The impact of a dedicated coronavirus disease 2019 primary angioplasty protocol on time components related to ST‑segment elevation myocardial infarction management in a 24/7 primary percutaneous coronary intervention–capable hospital

Abstract

Background Primary percutaneous coronary intervention (PPCI) as the treatment of choice for ST-segment elevation myocardial infarction (STEMI) should be rapidly performed. It is necessary to use preventive strategies during the coronavirus disease 2019 (COVID-19) outbreak, which is an ongoing global concern. However, critical times in STEMI management may be influenced by the implementation of infection control protocols. aims We aimed to investigate the impact of our dedicated COVID-19 PPCI protocol on time components related to STEMI care and catheterization laboratory personnel safety. A subendpoint analysis to compare patient outcomes at a median time of 70 days during the pandemic with those of patients treated in the preceding year was another objective of our study. methods Patients with STEMI who underwent PPCI were included in this study. Chest computed tomography (CT) and real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) tests were performed in patients suspected of having COVID-19. A total of 178 patients admitted between February 29 and April 30, 2020 were compared with 146 patients admitted between March 1 and April 30, 2019. results Severe acute respiratory syndrome coronavirus 2 infection was confirmed by rRT-PCR in 7 cases. In 6 out of 7 patients, CT was indicative of COVID-19. There were no differences between the study groups regarding critical time intervals for reperfusion in STEMI. The 70-day mortality rate before and during the pandemic was 2.73% and 4.49%, respectively (P = 0.4). conclusions The implementation of the dedicated COVID-19 PPCI protocol in patients with STEMI allowed us to achieve similar target times for reperfusion, short-term clinical outcomes, and staff safety as in the prepandemic era.

The Global Effect of the COVID-19 Pandemic on STEMI Care: A Systematic Review and Meta-analysis

“…A total of 32 studies met our inclusion criteria. Four studies each originated from China, 4,24,32,33 Italy, 20,[34][35][36] and North America, [37][38][39][40] 3 each from France [41][42][43] and Turkey, [44][45][46] 2 from the United Kingdom, 47,48 and 1 each from Austria, 49 Belgium, 50 Egypt, 51 Iran, 52 Israel, 53 Japan, 54 Pakistan, 55 Poland, 56 Singapore, 23 Spain, 57 and Switzerland. 60 One study was a multicentred cohort study of various databases belonging to different European countries.…”

Acute coronary syndromes during the first and the second wave of COVID-19

“…The improvement in time to treatment between the first to the second wave of COVID-19 is likely related to the application of standardized protocols for fast-track treatment of STEMI with separate pathways to avoid the spread of infection during hospitalization that have been reported in a position paper endorsed by scientific societies [9] . The implementation of the dedicated protocol allowed to obtain time of reperfusion, short-term clinical outcomes, and staff safety similar to the targets before the pandemic [10] .…”

Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis

“…Additionally, 56 records were excluded based on several reasons: 1) outcomes of interest were not relevant ( n = 31); 2) a comparison between two period was not reported ( n = 16); 3) articles were case report/series ( n = 9). Eventually, a total of 35 studies with 62,247 participants 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 were evaluated in our meta-analysis. STEMI patients who presented in the pandemic period were older, predominately from male population, had a higher prevalence of comorbid conditions, and had worse cardiac function during hospital admission.…”