Recommendations for safe and effective practice of interventional cardiology during COVID-19 pandemic: Expert opinion from Jordan and Palestine

Daralammouri, Yunis; Azamtta, Murad; Hamayel, Hamza; Jaber, Dina Abu; Adas, Amro; Hussein, Izz-Eddein; Hantash, Hadi Abu; Hammoudeh, Ayman; Mousa, Eyas; Nasr, Mohammed

doi:10.59049/2790-0231.1053

Cited by 4 publications

(3 citation statements)

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“…This policy has also been applied by some countries such as China, Taiwan, Palestine, Iran, and India. 4 – 6 , 11 , 12 Fibrinolytic therapy is considered as it can reduce the delay time that occurs in STEMI patients during COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…The high rate of disease transmission of SARS-CoV-2 has created changes in the algorithm of diagnosis and therapy in hospitals. 4 – 6 Additional screening COVID-19 tests, wearing personal protective equipment, and performing disinfection of medical equipment and wards must be done to prevent the possibility of transmission. 7 , 8 These conditions have potential to hamper treatment response in managing patients with emergency conditions including STEMI.…”

Section: Introductionmentioning

confidence: 99%

“…In response to those obstacles, some countries have changed their policy on the management of STEMI patients by prioritizing fibrinolytic therapy. 4 – 6 , 11 , 12 This policy has also been applied in Dr. Cipto Mangunkusumo Hospital (CMH). Therefore, this study aimed to provide knowledge about the effects of the COVID-19 pandemic on the management of STEMI patients in Indonesia.…”

Section: Introductionmentioning

confidence: 99%

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Effects of the COVID-19 pandemic on the management of ST-Segment elevation myocardial infarction in Indonesia: a cohort study

et al. 2022

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Background: ST-segment elevation myocardial infarction (STEMI) is a form of acute coronary syndrome with high mortality rate. Management of STEMI should be performed as soon as possible to prevent further damage. With the emergence of coronavirus disease 2019 (COVID-19), it may face obstacles. To overcome those problems, some changes in policy focusing on fibrinolytic therapy in STEMI patients have been applied. This study aimed to identify the effects of COVID-19 in management of STEMI patients in Indonesia. Methods: This retrospective study was conducted in Dr. Cipto Mangunkusumo Hospital (CMH), the national referral center in Indonesia. We compared data between 2018 to 2019 and 2020 to 2021 as before and during COVID-19 pandemic period, respectively. We analyzed the effects of COVID-19 on STEMI patients' visits to hospital i.e., monthly hospital admission and symptoms-to-hospital, management of STEMI i.e., the strategies and time of reperfusion, and clinical outcomes of STEMI patients i.e., major adverse coronary event and mortality. Results: There was a significant statistically reduced mean of monthly hospital admissions from 11 to 7 (p = 0.002) and prolonged duration of symptoms-to-hospital during COVID-19 from 8 to 12 hours (p = 0.005). There was also a decrease in primary percutaneous coronary intervention (PPCI) procedures during COVID-19 (65.2% vs. 27.8%, p<0.001), which was accompanied by an increased number of fibrinolytic (1.5% vs. 9.5%, p<0.001) and conservative therapy (28.5% vs. 55.6%, p <0.01). Moreover, there was also a prolonged duration of diagnosis-to-wire-crossing time (160 vs. 186 minutes, p = 0.005), meanwhile, percentage of urgent PCI, door-to-needle time, and clinical outcomes were not statistically significant. Conclusions: During COVID-19 pandemic, the number STEMI patients declined in monthly hospital admission, delays in symptoms-to-hospital time, changes in type of reperfusion strategy, and delays in PPCI procedures in CMH. Meanwhile, fibrinolytic time and clinical outcomes were not affected.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of the COVID-19 pandemic on the management of ST-Segment elevation myocardial infarction in Indonesia: a cohort study

et al. 2022

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Management and Outcomes of Patients With STEMI During the COVID-19 Pandemic in China

Xiang

Zhang

et al. 2020

Journal of the American College of Cardiology

199

217

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Background ST-segment elevation myocardial infarction (STEMI) is a fatal cardiovascular emergency requiring rapid reperfusion treatment. During the coronavirus disease-2019 (COVID-19) pandemic, medical professionals need to strike a balance between providing timely treatment for STEMI patients and implementing infection control procedures to prevent nosocomial spread of COVID-19 among health care workers and other vulnerable cardiovascular patients. Objectives This study evaluates the impact of the COVID-19 outbreak and China Chest Pain Center’s modified STEMI protocol on the treatment and prognosis of STEMI patients in China. Methods Based on the data of 28,189 STEMI patients admitted to 1,372 Chest Pain Centers in China between December 27, 2019 and February 20, 2020, the study analyzed how the COVID-19 outbreak and China Chest Pain Center’s modified STEMI protocol influenced the number of admitted STEMI cases, reperfusion strategy, key treatment time points, and in-hospital mortality and heart failure for STEMI patients. Results The COVID-19 outbreak reduced the number of STEMI cases reported to China Chest Pain Centers. Consistent with China Chest Pain Center’s modified STEMI protocol, the percentage of patients undergoing primary percutaneous coronary intervention declined while the percentage of patients undergoing thrombolysis increased. With an average delay of approximately 20 min for reperfusion therapy, the rate of in-hospital mortality and in-hospital heart failure increased during the outbreak, but the rate of in-hospital hemorrhage remained stable. Conclusions There were reductions in STEMI patients’ access to care, delays in treatment timelines, changes in reperfusion strategies, and an increase of in-hospital mortality and heart failure during the COVID-19 pandemic in China.

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Coronavirus Disease 2019 and Catheterisation Laboratory Considerations: “Looking for Essentials”

et al. 2020

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The current coronavirus disease 2019 (COVID-19) outbreak is a significant health crisis that impacts every healthcare system worldwide, and has led to a dramatic change in dealing with different diseases during the pandemic. Interventional cardiologists are frontline workers who deal with many cardiovascular emergencies, either in patients with proven COVID-19 or in suspected cases. Many heart associations worldwide are currently setting appropriate recommendations for the management of emergency cardiac interventions. In this expert opinion, the authors highlight the essential requirements in the cardiac catheterisation laboratory during the COVID-19 pandemic.

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Recommendations for safe and effective practice of interventional cardiology during COVID-19 pandemic: Expert opinion from Jordan and Palestine

Cited by 4 publications

References 0 publications

Effects of the COVID-19 pandemic on the management of ST-Segment elevation myocardial infarction in Indonesia: a cohort study

Effects of the COVID-19 pandemic on the management of ST-Segment elevation myocardial infarction in Indonesia: a cohort study

Management and Outcomes of Patients With STEMI During the COVID-19 Pandemic in China

Coronavirus Disease 2019 and Catheterisation Laboratory Considerations: “Looking for Essentials”

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