Changes in clinical features and outcomes in three major critical diseases after COVID-19 pandemic: acute myocardial infarction, stroke, and cardiac arrest. (Special Issue: COVID-19 in the emergency department: epidemiology and changes throughout the pandemic.)
Signa Vitae
; 18(5):86-94, 2022.
Article
in English
| CAB Abstracts | ID: covidwho-2040592
ABSTRACT
A few months after the onset of the coronavirus Disease 2019 (COVID-19) pandemic, the worse prognoses of acute myocardial infarction, ischemic and hemorrhagic stroke, and cardiac arrest were reported. This study aimed to investigate the changes in the characteristics and prognoses of these diseases in the emergency department (ED) over a year after pandemic's onset. This was a retrospective observational study. The year 2019 was defined as the pre-period, while the year from February 2020 to January 2021 was defined as the post-period. Adult patients diagnosed with acute myocardial infarction, ischemic stroke, hemorrhagic stroke, or cardiac arrest during the study period were included. The primary outcome was in-hospital mortality. Time series analyses using autoregressive integrated moving average (ARIMA)(p,d,q) model were performed to evaluate the changes between periods. A multivariable logistic regression analysis of factors affecting in-hospital mortality was performed. The proportions of patients with acute myocardial infarction (0.8% vs. 1.1%, p < 0.001), hemorrhagic stroke (1.0%vs. 1.2%, p = 0.011), and cardiac arrest (0.9% vs. 1.1%, p = 0.012) increased in the post-period. The post-period was independently associated with in-hospital mortality in acute myocardial infarction (adjusted odds ratio (aOR) 2.54, 95% confidence interval (95% CI) 1.06-6.08, p = 0.037) and hemorrhagic stroke (aOR 1.74, 95% CI 1.11-2.73, p = 0.016), but not for ischemic stroke or cardiac arrest. Over a year after onset of the COVID-19 pandemic in Korea, the number of patients with acute myocardial infarction, hemorrhagic stroke, and cardiac arrest in the ED increased. An independent association between the post-period and mortality was observed for acute myocardial infarction, and hemorrhagic stroke. This study provides important information for future studies and policies.
Non-communicable Human Diseases and Injuries [VV600]; Prion, Viral, Bacterial and Fungal Pathogens of Humans [VV210]; Mathematics and Statistics [ZZ100]; Demography [UU200]; myocardial infarction; human diseases; viral diseases; stroke; coronavirus disease 2019; mortality; myocardial ischaemia; risk factors; pandemics; public health; epidemiology; disease course; severe course; heart failure; heart diseases; heart; prognosis; ischaemia; hospitals; adults; patients; haemorrhage; time series; mathematical models; regression analysis; predictive value; trends; acute course; Severe acute respiratory syndrome coronavirus 2; man; Korea Republic; Severe acute respiratory syndrome-related coronavirus; Betacoronavirus; Coronavirinae; Coronaviridae; Nidovirales; positive-sense ssRNA Viruses; ssRNA Viruses; RNA Viruses; viruses; Homo; Hominidae; primates; mammals; vertebrates; Chordata; animals; eukaryotes; APEC countries; East Asia; Asia; high income countries; OECD Countries; very high Human Development Index countries; heart attack; SARS-CoV-2; viral infections; death rate; ischaemic heart disease; myocardial ischemia; disease progression; coronary diseases; ischemia; bleeding; hemorrhage; South Korea
Full text:
Available
Collection:
Databases of international organizations
Database:
CAB Abstracts
Type of study:
Observational study
/
Prognostic study
Language:
English
Journal:
Signa Vitae
Year:
2022
Document Type:
Article
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