The impact of COVID-19 on myocardial infarctions, strokes and out-of-hospital cardiopulmonary arrests: an observational retrospective study on time-sensitive disorders in the Friuli Venezia Giulia region (Italy)

International Journal of Emergency Medicine

Research

Federico Nadalin¹  Vincenzo Mione¹  Manila Andrian¹  Chiara Daneluzzi²  Paolo Passadore²  Stefano Novello²  Daniela Pavan²  Rita Belfiore²  Simone Lorenzut³  Annarita Tullio³  Gian Luigi Gigli³  Cristina Lutman³  Leonardo Spedicato³  Gianfranco Sinagra⁴  Enrico Fabris⁴  Serena Rakar⁴  Alberto Peratoner⁴  Giovanni Buttignon⁴  Paolo Manganotti⁴  Carlo Pegani⁴  Marcello Naccarato⁴  Massimo Borelli⁵ 

[1] Azienda Regionale di Coordinamento della Salute, Udine, Italy;Azienda Sanitaria Friuli Occidentale, Pordenone, Italy;Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy;Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy;UMG School of PhD Programmes, University Magna Graecia of Catanzaro, Catanzaro, Italy;

关键词: COVID-19;    Mortality;    Acute myocardial infarction;    Stroke;    Cardiopulmonary arrest;    Emergency medical service (EMS);    Cardiopulmonary resuscitation;   

DOI  :  10.1186/s12245-022-00473-x

 received in 2022-08-19, accepted in 2022-12-19,  发布年份 2022

来源: Springer

【 摘 要 】

The COVID-19 global pandemic has changed considerably the way time-sensitive disorders are treated. Home isolation, people’s fear of contracting the virus and hospital reorganisation have led to a significant decrease in contacts between citizens and the healthcare system, with an expected decrease in calls to the Emergency Medical Services (EMS) of the Friuli-Venezia Giulia (FVG) region. However, mortality in clinical emergencies like acute ST-elevation myocardial infarction (STEMI), stroke and out-of-hospital cardiopulmonary arrest (OHCA) remained high. An observational retrospective cross-sectional study was carried out in FVG, taking into account the period between March 1, 2020, and May 31, 2020, the first wave of the COVID-19 pandemic, and comparing it with the same period in 2019. The flow of calls to the EMS was analysed and COVID-19 impact on time-sensitive disorders (STEMIs, ischemic strokes and OHCPAs) was measured in terms of hospitalisation, treatment and mortality. Despite a −8.01% decrease (p value ˂0.001) in emergency response, a 10.89% increase in calls to the EMS was observed. A lower number of advanced cardiopulmonary resuscitations (CPR) (75.8 vs 45.2%, p=0.000021 in April) and ROSC (39.1 vs 11.6%, p=0.0001 in April) was remarked, and survival rate dropped from 8.5 to 5%. There were less strokes (−27.5%, p value=0.002) despite a more severe onset of symptoms at hospitalisation with NHISS˃10 in 38.47% of cases. Acute myocardial infarctions decreased as well (−20%, p value=0.05), but statistical significances were not determined in the variables considered and in mortality. Despite a lower number of emergency responses, the number of calls to the EMS was considerably higher. The number of cardiac arrests treated with advanced CPR (ALS) was lower, but mortality was higher. The number of strokes decreased as well, but at the time of hospitalisation the clinical picture of the patient was more severe, thus affecting the outcome when the patient was discharged. Finally, STEMI patients decreased; however, no critical issues were observed in the variables taken into account, neither in terms of response times nor in terms of treatment times.

【 授权许可】

CC BY   
© The Author(s) 2022