ABSTRACT
BACKGROUND: The COVID-19 Pandemic has put enormous pressure on the healthcare system globally, causing many healthcare organizations to cancel elective admission for coronary angiograms. The purpose of this study is to assess changes in ST segment elevation myocardial infarction (STEMI) practice, including the number of patients, door to balloon time and time from the onset of symptoms until reperfusion therapy in a tertiary center in Saudi Arabia. METHODS: This is a single center retrospective observational study, comparing all STEMI patients in the last five months of 2019 (Pre-COVID-19 period) with the first 5 months of 2020 (COVID -19 period) in regards to the volume of STEMI patients, symptoms onset to ER arrival time, door to balloon timing and the reperfusion therapy strategy. RESULTS: A total number of 173 STEMI patients were analyzed; 81 STEMI patients in the Pre-COVID-19 period and 92 STEMI patients in the COVID-19 period. When compared with pre-COVID period, there was a statistically non-significant increase in STEMI patients (12%), slight delay in the door to balloon timing; 94 vs 87 minutes. As well, there was more delay from onset of symptoms to presentation to the ER (>12 hours from symptoms onset to ER arrival (16% vs, 4% in group 1). Primary percutaneous coronary intervention (PPCI) was the main modality between the 2 groups without significant differences (100% Pre-COVID vs. 97% COVID-19 period). CONCLUSION: There was some delay of STEMI patient's presentation to the hospital during Covid-19 timing, without significant changes in the medical practice of care.
ABSTRACT
The COVID-19 Pandemic has put enormous pressure on the healthcare system globally, causing many healthcare organizations all over the world to cancel or stop elective procedures in their cardiac catheterization laboratoires. This delay in elective procedures with no doubt has led to a suspension of patient care primarily to those with severe aortic stenosis, which might place them at higher risk for cardiovascular complications like sudden death and heart failure. Health Care Worker are faced with the uncertainty of contracting infections while performing procedures in patients with a confirmed diagnosis of COVID-19 or suspected cases. This unprecedented situation is very challenging for the safety of Health Care Worker. Hence, in this article, we aim to summarize some of the current guidelines as to how to triage patients in need for Trans Catheter Aortic Valve Implantation (TAVI), during this ongoing pandemic, and will address some necessary considerations related to the preparation of catheterization laboratories and personal during the COVID-19 pandemic.
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%, nâ¯=â¯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%, noâ¯=â¯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.