Hwang Soo-Hee, Chang Youngs, Bai Haibin, Yun Jieun, Lee Hyejin, Lee Jin Yong
HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju-si, Gangwon-do, Republic of Korea.
Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, Republic of Korea.
PLoS One. 2025 Feb 21;20(2):e0316943. doi: 10.1371/journal.pone.0316943. eCollection 2025.
The purpose of this study is to investigate the impact of COVID-19 on admission and in-hospital mortality of patients with acute myocardial infarction (AMI).
We constructed a dataset of monthly hospitalizations and mortality of inpatients with AMI from January 2017 to December 2021 utilizing the National Health Insurance Claims Data which covers nearly the entire population. Using an interrupted time series (ITS), we investigated how COVID-19 affected hospitalizations and in-hospital deaths of patients with AMI.
During the study period, the average age of patients with AMI was 65.2-65.8 years, and the ratio of men to women was higher, with 73.0-75.3% of patients being men and 24.7-27.0% being women. ITS analysis showed that admission rates of patients with AMI decreased one per 100,000 population due to COVID-19 (P<0.001). Reductions in admission rates were greatest among men, those aged 55 and older, and people with medical aid. COVID-19 did not affect inpatient mortality (p = 0.9608), but in-hospital mortality decreased from 12% to 7% in the medical aid group.
Overall, we found that COVID-19 had an impact on admission rates of patients with AMI but did not have a significant impact on in-hospital mortality. However, we also found differential impacts by sex, age, and socioeconomic status, indicating some may be more vulnerable. This highlights the importance of identifying and supporting these vulnerable populations to prevent poorer health outcomes.
本研究旨在调查新型冠状病毒肺炎(COVID-19)对急性心肌梗死(AMI)患者入院率和院内死亡率的影响。
我们利用覆盖几乎全部人口的国民健康保险理赔数据,构建了一个2017年1月至2021年12月期间AMI住院患者月度住院情况和死亡率的数据集。使用中断时间序列(ITS)分析,我们研究了COVID-19如何影响AMI患者的住院情况和院内死亡情况。
在研究期间,AMI患者的平均年龄为65.2 - 65.8岁,男性与女性的比例更高,男性患者占73.0 - 75.3%,女性患者占24.7 - 27.0%。ITS分析表明,由于COVID-19,AMI患者的入院率每10万人中减少了1例(P<0.001)。入院率下降在男性、55岁及以上人群和有医疗救助的人群中最为明显。COVID-19并未影响住院患者的死亡率(p = 0.9608),但在医疗救助组中,院内死亡率从12%降至7%。
总体而言,我们发现COVID-19对AMI患者的入院率有影响,但对院内死亡率没有显著影响。然而,我们也发现了性别、年龄和社会经济地位的差异影响,表明一些人可能更易受到影响。这凸显了识别和支持这些弱势群体以预防更差健康结果的重要性。