ST elevation acute myocardial infarction has high mortality and morbidity rates. It is normally treated with primary PCI. The whole system has established very effective protocols to minimize ischemic time from symptom onset to definite treatment in the cath lab.
This study reports the experience in Hong Kong since January 2020, when all emergency protocols to contain the Covid-19 pandemic were activated.
This required suspending of all non-essential visits and adjusting services both for hospitalized and ambulatory patients.
Between January 25 and February 10 2020, there were significant changes in assistance time compared against primary PCI in the same period one year earlier.
The most affected was time between symptom onset and first medical contact. This depends mostly on patients, who will most likely wait at home for fear of catching Covid-19.
Historically, time from symptom onset to first medical contact is approximately 82 minutes, and it extended to 318 minutes during the pandemic.
We can scarcely understand the direct impact of this pandemic on the population’s health, let alone measure its indirect impact.
To the extended onset to first contact time, we should add the extra time needed to identify patient epidemiology, contact history, symptoms, etc.
Finally, when primary PCI is indicated, we should also add extra time for safe patient transport, which involves time for all cath lab staff to wear protective gear.
Reference: Chor-Cheung Frankie Tam et al. Circ Cardiovasc Qual Outcomes. 2020;13:e006631.
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