INCIDENCE, CLINICAL CHARACTERISTICS, AND OUTCOMES OF ACUTE STEMI DURING THE COVID-19 PANDEMIC AT A TERTIARY REFERRAL CENTER

ABSTRACT

BACKGROUND: The aim of this study was to describe the characteristics and in-hospital outcomes of acute ST- segment elevationmyocardial infarction (STEMI) patients during the COVID-19 pandemic at Piedmont Athens Regional (PAR), a 330-bed tertiary referral center in Northeast Georgia. METHODS: We conducted a retrospective study involving patients admitted at PAR to evaluate consecutive STEMI patients admitted throughout an 8- week period during the COVID-19 outbreak. These patients were compared with consecutive STEMI patients admitted during the corresponding period in 2019. The primary endpoint was defined as a composite of malignant arrhythmia, congestive heart failure, and in-hospital mortality. Secondary outcomes included individual components of primary outcome, cardiogenic shock, mechanical complications, electrical complications, re- infarction, stroke, and pericarditis. RESULTS: This study cohort was comprised of 64 consecutive acute STEMI patients, of whom 30 (46.9%) were hospitalized during the COVID-19 outbreak. STEMI patients in both the COVID-19 and control groups had similar comorbidities, Killip classification score, and clinical presentations. The median time from symptom onset to reperfusion (total ischemic time) was lengthened from 99.5 minutes (IQR 84.8-132) in 2019 to 149 minutes (IQR 96.3- 231.8, p-value = 0.032) in 2020. Hospitalization during the COVID-19 era was independently associated with an increased risk for combined inhospital outcome (OR 3.96, p-value = .046). CONCLUSIONS: STEMI patients admitted during the first wave of COVID- 19 outbreak experienced longer total ischemic time and increased risk for combined in-hospital outcomes compared to the corresponding period in 2019 at PAR.