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Impact of Public Health Emergency Response to COVID-19 on Management and Outcome for STEMI Patients in Beijing-A Single-Center Historic Control Study.

ABSTRACT: Coronavirus disease 2019 (COVID-19) pandemic poses great challenge on public health globally. To clarify the impact of COVID-19 pandemic on in-hospital management and outcomes for ST-segment elevation myocardial infarction (STEMI) patients in the nonepicenter. We enrolled consecutive STEMI patients who visited Fuwai Hospital from January to March, 2020 (N = 73) and also established a historical control including all consecutive STEMI patients in the same period of 2019 (N = 95). The primary outcome was defined as a composite endpoint of all-cause death, heart failure, cardiac shock, and cardiac arrest during hospitalization. Emergency response for COVID-19 resulted in a significant 77.6% reduction in the number of primary percutaneous coronary intervention, and a trend toward higher rate of primary composite endpoint (15.1% vs 11.6%, P = 0.51). COVID-19 pandemic results in a significant reduction in emergent reperfusion therapy, and a trend toward higher in-hospital adverse events risk.

SUBMITTER: Song C

PROVIDER: S-EPMC7462598 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Impact of Public Health Emergency Response to COVID-19 on Management and Outcome for STEMI Patients in Beijing-A Single-Center Historic Control Study.

Song Chenxi C Liu Shuai S Yin Dong D Wang Yang Y Zhao Yanyan Y Yang Weixian W Qiao Shubin S Dou Kefei K Xu Bo B

Current problems in cardiology 20200901 3

Coronavirus disease 2019 (COVID-19) pandemic poses great challenge on public health globally. To clarify the impact of COVID-19 pandemic on in-hospital management and outcomes for ST-segment elevation myocardial infarction (STEMI) patients in the nonepicenter. We enrolled consecutive STEMI patients who visited Fuwai Hospital from January to March, 2020 (N = 73) and also established a historical control including all consecutive STEMI patients in the same period of 2019 (N = 95). The primary outc ...[more]

PMID: 33032817

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Project description:Introduction On April 29, 2020, China entered a normalization stage of prevention and control. By December 2021, more than 40 outbreaks had occurred in China, which reflected the shortcomings of the pandemic prevention and control measures in China at that time. As the capital city of China, Beijing faces more pressure in epidemic prevention and control. Material and Methods We used the COVID-19 cluster containment evaluation indicators to determine the effects of prevention and control measures on four COVID-19 outbreaks in Beijing. After considering the specificity and operability of evaluation indicators and the availability of evaluation data, the evaluation system in our study consisted of six dimensions: epidemic prevention and control effect, discovery and detection ability, precision prevention and control capability, public protection effect, medical treatment and nosocomial infection prevention and control ability, and information release and public opinion response ability. Results The composite scores of the prevention and control effects of the Xinfadi, Shunyi, Daxing, and Ejina Banner–associated COVID-19 outbreaks in Beijing were 62, 82, 87, and 76, respectively. In the six dimensions, the epidemic prevention and control effect, discovery and detection ability, precision prevention and control capability, and public protection effect scores for the Xinfadi outbreak were lower than those for the Shunyi, Daxing and Ejina Banner–associated outbreaks. The medical treatment and nosocomial infection prevention and control ability scores for the outbreak associated with Ejina Banner were lower than those for the Xinfadi, Shunyi, and Daxing outbreaks. Conclusion In managing cluster outbreaks, Beijing was able to detect index cases early enough to reduce the scale and duration of the outbreak and consistently release official information to reduce public panic, standardize the management of centralized quarantine sites to prevent cross-infection, adhere to the " dynamic COVID‐zero" strategy to accurately prevent and control outbreaks, reduce the societal influence of the pandemic, and coordinate the epidemic prevention and control and socio-economic development. Graphical abstract Image, graphical abstract

Project description:IntroductionHybrid emergency room systems (HERSs) have shown promise for the management of severe trauma by reducing mortality. However, the effectiveness of HERSs in the treatment of acute ischemic stroke (AIS) remains unclear. This study aimed to evaluate the impact of HERSs on treatment duration and neurological outcomes in patients with AIS undergoing endovascular therapy.Materials and methodsThis single-center retrospective study included 83 patients with AIS who were directly transported to our emergency department and underwent endovascular treatment between June 2017 and December 2023. Patients were divided into the HERS and conventional groups based on the utilization of HERSs. The primary outcome was the proportion of patients achieving a favorable neurological outcome (modified Rankin Scale score 0-2) at 30 days. The secondary outcomes included door-to-puncture and door-to-recanalization times. Univariate analysis was performed using the Mann-Whitney U test for continuous variables and the chi-squared test or Fisher's exact test for categorical variables, as appropriate.ResultsOf the 83 eligible patients, 50 (60.2%) were assigned to the HERS group and 33 (39.8%) to the conventional group. The median door-to-puncture time was significantly shorter in the HERS group than in the conventional group (99.5 vs. 131 min; p = 0.001). Similarly, the median door-to-recanalization time was significantly shorter in the HERS group (162.5 vs. 201.5 min, p = 0.018). Favorable neurological outcomes were achieved in 16/50 (32.0%) patients in the HERS group and 6/33 (18.2%) in the conventional group. The HERS and conventional groups showed no significant difference in the proportion of patients achieving favorable neurological outcomes (p = 0.21).ConclusionImplementation of the HERS significantly reduced the door-to-puncture and door-to-recanalization times in patients with AIS undergoing endovascular therapy. Despite these reductions in treatment duration, no significant improvement in neurological outcomes was observed. Further research is required to optimize patient selection and treatment strategies to maximize the benefits of the HERS in AIS management.

Dataset Information

Impact of Public Health Emergency Response to COVID-19 on Management and Outcome for STEMI Patients in Beijing-A Single-Center Historic Control Study.

Publications

Impact of Public Health Emergency Response to COVID-19 on Management and Outcome for STEMI Patients in Beijing-A Single-Center Historic Control Study.

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