Characteristics of patients with ST-segment elevated myocardial infarction (STEMI) at the initial stage of the COVID-19 pandemic: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has become a new challenge to the medical system in various countries. The patients with ST-segment elevated myocardial infarction (STEMI) were also affected. METHODS: We used a random-effects mode to analyze the differences of the baseline characteristics and therapeutic features between STEMI patients admitted before and after the start of the COVID-19 pandemic. RESULTS: Thirty eight studies involving 79,753 patients were included in this analysis. The number of hospitalized STEMI patients decreased by 26% after the start of the COVID-19 pandemic. There were no differences in age, sex, prevalence of diabetes, hypertension, dyslipidemia or percutaneous coronary intervention rate between the STEMI patients before and after the start of the COVID-19 pandemic. However, the STEMI patients admitted after the start of the COVID-19 pandemic had a significantly increased time from symptom onset to first medical contact (standard mean difference 0.51, 95% confidence interval 0.24-0.78, p < .001) and an increased in-hospital mortality (odds ratio 1.70, 95% confidence interval1.14-2.56, p < .001); The in-hospital mortality of the STEMI patients with COVID-19 was 24% (95% confidence interval 0.15-0.33); The in-hospital mortality of the STEMI patients with COVID-19 was significantly higher than that of the STEMI patients without COVID-19 at the initial stage of the COVID-19 pandemic (odds ratio 7.28, 95% confidence interval 2.75-19.28, p < .001). CONCLUSION: The number of admitted STEMI patients was reduced while the in-hospital mortality and the time from symptom onset to first medical contact were increased during the COVID-19 pandemic.