Impact on hospital admission of ST-elevation myocardial infarction patients during coronavirus disease 2019 pandemic in an Italian Hospital

Liberto, Ilenia Alessandra Di; Pilato, Gerlando; Geraci, Salvatore; Milazzo, Diego; Vaccaro, Giovanni; Buccheri, Sergio; Caramanno, Giuseppe

doi:10.2459/jcm.0000000000001053

Cited by 14 publications

(13 citation statements)

References 5 publications

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“…9-11 Cardiovascular emergencies payed significant tolls with a significant delay in time-sensitive emergency operations. 9,19 More recent evidences, consistent with our results, showed a significant decrease in mean number of endovascular therapies per hospital performed before and after COVID-19 confinement along with a significant increase in mean stroke onset-to groin puncture time 260 .A delayed presentation of STEMI patients that may led to worsened prognosis and unnecessary deaths has also been observed 261 . Moreover, an additional study confirmed that more in-hospital cardiovascular deaths occurred in March 2020 compared with March 2019, a finding possibly due to late hospital presentations and consequent greater disease severity that affected eligibility and outcome of cardiovascular procedures 262 .…”

Section: Discussionsupporting

confidence: 87%

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

Lugli

Ottaviani

Botta

et al. 2020

Preprint

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Background: Italy has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties during the pandemic in Italy. Methods: A PRISMA guideline-based systematic review of the available literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19. Findings: Of the 4643 potentially eligible studies identified by the search, 247 studies were included in the systematic review. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine during the pandemic. Interpretation: Our work highlights the changes taking place in the Italian public healthcare system in order to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.

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Section: Discussionsupporting

confidence: 87%

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

Lugli

Ottaviani

Botta

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…On September 14th 2020, the World Health Organization has registered 28,584,158 confirmed cases of coronavirus disease 2019 (COVID- 19), and 916,955 deaths due to COVID-19 worldwide [1]. The new coronavirus (SARS-CoV-2) that causes COVID-19 continues to challenge public health systems across the globe.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to the general observation of a decrease in emergency consultations, trends of admissions with specific medical conditions have been published. Several studies reported that admission numbers decreased for cardiovascular emergencies such as acute coronary syndrome (ACS), both ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) [19][20][21][22][23][24][25], as well as for stroke and transient ischemic attack (TIA) [26][27][28][29]. Evidence about trends for diagnoses other than cardiovascular diseases is scarce.…”

Section: Introductionmentioning

confidence: 99%

Differential trends of admissions in accident and emergency departments during the COVID-19 pandemic in Germany

et al. 2021

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Background Recent studies have shown a decrease of admissions to accident and emergency (A&E) departments after the local outbreaks of COVID-19. However, differential trends of admission counts, for example according to diagnosis, are less well understood. This information is crucial to inform targeted intervention. Therefore, we aimed to compare admission counts in German A&E departments before and after 12th march in 2020 with 2019 according to demographic factors and diagnosis groups. Methods Routine data of all admissions between 02.12.2019–30.06.2020 and 01.12.2018–30.06.2019 was available from six hospitals in five cities from north-western, eastern, south-eastern, and south-western Germany. We defined 10 diagnosis groups using ICD-10 codes: mental disorders due to use of alcohol (MDA), acute myocardial infarction (AMI), stroke or transient ischemic attack (TIA), heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), cholelithiasis or cholecystitis, back pain, fractures of the forearm, and fractures of the femur. We calculated rate ratios comparing different periods in 12.03.2020–30.06.2020 with 12.03.2019–30.06.2019. Results Forty-one thousand three hundred fifty-three cases were admitted between 12.03.2020–30.06.2020 and 51,030 cases between 12.03.2019–30.06.2019. Admission counts prior to 12.03. were equal in 2020 and 2019. In the period after 12.03., the decrease of admissions in 2020 compared to 2019 was largest between 26.03. and 08.04. (− 30%, 95% CI − 33% to − 27%). When analysing the entire period 12.03.-30.06., the decrease of admissions was heterogeneous among hospitals, and larger among people aged 0–17 years compared to older age groups. In the first 8 weeks after 12.03., admission counts of all diagnoses except femur fractures and pneumonia declined. Admissions with pneumonia increased in this early period. Between 07.05. and 30.6.2020, we noted that admissions with AMI (+ 13%, 95% CI − 3% to + 32%) and cholelithiasis or cholecystitis (+ 20%, 95% CI + 1% to + 44%) were higher than in 2019. Conclusions Our results suggest differential trends of admission counts according to age, location, and diagnosis. An initial decrease of admissions with MDA, AMI, stroke or TIA, heart failure, COPD, cholelithiasis or cholecystitis, and back pain imply delays of emergency care in Germany. Finally, our study suggests a delayed increase of admissions with AMI and cholelithiasis or cholecystitis.

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“…Of those, three were also excluded due to the incompleteness of the data and contents. At least, 18 articles were desirable for the last analysis (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Table 1 illustrates the basic characteristics of the studies included.…”

Section: Resultsmentioning

confidence: 99%

The changes in therapeutic and managerial protocols for patients suffering ST-segment elevation myocardial infarction in COVID-19 pandemic; a systematic review and meta-analysis

et al. 2020

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Introduction: Apart from the direct effect of COVID-19 on the incidence of ischemic heart disease, the pandemic effect of this infection on the control of ischemic heart disease and on the clinical consequences of these patients and also their hospital admission is also significant. Objectives: The present review attempted to assess the admission rate, treatment protocols, and outcome changes in patients suffering ST-segment elevation myocardial infarction (STEMI) in the COVID-19 outbreak. Materials and Methods: The included studies were identified through electronically reviewing the manuscripts databases of MEDLINE, EMBASE, Web of knowledge, and Google Scholar from inception to September 2020. The titles and abstracts of the manuscripts were screened by two blinded reviewers followed by an in-depth assessment of the full texts for assigning the inclusion appropriateness. Results: Eighteen articles (including 6225 STEMI patients hospitalized within the COVID-19 pandemic duration and 55711 STEMI patients in pre-COVID-19 periods) were desirable for the final analysis. A longer delay among symptom onset and first medical contact (FMC) in the COVID-19 lockdown period than before the COVID-19 pandemic was revealed. Comparing STEMI-related death in the COVID-19 period compared to the pre-COVID-19 duration showed a significantly higher death rate and a higher rate of thrombolytic therapy. The examined pre-COVID-19 and COVID-19 periods showed a reduction in STEMI patients’ admissions reached 30.9%. Additionally, entering the COVID-19 period resulted in a significant 44.4% reduction in the number of primary percutaneous coronary intervention. Conclusion: During the COVID-19 pandemic, the management of STEMI has undergone significant changes, including reduced hospital admissions, reduced invasive and semi-invasive treatment interventions, increased STEMI-related mortality, increased thrombolytic therapy, and delayed patients’ referral to the hospitals.

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Impact on hospital admission of ST-elevation myocardial infarction patients during coronavirus disease 2019 pandemic in an Italian Hospital

Cited by 14 publications

References 5 publications

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

Differential trends of admissions in accident and emergency departments during the COVID-19 pandemic in Germany

The changes in therapeutic and managerial protocols for patients suffering ST-segment elevation myocardial infarction in COVID-19 pandemic; a systematic review and meta-analysis

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