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PLoS One ; 15(10): e0241149, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1388891

RESUMEN

INTRODUCTION: Early reports described decreased admissions for acute cardiovascular events during the SarsCoV-2 pandemic. We aimed to explore whether the lockdown enforced during the SARSCoV-2 pandemic in Israel impacted the characteristics of presentation, reperfusion times, and early outcomes of ST-elevation myocardial infarction (STEMI) patients. METHODS: A multicenter prospective cohort comprising all STEMI patients treated by primary percutaneous coronary intervention admitted to four high-volume cardiac centers in Israel during lockdown (20/3/2020-30/4/2020). STEMI patients treated during the same period in 2019 served as controls. RESULTS: The study comprised 243 patients, 107 during the lockdown period of 2020 and 136 during the same period in 2019, with no difference in demographics and clinical characteristics. Patients admitted in 2020 had higher admission and peak troponin levels, had a 2.4 fold greater likelihood of Door-to-balloon times> 90 min (95%CI: 1.2-4.9, p = 0.01) and 3.3 fold greater likelihood of pain-to-balloon times> 12 hours (OR 3.3, 95%CI: 1.3-8.1, p<0.01). They experienced higher rates hemodynamic instability (25.2% vs 14.7%, p = 0.04), longer hospital stay (median, IQR [4, 3-6 Vs 5, 4-6, p = 0.03]), and fewer early (<72 hours) discharge (12.4% Vs 32.4%, p<0.001). CONCLUSIONS: The lockdown imposed during the SARSCoV-2 pandemic was associated with a significant lag in the time to reperfusion of STEMI patients. Measures to improves this metric should be implemented during future lockdowns.


Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles/normas , Admisión del Paciente/estadística & datos numéricos , Infarto del Miocardio con Elevación del ST/cirugía , Tiempo de Tratamiento/estadística & datos numéricos , Anciano , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/virología , Femenino , Humanos , Israel/epidemiología , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Admisión del Paciente/normas , Alta del Paciente/estadística & datos numéricos , Intervención Coronaria Percutánea/estadística & datos numéricos , Estudios Prospectivos , Sistema de Registros/estadística & datos numéricos , SARS-CoV-2/patogenicidad , Infarto del Miocardio con Elevación del ST/diagnóstico , Factores de Tiempo , Resultado del Tratamiento
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