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. 2020 Jul 1;6(3):210-216.
doi: 10.1093/ehjqcco/qcaa046.

Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology

Guilherme Pessoa-Amorim  1   2 , Christian F Camm  1   3 , Parag Gajendragadkar  1   3   4 , Giovanni Luigi De Maria  2   5 , Celine Arsac  6 , Cecile Laroche  6 , José Luis Zamorano  7 , Franz Weidinger  8 , Stephan Achenbach  9 , Aldo P Maggioni  6   10 , Chris P Gale  11   12   13 , Athena Poppas  14 , Barbara Casadei  2   3   4
Affiliations

Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology

Guilherme Pessoa-Amorim et al. Eur Heart J Qual Care Clin Outcomes. .

Abstract

Aims: The COVID-19 pandemic required a significant redeployment of worldwide healthcare resources. Fear of infection, national lockdowns and altered healthcare priorities have the potential to impact utilisation of healthcare resources for non-communicable diseases. To survey health professionals' views of the impact of the COVID-19 pandemic on the rate and timing of admission of patients with ST-elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) administered an internet-based questionnaire to cardiologists and cardiovascular nurses across 6 continents.

Methods and results: 3101 responses were received from 141 countries across 6 continents. 88.3% responded that their country was in "total lockdown" and 7.1% in partial lockdown. 78.8% responded that the number of patients presenting with STEMI was reduced since the coronavirus outbreak and 65.2% indicated that the reduction in STEMI presentations was >40%. Approximately 60% of all respondents reported that STEMI patients presented later than usual and 58.5% that >40% of STEMI patients admitted to hospital presented beyond the optimal window for primary percutaneous intervention (PCI) or thrombolysis. Independent predictors of the reported higher rate of delayed STEMI presentation were a country in total lockdown, >100 COVID-19 cases admitted locally, and the complete restructuring of the local cardiology service.

Conclusion: The survey indicates that the impact of COVID-19 on STEMI presentations is likely to be substantial, with both lower presentations and a higher rate of delayed presentations occurring. This has potentially important ramifications for future healthcare and policy planning in the event of further waves of this pandemic.

Keywords: COVID-19; European Society of Cardiology; ST-elevation myocardial infarction.

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Figures

Figure 1
Figure 1
Distribution of responses overall and for each continent.
Figure 2
Figure 2
Distribution of responses overall and for each continent for those respondents who reported a lower number of ST-elevation myocardial infarction presentations since the COVID-19 outbreak.
Figure 3
Figure 3
Distribution of responses overall and for each continent.
Figure 4
Figure 4
Distribution of responses overall and for each continent.
Figure 5
Figure 5
National and hospital factors associated with a higher likelihood to report delays in ST-elevation myocardial infarction admissions.
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