Impact of COVID-19 outbreak in stemi patients in the regional emergency center in Seoul, Korea

초록

Background and Aims : The highly infectious character of COVID-19 demands healthcare personnel to be alert and implement special infection control measures to limit its virulence. AMI patients’ prognosis depends on early diagnosis and prompt treatment. For such reasons, early transportation to the center with skilled and qualified cardiologists is critical in post AMI prognosis. However, patients who fear acquiring COVID-19 visit the hospital at a delayed time. Therefore, we presumed the COVID-19 outbreak might cause a delay in the process of STEMI patients receiving PCI in the ED. Moreover, we wanted to evaluate the outcome. Methods: We collected data from a hospital-based registry. Our center has a cardiology team standby for 24/7 PCI, and the cardiology team is alerted by an urgent treatment processing system (UTPS). UTPS is an alert system that requires corresponding specialists to respond in priority. We set the pre-COVID 19 periods before January 1, 2020, and the COVID 19 periods after January 1, 2020. We compared data from two periods to assess the noticeable differences. Results: During the COVID-19 period, there was a noticeable decrease in STEMI patients. After arrival, alerting cardiology specialists process time was delayed in the COVID period group. Also, puncture time after cardiologist arrival and Puncture to balloon time was significantly longer in the COVID period group. More patients suffered from MACE during the COVID-19 period without statistical significance (p=0.012). The number of patients admitted to ICU and expired were similar. Conclusions: Early recognition of critically ill patients will lead to lower misdiagnosis rates, an increase in prompt treatments, and improving prognosis.