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2021 ; 97
(2
): E194-E197
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English Wikipedia
Impact of coronavirus disease 2019 (COVID-19) outbreak on outcome of myocardial
infarction in Hong Kong, China
#MMPMID32367683
Tam CF
; Cheung KS
; Lam S
; Wong A
; Yung A
; Sze M
; Fang J
; Tse HF
; Siu CW
Catheter Cardiovasc Interv
2021[Feb]; 97
(2
): E194-E197
PMID32367683
show ga
OBJECTIVE: To determine whether COVID-19 may adversely affect outcome of
myocardial infarction (MI) patients in Hong Kong, China. BACKGROUND: The COVID-19
pandemic has infected thousands of people and placed enormous stress on
healthcare system. Apart from being an infectious disease, it may affect human
behavior and healthcare resource allocation which potentially cause treatment
delay in MI. METHODS: This was a single center cross-sectional observational
study. From November 1, 2019 to March 31, 2020, we compared outcome of patients
admitted for acute ST-elevation MI (STEMI) and non-ST elevation MI (NSTEMI)
before (group 1) and after (group 2) January 25, 2020 which was the date when
Hong Kong hospitals launched emergency response measures to combat COVID-19.
RESULTS: There was a reduction in daily emergency room attendance since January
25, 2020 (group 1,327/day vs. group 2,231/day) and 149 patients with diagnosis of
MI were included into analysis (group 1 N = 85 vs. group 2?N = 64). For STEMI,
patients in group 2 tended to have longer symptom-to-first medical contact time
and more presented out of revascularization window (group 1 27.8 vs. group 2
33%). The primary composite outcome of in-hospital death, cardiogenic shock,
sustained ventricular tachycardia or fibrillation (VT/VF) and use of mechanical
circulatory support (MCS) was significantly worse in group 2 (14.1 vs. 29.7%, p =
.02). CONCLUSIONS: More MI patients during COVID-19 outbreak had complicated
in-hospital course and worse outcomes. Besides direct infectious complications,
cardiology community has to acknowledge the indirect effect of communicable
disease on our patients and system of care.