Statistical findings and outcomes of acute coronary syndrome patients during COVID-19 pandemic: A cross sectional study

Abstract

Time to treatment of acute coronary syndrome (ACS) can be a matter of life or death considering its major contribution to cardiovascular mortality. The sudden outbreak of the Coronavirus Disease in 2019 (COVID-19) caused great uncertainty in achieving ACS time-frame goals. This study assesses ACS presentation time and outcomes before and during the COVID-19 pandemic. A total of 1287 ACS patients were included in this cross-sectional study. We compared mortality and other outcomes during hospital admission. Before-COVID was deemed as admission between March 2018 and February 2020, while admission between March 2020 and February 2022 was deemed as during-COVID. The association of admission on outcomes was measured using regression statistics. There was a 51.2% decline of total patients before-COVID (865 patients) to during-COVID (422 patients). While there is no difference in first medical contact (FMC) before [3h (IQR 1-7)] compared to during the pandemic [3h (IQR 2-9), p 0.058], we found a decrease in door to wire time<12h (43.41% vs 18.98%, p<0.001). There was also a non-significant decrease in fibrinolysis (20.45% vs 15.18%, p 0.054) but an increase in those undergoing percutaneous coronary intervention (PCI) (58.36% vs 77.04%, p value<0,001). We also found reduced mortality (12.52% vs 9.69%, p 0.151), heart failure (28.16% vs 25.81%, p 0.31), but more cardiogenic shock during the pandemic (9.19% vs 13.33%, p 0.028). While the mortality seems statistically unaffected, we found less admission and prolonged door to wire time during-COVID pandemic.