Physicians' Academy for Cardiovascular Education

Delay in seeking medical help by STEMI patients during the COVID-19 outbreak

Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China

Literature - Tam CF, Cheung KS, Lam S et al., - Circ Cardiovasc Qual Outcomes. 2020. doi: 10.1161/CIRCOUTCOMES.120.006631.

Introduction and methods

The potential negative impact of a community outbreak of infectious disease like the COVID-19 pandemic on proper health care of STEMI patients is not understood.

The present study evaluated the impact of the COVID-19 outbreak on STEMI care in a single center in Hong Kong during the COVID-19 outbreak, from January 25, 2020, when hospitals in Hong Kong started to institute emergency infection protocols to contain COVID-19, until February 10, 2020. Included were patients (n=7) with PPCI-treated STEMI and who did not suffer from a COVID-19 infection. 6 Patients presented during office hours and 1 during non-office hours. STEMI care was compared to treatment of STEMI patients treated with PPCI in the prior year (from February 1, 2018 until January 31, 2019) (n=108), before the COVID-19 outbreak.

Outcome measures were defined as times from (1) patient-reported chest discomfort onset to first medical contact, (2) patient arrival at the Accident and Emergency Department to successful wire crossing during PPCI and (3) patient arrival at the catheterization laboratory to successful wire crossing.

Main results

Conclusion

In a hospital in Hong Kong, there were delays in seeking medical help by 7 STEMI patients, most visible in the time from symptom onset to first medical contact, after institution of infection control measures due to the COVID-19 outbreak, as compared to STEMI care of similar patients before the outbreak. In addition, due to the COVID-19 outbreak, time from patient arrival at the emergency department to successful wire crossing during PPCI, as well as time from patient arrival at the catheterization laboratory to successful wire crossing, were also delayed. This study shows how public health emergencies such as the COVID-19 outbreak can have an indirect effect on healthcare in unrelated areas.

Find this article online at Circ Cardiovasc Qual Outcomes

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