Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Jun;47(3):258-264.
doi: 10.1007/s00059-021-05058-7. Epub 2021 Aug 17.

Outcomes of patients with ST-segment myocardial infarction admitted during the COVID-19 pandemic : A prospective, observational study from a tertiary care center in Germany

M Rattka  1 , C Winsauer  2 , L Stuhler  2 , K Thiessen  2 , M Baumhardt  2 , T Stephan  2 , W Rottbauer  2 , A Imhof  3
Affiliations
Observational Study

Outcomes of patients with ST-segment myocardial infarction admitted during the COVID-19 pandemic : A prospective, observational study from a tertiary care center in Germany

M Rattka et al. Herz. 2022 Jun.

Erratum in

Abstract
in English, German

Background: Since the beginning of the SARS-CoV‑2 outbreak, healthcare professionals reported that patients admitted with ST-segment myocardial infarction (STEMI) were in worse condition compared to STEMI patients admitted before the outbreak. However, data on their outcomes are sparse.

Methods: We conducted a prospective, observational, cohort study of STEMI patients admitted during the COVID-19 pandemic from March 21, 2020 to July 31, 2020 (COVID-19 group). Clinical outcomes, 30-day mortality, and reasons potentially related to a delay in patient presentation were assessed and compared with STEMI patients admitted between November 1, 2019 and March 20, 2020 (pre-COVID-19 group).

Results: A total of 124 patients were enrolled, comprising 57 patients in the pre-COVID-19 group and 67 patients in the COVID-19 group. Significantly more patients in the COVID-19 group had a time to first medical contact of greater than 24 h. Additionally, those admitted during the pandemic had a significantly lower left ventricular ejection fraction (LVEF), worse thrombolysis in myocardial infarction (TIMI) flow, received circulatory support significantly more often, and had a significantly higher 30-day mortality. Furthermore, significantly more patients stated that "information by the media" made them hesitate to contact the emergency medical services as soon as possible.

Conclusion: Here, we show that STEMI patients admitted during the COVID-19 pandemic had significantly prolonged times to first medical contact, were in worse condition at admission, and had an increased 30-day mortality. Additionally, we found that "information by the media" made patients during COVID-19 hesitate to contact the emergency medical services. Consequently, public health strategies have to be developed to avoid potential excess mortality of STEMI patients during the pandemic.

Zusammenfassung: HINTERGRUND: Seit Beginn des Ausbruchs der SARS-CoV-2-Pandemie berichteten medizinisch Tätige, dass mit einem ST-Strecken-Hebungs-Infarkt (STEMI) aufgenommene Patienten in einem schlechteren Zustand waren als STEMI-Patienten mit stationärer Aufnahme vor dem Ausbruch. Allerdings ist die Datenlage zu deren Ergebnissen spärlich.

Methoden: Es wurde eine prospektive Beobachtungs-Kohortenstudie an STEMI-Patienten mit stationärer Aufnahme während der COVID-19-Pandemie vom 21. März bis 31. Juli 2020 (COVID-19-Gruppe) durchgeführt. Klinische Ergebnisse, 30-Tage-Mortalität und potenziell mit einer verspäteten Patientenvorstellung assoziierte Gründe wurden untersucht und mit STEMI-Patienten verglichen, die zwischen 1. November 2019 und 20. März 2020 stationär aufgenommen worden waren (Prä-COVID-19-Gruppe).

Ergebnisse: In die Studie wurden 124 Patienten eingeschlossen, 57 in die Prä-COVID-19-Gruppe und 67 in die COVID-19-Gruppe. In der COVID-19-Gruppe betrug die Zeit bis zum medizinischen Erstkontakt bei signifikant mehr Patienten länger als 24 h. Darüber hinaus wiesen während der Pandemie aufgenommene Patienten eine deutlich niedrigere linksventrikuläre Ejektionsfraktion (LVEF) und einen schlechteren TIMI-Wert („thrombolysis in myocardial infarction“) auf, sie erhielten öfter Kreislaufunterstützung und hatten eine deutlich höhere 30-Tage-Mortalität. Außerdem gaben deutlich mehr Patienten an, dass sie aufgrund der „Information durch die Medien“ gezögert hatten, schnellstmöglich den medizinischen Notfalldienst zu kontaktieren.

Schlussfolgerung: Die Autoren zeigen, dass STEMI-Patienten mit stationärer Aufnahme während der COVID-19-Pandemie signifikant längere Zeiten bis zum medizinischen Erstkontakt aufwiesen, sich in schlechterem Zustand präsentierten und eine erhöhte 30-Tage-Mortalität aufwiesen. Außerdem stellten die Autoren fest, dass die „Information durch die Medien“ die Patienten zögern ließ, den medizinischen Notfalldienst zu kontaktieren. Folglich sollten Strategien des öffentlichen Gesundheitswesens entwickelt werden, um während der Pandemie eine potenzielle Übersterblichkeit von STEMI-Patienten zu verhindern.

Keywords: Emergency medical services; Epidemiology; Mortality; SARS-CoV‑2; STEMI.

PubMed Disclaimer

Conflict of interest statement

M. Rattka, C. Winsauer, L. Stuhler, K. Thiessen, M. Baumhardt, T. Stephan, W. Rottbauer and A. Imhof declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patient allocation and number of STEMI patient admissions. Between November 1, 2019 and July 31, 2020, 167 patients with STEMI were admitted to our tertiary care center. Of those, 124 patients met the inclusion criteria and gave written informed consent, and were enrolled in our study (a). The number of STEMI admissions did not decrease after the first COVID-19-positive patients had been identified in March 2020 (b)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rosenbaum L. The untold toll—the pandemic’s effects on patients without Covid-19. N Engl J Med. 2020;382:2368–2371. doi: 10.1056/NEJMms2009984. - DOI - PubMed
    1. Kittleson MM. The invisible hand—medical care during the pandemic. N Engl J Med. 2020;382:1586–1587. doi: 10.1056/NEJMp2006607. - DOI - PubMed
    1. Pessoa-Amorim G, Camm CF, Gajendragadkar P, De Maria GL, Arsac C, Laroche C, et al. Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology. Eur Heart J Qual Care Clin Outcomes. 2020;6:210–216. doi: 10.1093/ehjqcco/qcaa046. - DOI - PMC - PubMed
    1. Rattka M, Baumhardt M, Dreyhaupt J, Rothenbacher D, Thiessen K, Markovic S, et al. 31 days of COVID-19—cardiac events during restriction of public life—a comparative study. Clin Res Cardiol. 2020;109:1476–1482. doi: 10.1007/s00392-020-01681-2. - DOI - PMC - PubMed
    1. De Filippo O, D’Ascenzo F, Angelini F, Bocchino PP, Conrotto F, Saglietto A, et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. N Engl J Med. 2020;383:88–89. doi: 10.1056/NEJMc2009166. - DOI - PMC - PubMed

Publication types

MeSH terms