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STEMI and COVID-19 Pandemic in Saudi Arabia
Insights
The COVID-19 pandemic reduced ST-segment elevation myocardial infarction (STEMI) volumes and increased symptom-to-treatment times, despite maintaining care standards. Patient presentation delays were observed during the pandemic.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- The COVID-19 pandemic significantly impacted global healthcare, leading to reduced elective admissions and increased virtual care.
- Understanding the pandemic's effect on acute cardiovascular events like ST-segment elevation myocardial infarction (STEMI) is crucial.
Purpose of the Study:
- To assess changes in STEMI volumes, door-to-reperfusion times, and in-hospital events before and during the COVID-19 pandemic.
- To compare STEMI patient care metrics between the pre-COVID-19 (PC) and acute COVID-19 (AC) periods.
Main Methods:
- Retrospective analysis of 1,785 acute STEMI cases across 16 centers in Saudi Arabia.
- Data collected from January 1 to April 30, 2020 (COVID-19 period) and compared to January 1 to April 30, 2018-2019 (pre-COVID period).
Main Results:
- Total STEMI volumes decreased by 28% (n=500) and reperfusion-treated STEMI volumes by 27.6% (n=450) during the pandemic.
- Door-to-balloon time <90 minutes was achieved in 73.1% of cases in 2020.
- The proportion of patients experiencing symptom onset to reperfusion times >12 hours significantly increased to 17.2% in 2020 compared to <3% pre-COVID.
- No significant differences were found in in-hospital events or length of hospital stay between the periods.
Conclusions:
- STEMI volumes decreased during the COVID-19 pandemic, with a notable increase in delayed patient presentation.
- The standard of care for STEMI patients was maintained, but delays in seeking medical attention were evident.
Abstract:
The COVID-19 pandemic had significant impact on health care worldwide which has led to a reduction in all elective admissions and management of patients through virtual care. The purpose of this study is to assess changes in STEMI volumes, door to reperfusion, and the time from the onset of symptoms until reperfusion therapy, and in-hospital events between the pre-COVID-19 (PC) and after COVID-19 (AC) period. All acute ST-segment elevation myocardial infarction (STEMI) cases were retrospectively identified from 16 centers in the Kingdom of Saudi Arabia during the COVID-19 period from January 01 to April 30, 2020. These cases were compared to a pre-COVID period from January 01 to April 30, 2018 and 2019. One thousand seven hundred and eighty-five patients with a mean age 56.3 (SD ± 12.4) years, 88.3% were male. During COVID-19 Pandemic the total STEMI volumes was reduced (28%, n = 500), STEMI volumes for those treated with reperfusion therapy was reduced too (27.6%, n= 450). Door to balloon time < 90 minutes was achieved in (73.1%, no = 307) during 2020. Timing from the onset of symptoms to the balloon of more than 12 hours was higher during 2020 comparing to pre-COVID 19 years (17.2% vs <3%, respectively). There were no differences between the AC and PC period with respect to in-hospital events and the length of hospital stay. There was a reduction in the STEMI volumes during 2020. Our data reflected the standard of care for STEMI patients continued during the COVID-19 pandemic while demonstrating patients delayed presenting to the hospital.
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