Patient voluntarily delays call to emergency medical system for ST-elevation myocardial infarction during COVID-19 pandemic

Baldi, Enrico; Auricchio, Angelo; Cresta, Ruggero; Vanetta, Chiara; Anselmi, Luciano; Pedrazzini, Giovanni; Benvenuti, Claudio

doi:10.1016/j.ijcha.2021.100824

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…Also, delays in EMS response time including time form EMS call to scene arrival and scene arrival to door time have been reported [ 52 ]. However, the majority of studies found increased time form symptom onset to EMS call between pre-pandemic and pandemic periods [ [55] , [56] , [57] ]. While EMS may play a role in the increased onset-to-door time found in this study, the increased time to EMS call found in articles suggest that it may be due increased patient hesitancy to seek medical care due to fear of COVID-19 exposure.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on emergency department management of stroke and STEMI. A narrative review

Banfield¹,

Elghawy²,

Dewanjee³

et al. 2022

The American Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on emergency department management of stroke and STEMI. A narrative review

Banfield¹,

Elghawy²,

Dewanjee³

et al. 2022

The American Journal of Emergency Medicine

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“…Reports from the US, the country with the highest number of COVID-19 cases in 2020, showed a 70% reduction in ACS admissions, while New Zealand, which maintained very low infection rates, observed a 28% reduction in ACS admissions [ 12 , 13 ]. A study from Swiss Ticino Canton showed an increase in the symptom-to-door time due to delay in call for EMS services despite the low COVID infection rate in the region [ 14 ]. The decrease in ACS hospitalization has been variously attributed to overwhelmed health systems due to COVID patients, fear of nosocomial COVID-19 exposure among patients, and societal restrictions related to lockdown.…”

Section: Discussionmentioning

confidence: 99%

Cases of acute coronary syndrome and presumed cardiac death prior to arrival at an urban tertiary care hospital in Pakistan during the COVID-19 pandemic

et al. 2022

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Background A reduction in overall acute coronary syndrome (ACS) cases, increases in the severity of ACS presentation, and increased rates of out-of-hospital cardiac arrest (OHCA) have been reported from multiple countries during the COVID-19 pandemic. The attributed factors include COVID-19 infection, fear of COVID-19 and resultant avoidance of health care facilities, and restrictions on mobility. Pakistan, a country with a high burden of cardiovascular disease (CVD) and challenges related to health care access, will be expected to demonstrate these same findings. Therefore, we compared ACS hospitalization, ACS severity, and patients who have already died (dead on arrival, or DOA) due to presumed OHCA at a tertiary cardiac hospital during pre-pandemic and intra-pandemic periods in Pakistan. Methods Standardized data elements were extracted from the charts of patients with ACS, and telephonic verbal autopsies (VA) using a validated tool were conducted for patients who were arrived DOA. As a comparison, cases during the same months prior to the COVID-19 were analyzed for respective waves. Events were counted, and proportions and frequencies are reported for each time period. Results A total of 4,480 ACS cases were reviewed; 1,216 cases during March-July 2019, 804 cases in the same months of 2020 (33.8% decrease); 1,304 cases in August 2019-January 2020 and 1,157 in the corresponding months of 2020 and 2021 (11.2% decrease). There was no observed change in the baseline characteristics of patients with ACS or their symptom-to-door time, and in-hospital mortality was unchanged across all time periods. There were 218 DOA cases in pre-pandemic months and 360 cases during the pandemic. The pre-pandemic rate of DOA was 12/1000 emergency patients (95% CI 10–13) compared to 22/1000 (95% CI 22–27) during the pandemic (30/1000in the 1st wave and 17/1000 during 2nd wave). On VA, CVD was found to be the major cause of death during both time periods. Conclusion At a cardiac hospital in Pakistan, the COVID-19 pandemic was associated with a reduction in ACS hospitalization and an increased DOA rate.

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“…Concerning the pandemic-related causes, the unprecedented reduction in outpatient visits experienced during the lockdown, especially in the first pandemic wave, had a detrimental effect on chronic patients [ 73 , 74 ]. However, undoubtedly, the major role was played by the fear of in-hospital infection [ 75 ], that lead many patients to delay the EMS call [ 76 , 77 ▪ ] or prevented them to call the EMS at all in case of time-dependent diseases (i.e. myocardial infarction, stroke, etc.)…”

Section: Causes Of the Increase In Out-of-hospital Cardiac Arrest Inc...mentioning

confidence: 99%

Cardiac arrest and coronavirus disease 2019

Baldi

Cortegiani

Savastano

2022

Current Opinion in Critical Care

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Purpose of reviewThe impact of the coronavirus disease 2019 (COVID-19) on the cardiovascular system has been highlighted since the very first weeks after the severe acute respiratory syndrome coronavirus 2 identification. We reviewed the influence of COVID-19 pandemic on cardiac arrest, both considering those occurred out of the hospital (OHCA) and in the hospital (IHCA). Recent findingsAn increase in OHCA incidence occurred in different countries, especially in those regions most burdened by the COVID-19, as this seems to be bounded to the pandemic trend. A change of OHCA patients' characteristics, with an increase of the OHCA occurred at home, a decrease in bystander cardiopulmonary resuscitation and automated external defibrillator use before Emergency Medical Service (EMS) arrival and an increase in non-shockable rhythms, have been highlighted. A dramatic drop in the OHCA patients' survival was pointed out in almost all the countries, regardless of the high or low-incidence of COVID-19 cases. Concerning IHCA, a reduction in survival was highlighted in patients with COVID-19 who sustained a cardiac arrest. SummaryCardiac arrest occurrence and survival were deeply affected by the pandemic. Informative campaigns to the population to call EMS in case of need and the re-allocation of the prehospital resources basing on the pandemic trend are needed to improve survival.

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Patient voluntarily delays call to emergency medical system for ST-elevation myocardial infarction during COVID-19 pandemic

Cited by 5 publications

References 12 publications

Impact of COVID-19 on emergency department management of stroke and STEMI. A narrative review

Impact of COVID-19 on emergency department management of stroke and STEMI. A narrative review

Cases of acute coronary syndrome and presumed cardiac death prior to arrival at an urban tertiary care hospital in Pakistan during the COVID-19 pandemic

Cardiac arrest and coronavirus disease 2019

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