Effect of regional COVID-19 outbreak to emergency department response on acute myocardial infarction: a multicenter retrospective study

¹Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
²Department of Emergency Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
³Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea
⁴Department of Emergency Medicine, Daegu Catholic University School of Medicine, Daegu, Korea

Correspondence

Sungbae Moon ,Tel: 053-420-6400, Fax: 053-428-2820, Email: snbaem@gmail.com,

Received: October 17, 2023; Revised: October 25, 2023 Accepted: October 27, 2023. Published online: April 30, 2025.

ABSTRACT

Objective:
The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments.
Method:
A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison.
Results:
The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups.
Conclusion:
The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Key words: Pandemics; COVID-19; SARS-CoV-2; ST elevation myocardial infarction; Treatment delay