compromised during this pandemic.…”

Section: Introductionmentioning

confidence: 99%

Fibrinolysis Therapy Combined with Deferred PCI versus Primary Angioplasty for STEMI Patients During the COVID-19 Pandemic: Preliminary Results from a Single Center

Jiang¹,

Meng²,

Hu³

et al. 2021

IJGM

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Introduction:The efficacy of fibrinolysis therapy with deferred percutaneous coronary angioplasty (FPCI) versus primary angioplasty (PPCI) during the coronavirus disease 2019 (COVID-19) pandemic is unclear when medical quarantine is needed. Patients and Methods: Acute ST segment elevation myocardial infarction (STEMI) patients underwent PPCI after finishing the screening protocol from January 23, 2020 to June 10, 2020 while FPCI was applied when COVID-19-confirmed cases reoccurred in Beijing near our hospital from June 11, 2020 to July 20, 2020. The door-to-balloon time (DTB) or door-to-needle time (DTN) as well as in-hospital adverse clinical outcomes were compared between the two groups. A propensity score-matched (PSM) analysis was performed to diminish the potential influence of confounding factors on the clinical outcomes. Results: A total of 126 STEMI patients underwent PPCI after finishing the screening protocol and 17 patients received FPCI before PSM. Patients who received FPCI were younger than patients who underwent PPCI (50.8±14.0 versus 64.1±14.2 years, p=0.001), and chronic kidney disease (CKD) was less common in FPCI patients than in patients who underwent PPCI (0% versus 24.6%, p=0.024). The DTN was significantly shorter than DTB (25.8±4.2 versus 61.1 ±10.7, p=0.000) before PSM. The DTN was significantly shorter than DTB (26.9±4.2 versus 64.9±23.6, p=0.000); however, the incidence rate of in-hospital ischemia and bleeding adverse clinical outcomes were comparable between the two groups after PSM. Conclusion: Fibrinolysis therapy combined with deferred PCI can reduce the ischemia time and has a similar in-hospital adverse clinical outcome rate compared with patients who underwent primary PCI during the COVID-19 pandemic.

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“…Thrombolytic therapy is considered the first-line therapy during the COVID-19 pandemic, according to the expert consensus of the Chinese Society of Cardiology, to decrease the risk of cross infection [ 19 ]. Based on experiences in China and other countries, the use of proper personal protective equipment (PPE) should be considered for persons performing primary PCI [ 20 – 24 ]. However, a reduction in patients who underwent primary PCI was observed, which was associated with a concern of cross infection from both doctors and patients [ 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical Outcomes in Patients with ST Elevation Myocardial Infarction with Percutaneous Coronary Intervention and the Use of a Telemedicine App Before and After the COVID-19 Pandemic at a Center in Beijing, China, from August 2019 to March 2020

Jiang

Meng

et al. 2020

Med Sci Monit

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COVID-19 sends STEMI to quarantine!?

Cited by 13 publications

References 9 publications

Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

Fibrinolysis Therapy Combined with Deferred PCI versus Primary Angioplasty for STEMI Patients During the COVID-19 Pandemic: Preliminary Results from a Single Center

Comparison of Clinical Outcomes in Patients with ST Elevation Myocardial Infarction with Percutaneous Coronary Intervention and the Use of a Telemedicine App Before and After the COVID-19 Pandemic at a Center in Beijing, China, from August 2019 to March 2020

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