Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea - an observational study

BackgroundThe coronavirus disease 2019 (COVID-19) resulted in a marked decrease in the number of patient visits for acute myocardial infarction (AMI) and delayed patient response and intervention in several countries. This study evaluated the effect of the COVID-19 pandemic on the number of patients, patient response time (pain-to-door), and intervention time (door-to-balloon) for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). MethodsPatients with STEMI or NSTEMI visiting a hospital in South Korea who underwent primary coronary intervention during the COVID-19 pandemic (January 29, 2020, to December 31, 2020) were compared with those in the equivalent period in 2018 to 2019. Patient response and intervention times were compared for the COVID-19 pandemic window (2020) and the equivalent period in 2018 to 2019. ResultsWe observed no decrease in the number of patients with STEMI (P=0.50) and NSTEMI (P=0.94) during the COVID-19 pandemic compared to that in the previous years. Patient response times (STEMI: P=0.34; NSTEMI: P=0.89) during the overall COVID-19 pandemic period did not differ significantly. However, we identified a significant decrease in time to intervention among patients with STEMI (14%; p<0.01) during the early COVID-19 pandemic. ConclusionsWe found that the number of patient with STEMI and NSTEMI was consistent during the COVID-19 pandemic and that no time delays in patient response and intervention occurred. However, the door-to-balloon time among patients with STEMI significantly reduced during the early COVID-19 pandemic, which could be attributed to reduced emergency care utilization during the early pandemic.

Transmission dynamics of coronavirus disease 2019 outside of Daegu-Gyeongsangbuk provincial region in South Korea

We analyzed transmission of coronavirus disease 2019 in South Korea. We estimated that non-pharamaceutical measures reduced the immediate transmissibility by maximum of 34% for coronavirus disease 2019. Continuous efforts are needed for monitoring the transmissibility to optimize epidemic control.

Reduction in time delay of isolation in COVID-19 cases in South Korea

Korean public health authorities raised the public alert to its highest level on February 23, 2020 to mitigate the 2019 novel coronavirus disease epidemic. We have identified that the mean delay from symptom onset to isolation was reduced to one day after raising the alert. Vigilance can reduce this interval.