ABSTRACT
During the coronavirus pandemic 2019 (COVID-19), some studies showed differences in the profile of subjects presenting with acute coronary syndromes as well as in overall mortality due to the delay of presentation and other complications. The purpose of this study was to compare the profile and outcomes, with emphasis on all-cause in-hospital mortality, of ST-elevation myocardial infarction (STEMI) subjects presenting to the emergency department during the pandemic period compared with a control group from the previous year, 2019. The study enrolled 2011 STEMI cases, which were divided into two groups-pre-pandemic (2019-2020) and pandemic period (2020-2022). Hospital admissions for a STEMI diagnosis sharply decreased during the COVID-19 period by 30.26% during the first year and 25.4% in the second year. This trend was paralleled by a significant increase in all-cause in-hospital mortality: 11.5% in the pandemic period versus 8.1% in the previous year. There was a significant association between SARS-CoV-2 positivity and all-cause in-hospital mortality, but no correlation was found between COVID-19 diagnosis and the type of revascularization. However, the profile of subjects presenting with STEMI did not change over time during the pandemic; their demographic and comorbid characteristics remained similar.
ABSTRACT
Glucocorticoids have been widely used in various infectious diseases, due to their important anti-inflammatory effect, but there lack powerful data supporting this treatment with potential side effects. Notwithstanding, dexamethasone proved to be beneficial on secondary end-points such as: shorter duration of hospitalisation (2 days vs. 13 days) and a greater chance of home discharge alive in the first 28 days (rate ratio: 1.10;95% CI, 1.03 to 1.17), successful weaning of invasive ventilation (rate ratio: 1.47;95% CI, 1.20 to 1.78), lower probability of renal-replacement treatment (risk ratio: 0.61;95% CI, 0.48 to 0.76). The RECOVERY trial offers evidences that sustain the usage of dexamethasone at a dose of 6 mg once daily for up to 10 days to reduce the 28-day mortality in COVID-19 subjects requiring respiratory support, with or without ventilatory support.
ABSTRACT
Cardiovascular diseases have attracted our full attention not only because they are the main cause of mortality and morbidity in many countries but also because the therapy for and cure of these maladies are among the major challenges of the medicine in the 21st century [...].