Ayad Sherif, Shenouda Rafik, Henein Michael
Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt.
International Cardiac Center, Alexandria 21526, Egypt.
J Clin Med. 2021 Jan 14;10(2):278. doi: 10.3390/jcm10020278.
Primary percutaneous coronary intervention (PPCI) is one of the important clinical procedures that have been affected by the COVID-19 pandemic. In this study, we aimed to assess the incidence and impact of COVID-19 on in-hospital clinical outcome of ST elevation myocardial infarction (STEMI) patients managed with PPCI. This observational retrospective study was conducted on consecutive STEMI patients who presented to the International Cardiac Center (ICC) hospital, Alexandria, Egypt between 1 February and 31 October 2020. A group of STEMI patients presented during the same period in 2019 was also assessed (control group) and data was used for comparison. The inclusion criteria were established diagnosis of STEMI requiring PPCI.A total of 634 patients were included in the study. During the COVID-19 period, the number of PPCI procedures was reduced by 25.7% compared with previous year (mean 30.0 ± 4.01 vs. 40.4 ± 5.3 case/month) and the time from first medical contact to Needle (FMC-to-N) was longer (125.0 ± 53.6 vs. 52.6 ± 22.8 min, = 0.001). Also, during COVID-19, the in-hospital mortality was higher (7.4 vs. 4.6%, = 0.036) as was the incidence of re-infarction (12.2 vs. 7.7%, = 0.041) and the need for revascularization (15.9 vs. 10.7%, = 0.046). The incidence of heart failure, stroke, and bleeding was not different between groups, but hospital stay was longer during COVID-19 (6.85 ± 4.22 vs. 3.5 ± 2.3 day, = 0.0025). Conclusion: At the ICC, COVID-19 pandemic contributed significantly to the PPCI management of STEMI patients with decreased number and delayed procedures. COVID-19 was also associated with higher in-hospital mortality, rate of re-infarction, need for revascularization, and longer hospital stay.
直接经皮冠状动脉介入治疗（PPCI）是受2019冠状病毒病大流行影响的重要临床操作之一。在本研究中，我们旨在评估2019冠状病毒病对接受PPCI治疗的ST段抬高型心肌梗死（STEMI）患者院内临床结局的发生率和影响。本观察性回顾性研究针对2020年2月1日至10月31日期间在埃及亚历山大国际心脏中心（ICC）医院就诊的连续STEMI患者进行。同时评估了2019年同期就诊的一组STEMI患者（对照组），并将数据用于比较。纳入标准为确诊需要PPCI治疗的STEMI。本研究共纳入634例患者。在2019冠状病毒病期间，PPCI手术数量较上一年减少了25.7%（平均每月30.0±4.01例 vs. 40.4±5.3例），从首次医疗接触到穿刺（FMC-to-N）的时间更长（125.0±53.6分钟 vs. 52.6±22.8分钟，P = 0.001）。此外，在2019冠状病毒病期间，院内死亡率更高（7.4% vs. 4.6%，P = 0.036），再梗死发生率（12.2% vs. 7.7%，P = 0.041）和血运重建需求（15.9% vs. 10.7%，P = 0.046）也更高。心力衰竭、中风和出血的发生率在两组之间没有差异，但在2019冠状病毒病期间住院时间更长（6.85±4.22天 vs. 3.5±2.3天，P = 0.0025）。结论：在ICC，2019冠状病毒病大流行对STEMI患者的PPCI治疗产生了重大影响，手术数量减少且手术延迟。2019冠状病毒病还与更高的院内死亡率、再梗死率、血运重建需求和更长的住院时间相关。
