RESUMEN
The corona virus disease 2019 (COVID-19) outbreak may have delayed the treatment of patients with ST-segment elevated myocardial infarction (STEMI) in the emergency department (ED). This study aimed to determine the causes for treatment delay and evaluate the outcomes of such delays in STEMI patients undergoing primary percutaneous coronary intervention. This was a single-center retrospective observational study. Hospital records of STEMI patients who received primary percutaneous coronary intervention from 01 January 2019, to 31 December 2020, were assessed. The preCOVID-19 period was set before 01 January 2020, and the COVID-19 period was set after 01 January 2020, following which the data between these two periods were compared. During the COVID-19 period, there was a decrease in the reported incidence of STEMI patients compared with during the pre-COVID-19 period (incidence rate ratio, 0.74;95% confidence interval, 0.55–0.99;p = 0.04). After arrival at ED, the time from door to balloon significantly differed between the pre-COVID-19 and COVID-19 period (78.0 min vs. 102.0 min, p < 0.001). Also, the time to alert a cardiologist (16 min vs. 9 min), puncture time after cardiologist arrival (57 min vs. 42 min), and puncture to balloon time (19 min vs. 14 min) were significantly longer during the COVID period. However, the time from alert to cardiologist arrival was similar. Compared to the pre-COVID 19 period, more patients suffered from major adverse cardiac events during the COVID-19 period (n = 20 (25.3%) vs. n = 12 (11.2%), p = 0.012). In both periods, the number of patients admitted to the intensive care unit and died (106 vs. 79, 9 vs. 10, respectively) and the number of days spent in the ICU were similar. Early recognition of critically ill patients and appropriate response in the ED can lower misdiagnosis rates and increase prompt and correct treatments, thereby improving patient prognosis. [ FROM AUTHOR] Copyright of Signa Vitae is the property of Pharmamed Mado Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
RESUMEN
BackgroundOn December 31, 2019, a type of pneumonia with unknown origin was reported in Wuhan, China. It was named as coronavirus disease 2019 by the World Health Organization. Several studies showed that the outbreaks of infectious diseases affect the emergency department visits. Therefore, this study aimed to identify the epidemiological characteristics of patients visiting the emergency department during the coronavirus disease outbreak.MethodThis retrospective observational study was conducted in the three tertiary emergency departments. To evaluate the general characteristics of patients visiting the emergency department, data on sex, age, date and time of visit, initial blood pressure, heart rate, respiration rate, body temperature, level of consciousness, and disposition upon discharge were collected.ResultsA total of 180,192 patients were enrolled in this study. There were 52,245 patients who visited the emergency department during the coronavirus disease outbreak (December 2019–April 2020). This number was significantly reduced compared with the 64,405 and 63,542 patients who visited during the pre-coronavirus disease period. During the period of coronavirus disease outbreak, the proportion of alert patients began to decline from February to April. Also, the proportions of patients with Korean Triage and Acuity scores 4–5 and discharged patients decreased during the same period. The number of patients who were diagnosed with “influenza because of identified seasonal influenza virus” decreased to 1,507 (2.9%), compared with the 2,131 (3.4%) and 2,157 (3.3%) patients diagnosed with this condition during the pre-coronavirus disease period.ConclusionThe study showed changes in the patterns of emergency department visits during the coronavirus disease outbreak. During this period, the total number of patients and non-emergency patients visiting the emergency department decreased.