Clinical Characteristics, Management, and Outcomes of the Patients With ST-Segment Elevation Myocardial Infarction Before and During the COVID-19 Pandemic

Abstract

Background: The first case of coronavirus disease 2019 (COVID-19) in the United Arab Emirates (UAE) was reported on January 29, 2020. Various anecdotal reports suggest that fewer patients with ST-segment elevation myocardial infarction (STEMI) have been presented to the hospital during the COVID-19 pandemic. In this study, we examined the patient characteristics, in-hospital management, and outcomes of the patients with STEMI before and during the COVID-19 pandemic in Abu Dhabi, UAE. Methods: We analyzed the data retrospectively from January 1, 2019 to December 31, 2020 and stratified the same into two periods: before the pandemic (January 1, 2019 to January 28, 2020) and during the pandemic (January 29, 2020 to December 31, 2020). The patient-level data for the two periods were compared to identify the differences in the patient characteristics, in-hospital management, and 30-day mortality outcomes of the patients with STEMI. Results: During the COVID-19 pandemic, the number of STEMI cases was lower (n = 234) than before the pandemic (n = 266), and 11patients (4.7%) tested positive for COVID-19 during their hospital encounter. In comparison to before the pandemic, patients with STEMI were significantly younger (mean age: 50.39 years, standard deviation (SD) ± 10.32 years), less likely to present to the emergency department (ED), and more likely to have histories of hypercholesterolemia (P < 0.001) and coronary artery disease (P < 0.001). Significantly shorter door-to-balloon time (56.6 ± 27.26 min, P < 0.001) and decreased length of stay (4.7 ± 6.8 days, P < 0.001) were observed during the pandemic. However, no considerable difference in the 30-day mortality was observed in 2020 as compared to before the pandemic (2.1% versus 3.0%, respectively). Conclusions: Hospital presentation for the patients with STEMI decreased during the COVID-19 pandemic, with significant differences in the door-to-balloon time and length of hospital stay. This indicates that the hospital systems of care continued to operate with higher efficiency during the COVID-19 pandemic than before the pandemic in the UAE.