Ongoing COVID-19 Pandemic Effects on Admissions and In-Hospital Outcomes in Patients With ST-Elevation Myocardial Infarction (STEMI): An Albanian Observational Study

Leonard Simoni; Ilir Alimehmeti; Astrit Ceka; Ermir A Tafaj; Mirald Gina; Aldo Panariti; Fatjon Xhafaj; Alban Dibra; Artan Goda

doi:10.7759/cureus.26813

Ongoing COVID-19 Pandemic Effects on Admissions and In-Hospital Outcomes in Patients With ST-Elevation Myocardial Infarction (STEMI): An Albanian Observational Study

Cureus. 2022 Jul 13;14(7):e26813. doi: 10.7759/cureus.26813. eCollection 2022 Jul.

Authors

Leonard Simoni¹, Ilir Alimehmeti^{2

3}, Astrit Ceka⁴, Ermir A Tafaj¹, Mirald Gina¹, Aldo Panariti¹, Fatjon Xhafaj⁵, Alban Dibra¹, Artan Goda¹

Affiliations

¹ Cardiovascular Disease, University Hospital Center "Mother Teresa", Tirana, ALB.
² Health Commission, Academy of Sciences of Albania, Tirana, ALB.
³ Department of Family and Occupational Health, Faculty of Medicine, University of Medicine, Tirana, ALB.
⁴ Cardiovascular Disease, University Hospital Center Mother Teresa, Tirana, ALB.
⁵ Cardiovascular Disease, University Hospital Center 'Mother Teresa", Tirana, ALB.

Abstract

Background Multiple studies conducted worldwide and in Albania documented an important reduction of acute ST-elevation myocardial infarction (STEMI) admissions during the Coronavirus Disease 19 (COVID-19) pandemic. There are few studies regarding STEMI admissions and outcomes during the ongoing pandemic after the initial lockdown. We aimed to study STEMI admissions and in-hospital outcomes after the COVID-19 lockdown period. Methods A retrospective single-center study was conducted, collecting data for all consecutive STEMI admissions from March 9th, (the first COVID-19 case) until April 30^th, the corresponding period of 2020 total lockdown, for years 2019 and 2021. The control period was considered the year 2019 [pre-pandemic (PP)] and the study period was in 2021 [ongoing pandemic (OP)]. The incidence rate ratio (IRR) 95% confidence interval (CI) was used to compare all-STEMI admissions, invasive procedures, and risk ratio (RR) 95% CI to compare the mortality and complications rate between the study and control period. Results The study included 217 STEMI patients admitted in 2019, and 234 patients during the 2021 period. The overall-STEMI admissions IRR is in a similar range during the 2021 OP compared to the 2019 PP period IRR=1.07 (95%CI 0.90-1.28). Similar invasive procedures were observed during OP compared to PP period, respectively for coronary-angiography IRR= 1.07; (0.87-1.31), for all-PCI [1.12 (0.92-1.35)], and primary percutaneous coronary interventions (PCI) [1.09 (0.89-1.34)]. The STEMI death rate during OP compared to PP period was similar (7.3 vs. 7.4%), RR=1.01 (0.53-1.96), and a non-significant lower primary-PCI-death rate (4.0 vs 4.8%), RR= 0.83 (0.30-2.3)]. Conclusions After the initial reduction of admissions and invasive procedures in STEMI patients during the 2020 lockdown period and the increase of all-STEMI mortality, the number of hospitalizations, invasive procedures, and mortality returned to a similar range during OP compared to the PP period despite a highly incident ongoing COVID-19 pandemic.

Keywords: coronary invasive procedures; hospital admissions; mortality; ongoing covid-19 pandemic; st-elevation myocardial infarction.