During the COVID-19 pandemic in Berlin, MI hospitalizations decreased by 14%, pre-hospital delay was unchanged, and door-to-balloon times for STEMI were significantly shorter.
Did the COVID-19 pandemic affect the incidence, care delays, and hospital mortality of acute myocardial infarction patients in Berlin?
Despite a 14% reduction in MI hospitalizations during the COVID-19 pandemic in Berlin, pre-hospital and inpatient care structures remained functional with no increase in hospital mortality.
Absolute Event Rate: 0% vs 0%
Abstract Background The COVID-19 pandemic has led to restrictions in all important areas of healthcare worldwide. According to previous study data, the COVID-19 pandemic was also associated with a change in the incidence of inpatient myocardial infarction (MI) cases. How care delays and outcomes for myocardial infarction have developed during the COVID-19 pandemic compared to the time before in Berlin is still unclear. This study uses data from the Berlin-Brandenburg Myocardial Infarction Registry (B2HIR) to examine the documented incidence, care delays, and case fatality rates before and during the pandemic in Berlin. Methods We analyzed11,867 MI cases that were treated as inpatients in Berlin hospitals participating in the B2HIR (n=20) ≤24 hours after the onset of symptoms from March 1, 2018 to December 29, 2019 (pre-pandemic period) and from March 1, 2020 to December 29, 2021 (pandemic period). In addition, infection waves #1 to #4 were each considered separately within the pandemic period, and periods analogous to the waves were defined and compared during the pre-pandemic period. Results During the COVID-19 pandemic, 14% fewer MI patients were hospitalized and documented in the B2HIR than during the comparison period (p0.01). The pre-hospital delay (onset of symptoms to hospital admission) did not differ during vs. before the pandemic. The door-to-balloon time (DTB) for STEMI was significantly shorter during #1, #3, and #4 pandemic waves and cumulatively during the pandemic than during the comparison period. Hospital mortality was not significantly different during the pandemic waves vs. the comparison periods. (See Table 1 for detailed results) Conclusion In Berlin, there was a decrease in the incidence of hospitalization due to an acute MI during the COVID pandemic compared to before. The reason for this may be an actual reduction in the incidence, but also patient reluctance to contact the emergency services, a higher number of infarctions treated later (after 24 hours) or a higher number of untreated heart attacks. The pre-hospital delays of MI inpatient cases were comparable before and during the pandemic, and in-hospital care delays were mostly shorter during the pandemic. It can be concluded that, despite the burden of the pandemic, the pre-hospital and inpatient care structures in Berlin were functional. The reduction of MI hospitalization during the pandemic warrants further investigation.Table 1
Maisuradze et al. (Sat,) reported a other. During the COVID-19 pandemic in Berlin, MI hospitalizations decreased by 14%, pre-hospital delay was unchanged, and door-to-balloon times for STEMI were significantly shorter.