A-34 | Utilization of Thrombolytics for STEMI During the COVID-19 Pandemic

Abstract

The COVID-19 pandemic significantly impacted patients and healthcare systems worldwide, shifting practices on how acute STEMI was managed. Several studies have shown that total rates of hospital admissions for STEMI and PCI decreased during the pandemic compared to years prior. We investigated the use of thrombolytics for patients admitted for STEMI during first year of the COVID-19 pandemic. We identified all patients hospitalized for STEMI in 2020 using the National Inpatient Sample (NIS), identifying those with and without concurrent COVID-19 and who received thrombolytics. Logistic and linear regression was used for analyses of associations, with adjustment for potential confounders. We defined significance as a 2-tailed p-value of 0.05. There were 159,890 hospitalizations for STEMI in 2020, of which 1,475 recieved thrombolytics. Rates of thrombolytic usage for STEMI increased dramatically following declaration by the World Health Organization of COVID-19 pandemic in March 2020. (Figure 1) After adjusting for age, race, sex, hospital bed size, hospital location, hospital teaching status, insurance status, income level, and Elixhauser comorbidities; we found that patients with STEMI and concurrent COVID-19 infection were more likely to receive thrombolytic therapy (aOR 2.78, 95% CI 1.46 – 5.28) than patients without COVID-19. Our study found that patients admitted with STEMI and concurrent COVID-19 had significantly higher rates of thrombolytic usage than those without COVID-19. Further studies are needed to investigate the effect of COVID-19 on the outcomes of patients admitted for STEMI.