Pourasghari Hamid, Tavolinejad Hamed, Soleimanpour Samira, Abdi Zhaleh, Arabloo Jalal, Bragazzi Nicola Luigi, Behzadifar Masoud, Rashedi Sina, Omidi Negar, Ayoubian Ali, Tajdini Masih, Ghorashi Seyyed Mojtaba, Azari Samad
Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Tehran Heart Center Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Int J Cardiol Heart Vasc. 2022 May 23;41:101058. doi: 10.1016/j.ijcha.2022.101058. eCollection 2022 Aug.
Since the SARS-CoV-2 pandemic began, numerous studies have reported a concerning drop in the number of acute myocardial infarction (AMI) admissions. In the present systematic review and -analysis, we aimed to compare the rate of AMI admissions and major complication during the pandemic, in comparison with pre-pandemic periods. Three major databases (PubMed, Scopus, and Web of Science Core Collection) were searched. Out of 314 articles, 41 were entered into the study. Patients hospitalized for AMI were 35% less in the COVID-19 era compared with pre-pandemic periods, which was statistically significantly (OR = 0.65; 95% CI: 0.56-0.74; I = 99%; p < 0.001; 28 studies). Patients hospitalized for STEMI and NSTEMI were 29% and 34% respectively less in the COVID-19 era compared with periods before COVID-19, which was statistically significantly (OR = 0.71; 95% CI: 0.65 -0.78; I = 93%; p < 0.001; 22 studies, OR = 0.66; 95% CI: 0.58-0.73; I = 95%; p < 0.001; 14 studies). The overall rate of in-hospital mortality in AMI patients increased by 26% in the COVID-19 era, which was not statistically significant (OR = 1.26; 95% CI: 1.0-1.59; I = 22%; p < 0.001; six studies). The rate of in-hospital mortality in STEMI and NSTEMI patients increased by 15% and 26% respectively in the COVID-19 era, which was not statistically significant (OR = 1.15; 95% CI: 0.85-1.57; I = 48%; p = 0.035; 11 studies, OR = 1.35; 95% CI: 0.64-2.86; I = 45%; p = 0.157; 3 articles). These observations highlight the challenges in the adaptation of health-care systems with the impact of the COVID-19 pandemic.
自新冠疫情开始以来，众多研究报告称急性心肌梗死（AMI）入院人数出现了令人担忧的下降。在本系统综述与分析中，我们旨在比较疫情期间与疫情前相比AMI的入院率及主要并发症情况。我们检索了三个主要数据库（PubMed、Scopus和科学网核心合集）。在314篇文章中，41篇被纳入研究。与疫情前相比，新冠疫情期间因AMI住院的患者减少了35%，这具有统计学意义（OR = 0.65；95%置信区间：0.56 - 0.74；I² = 99%；p < 0.001；28项研究）。与新冠疫情前相比，新冠疫情期间因ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）住院的患者分别减少了29%和34%，这具有统计学意义（OR = 0.71；95%置信区间：0.65 - 0.78；I² = 93%；p < 0.001；22项研究，OR = 0.66；95%置信区间：0.58 - 0.73；I² = 95%；p < 0.001；14项研究）。新冠疫情期间，AMI患者的院内总体死亡率增加了26%，但无统计学意义（OR = 1.26；95%置信区间：1.0 - 1.59；I² = 22%；p < 0.001；6项研究）。新冠疫情期间，STEMI和NSTEMI患者的院内死亡率分别增加了15%和26%，无统计学意义（OR = 1.15；95%置信区间：0.85 - 1.57；I² = 48%；p = 0.035；11项研究，OR = 1.35；95%置信区间：0.64 - 2.86；I² = 45%；p = 0.157；3篇文章）。这些观察结果凸显了新冠疫情影响下医疗系统适应过程中的挑战。
