Impact of COVID-19 on Patients Hospitalized with ST-Segment Elevation Myocardial Infarction in the United States during the Early Pandemic: An Analysis of Outcomes, Care Delivery, and Racial Disparities in Mortality.
Harris MajeedKarthik GanguRahul ShekharShazib SagheerIshan GargHina ShujaAniesh BobbaPrabal ChourasiaSindhu Reddy AvulaAbu Baker SheikhPublished in: Infectious disease reports (2023)
The COVID-19 pandemic has impacted healthcare delivery to patients with ST-segment elevation myocardial infarction (STEMI). The aim of our retrospective study was to determine the effect of COVID-19 on inpatient STEMI outcomes and to investigate changes in cardiac care delivery during 2020. We utilized the National Inpatient Sample database to examine inpatient mortality and cardiac procedures among STEMI patients with and without COVID-19. In our study, STEMI patients with COVID-19 had higher inpatient mortality (47.4% vs. 11.2%, aOR: 3.8, 95% CI: 3.2−4.6, p < 0.001), increased length of stay (9.0 days vs. 4.3 days, p < 0.001) and higher cost of hospitalization (USD 172,518 vs. USD 131,841, p = 0.004) when compared to STEMI patients without COVID-19. STEMI patients with COVID-19 also received significantly less invasive cardiac procedures (coronary angiograms: 30.4% vs. 50.8%, p < 0.001; PCI: 32.9% vs. 70.1%, p < 0.001; CABG: 0.9% vs. 4.1%, p < 0.001) and were more likely to receive systemic thrombolytic therapy (4.2% vs. 1.1%, p < 0.001) when compared to STEMI patients without COVID-19. Our findings are the result of complications of SARS-CoV2 infection as well as alterations in healthcare delivery due to the burden of the COVID-19 pandemic.
Keyphrases
- st segment elevation myocardial infarction
- percutaneous coronary intervention
- coronavirus disease
- healthcare
- sars cov
- st elevation myocardial infarction
- end stage renal disease
- palliative care
- coronary artery disease
- newly diagnosed
- acute coronary syndrome
- ejection fraction
- acute myocardial infarction
- chronic kidney disease
- coronary artery bypass grafting
- antiplatelet therapy
- cardiovascular disease
- quality improvement
- heart failure
- atrial fibrillation
- peritoneal dialysis
- stem cells
- coronary artery
- metabolic syndrome
- mesenchymal stem cells
- aortic valve
- bone marrow
- health information
- adipose tissue
- smoking cessation
- coronary artery bypass
- acute ischemic stroke
- glycemic control