Nuffield Department of Population Health, University of Oxford, Oxford, UK.
NIHR Oxford Biomedical Research Centre, UK.
Eur Heart J Qual Care Clin Outcomes. 2020 Jul 1;6(3):210-216. doi: 10.1093/ehjqcco/qcaa046.
The COVID-19 pandemic required a significant redeployment of worldwide healthcare resources. Fear of infection, national lockdowns and altered healthcare priorities have the potential to impact utilisation of healthcare resources for non-communicable diseases. To survey health professionals' views of the impact of the COVID-19 pandemic on the rate and timing of admission of patients with ST-elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) administered an internet-based questionnaire to cardiologists and cardiovascular nurses across 6 continents.
3101 responses were received from 141 countries across 6 continents. 88.3% responded that their country was in "total lockdown" and 7.1% in partial lockdown. 78.8% responded that the number of patients presenting with STEMI was reduced since the coronavirus outbreak and 65.2% indicated that the reduction in STEMI presentations was >40%. Approximately 60% of all respondents reported that STEMI patients presented later than usual and 58.5% that >40% of STEMI patients admitted to hospital presented beyond the optimal window for primary percutaneous intervention (PCI) or thrombolysis. Independent predictors of the reported higher rate of delayed STEMI presentation were a country in total lockdown, >100 COVID-19 cases admitted locally, and the complete restructuring of the local cardiology service.
The survey indicates that the impact of COVID-19 on STEMI presentations is likely to be substantial, with both lower presentations and a higher rate of delayed presentations occurring. This has potentially important ramifications for future healthcare and policy planning in the event of further waves of this pandemic.
COVID-19 大流行要求全球医疗资源进行重大重新部署。对感染的恐惧、国家封锁和医疗优先事项的改变有可能影响非传染性疾病的医疗资源利用。为了调查卫生专业人员对 COVID-19 大流行对 ST 段抬高型心肌梗死（STEMI）患者入院率和时间的影响的看法，欧洲心脏病学会（ESC）向六大洲的心脏病专家和心血管护士进行了一项基于互联网的问卷调查。
共收到来自六大洲 141 个国家的 3101 份回复。88.3%的人表示他们的国家处于“全面封锁”状态，7.1%的人处于部分封锁状态。78.8%的人表示自冠状病毒爆发以来，出现 STEMI 的患者数量减少，65.2%的人表示 STEMI 患者减少超过 40%。大约 60%的受访者报告称 STEMI 患者就诊时间晚于往常，58.5%的人表示超过 40%的 STEMI 患者入院时间超过了直接经皮冠状动脉介入治疗（PCI）或溶栓治疗的最佳时间窗口。报告的 STEMI 就诊延迟率较高的独立预测因素是国家处于全面封锁状态、当地收治的 COVID-19 病例超过 100 例，以及当地心脏病学服务的全面重组。
该调查表明，COVID-19 对 STEMI 就诊的影响可能很大，就诊人数减少，就诊延迟率更高。这对未来在发生这种大流行的进一步浪潮时的医疗保健和政策规划具有重要意义。
