The impact of covid-19 pandemic on the treatment of myocardial infarction-a single center experience

ABSTRACT

Introduction: The corona virus disease-2019 (COVID-19) pandemic has been associated with decrease in the rate of myocardial infarction (MI), and this is likely related to patients delaying seeking care due to COVID-19 concerns. Methods: In this retrospective observational study, we compared all patient encounters who presented with MI to Ascension Saint Agnes Hospital, Baltimore, MD from March to December 2020 with a cohort of patient encounters who presented with MI during an equivalent period in 2019. We analyzed the data using Statistical Package for Social Sciences (SPSS) and used two sample t-test and Chi-square x to compare the outcomes between the two cohorts as appropriate. Results: We had 275 MI admissions that met our inclusion criteria. When comparing MI encounters in 2020 with encounters in 2019, there were no significant differences in mortality (2.1% vs. 4.5%, p=0.274), acute renal failure(14.9% vs. 18.7%, p=0.403), or intensive care unit admission (7.1% vs. 7.5%, p=0.892). There were no significant differences in modalities of treatment including cardiac catheterization (94.3% vs. 95.5%, p=0.652), or medical treatment alone (13.5% vs. 18.7%, p=0.241) in 2020 vs. 2019. Referrals for coronary artery bypass graft surgery (CABG) were significantly higher in 2020 than in 2019 (8.5% vs. 3.0%, p=0.050). When comparing patients who presented during the first 5 months of the pandemic (March-July) with patients who presented in the last 5 months of the pandemic in 2020 (August-December);there were significant decrease in rate of cardiac catheterization (90.5% vs. 98.5%, p = 0.041), and significant increase in rate of medical treatment alone (18.9% vs. 7.5%, p = 0.047) in the first 5 months. Conclusions: The first five months of the pandemic were associated with a significant decrease in rates of pursuing cardiac catheterization along with an increase rates of medical treatment alone compared with the following five months.