Management Trends in the Cath Lab During the COVID-19 Period, an Egyptian Survey

Abstract

The World Health Organization (WHO) announced that the novel coronavirus pneumonia pandemic caused by SARS-CoV-2 was classified as a public health emergency of international concern on January 30, 2020 Egypt's health ministry had announced the first case in the country at Cairo International Airport involving a Chinese national on 14 February 2020. Case decisions in the cath labs should be individualized, taking into account the risk of 2019 novel coronavirus (COVID-19) exposure versus the risk of delay in diagnosis or therapy. In patients with known or suspected COVID-19 and ischemic heart disease, the balance of staff exposure and patient benefit will need to be weighed carefully. Aim of the work: Analyzing and assessing the impact of COVID 19 pandemic on the: (1) volume, type of patients, and the different procedures performed. (2) The changes in management trends of cardiologists in the cath labs. Results: This study has surveyed 30 cath labs distributed all over Egypt during COVID-19 pandemic with 43.35% in urban area and 56.7% in rural areas. Only 63.3% of surveyed centers were well equipped to deal with COVID-19 active patients and full personal protective equipment was worn in only 6.7% of patients. A decrease in the volume of new acute coronary syndrome (ACS) patients, ST-elevation myocardial infarction patients and primary percutaneous coronary intervention (PCI) was recorded in 80%, 83%, and 80% of the surveyed centers respectively. Regarding the delay in the invasive management for patients with ACS due to diagnostic testing, there was 100% delay in all surveyed centers with 70% of centers suffering from delay in primary PCI due to awaited testing. On the other hand, there was a decrease in the volume of patients receiving elective procedures in 83.3% of cath labs. Conclusion: The management trends in the current Egyptian survey were significantly impacted during COVID-19 pandemic. Primary PCI volume much reduced and takes longer time than should be.

Impact of the COVID-19 pandemic on the hospitalizations, time course, presenting symptoms, and mid-term outcomes in patients with myocardial infarctions in a Japanese multi-center registry

“…On the other hand, the results outside of Japan have shown an increase in the mortality from AMIs in the after-pandemic period [ 18 – 20 ]. The reason could be considered to be that the STATs of AMIs and the enforcement rate of a primary PCI differed between our study and the other countries [ 20 , 21 ]. In an observational study in China, the pre-hospital and in-hospital treatment times for STEMIs after the COVID-19 pandemic were significantly longer than those before, which resulted in a mortality increase [ 20 ].…”

“…In an observational study in China, the pre-hospital and in-hospital treatment times for STEMIs after the COVID-19 pandemic were significantly longer than those before, which resulted in a mortality increase [ 20 ]. In an observational study in Egypt, the volume of primary PCIs decreased at 80% of the centers [ 21 ]. In the present study, the enforcement rate of a primary PCI (97.8% vs. 98.5%, p = 0.74) and STATs were maintained in the after-pandemic period, which might be related to the lack of significant differences in the mid-term outcomes between the two time periods.…”

Impact of COVID-19 pandemic on catheter ablation in China: A spatiotemporal analysis

“…Despite this, there was a substantial decline in medical care for several urgent cases, such as delays in the emergency intervention for acute coronary syndrome ( 3 – 6 ). As a consequence, non-emergency procedures had been hit harder ( 7 – 9 ).…”