Impact of COVID-19 pandemic on emergency medical system and management strategies in patients with acute coronary syndrome

Sci Rep. 2023 Mar 29;13(1):5120. doi: 10.1038/s41598-023-32223-1.

Abstract

The global coronavirus disease-2019 (COVID-19) pandemic is associated with reduced rate of percutaneous coronary intervention (PCI). However, there were a few data showing how emergency medical system (EMS) and management strategies for acute coronary syndrome (ACS) changed during the pandemic. We sought to clarify changes on characteristics, treatments, and in-hospital mortality of patients with ACS transported via EMS between pre- and post-pandemic. We examined consecutive 656 patients with ACS admitted to Sapporo City ACS Network Hospitals between June 2018 and November 2021. The patients were divided into pre- and post-pandemic groups. The number of ACS hospitalizations declined significantly during the pandemic (proportional reduction 66%, coefficient -0.34, 95% CI -0.50 to -0.18, p < 0.001). The median time from an EMS call to hospital was significantly longer in post-pandemic group than in pre-pandemic group (32 [26-39] vs. 29 [25-36] min, p = 0.008). There were no significant differences in the proportion of patients with ACS receiving PCI, and in-hospital mortality between the groups. The COVID-19 pandemic had a significant impact on EMS and management in patients with ACS. Although a significant decline was observed in ACS hospitalizations, the proportion of patients with ACS receiving emergency PCI remained during the pandemic.

MeSH terms

  • Acute Coronary Syndrome* / epidemiology
  • Acute Coronary Syndrome* / therapy
  • COVID-19* / epidemiology
  • COVID-19* / therapy
  • Hospitalization
  • Humans
  • Pandemics
  • Percutaneous Coronary Intervention*
  • Treatment Outcome