COVID-19 pandemic affects STEMI numbers and in-hospital mortality: results of a nationwide analysis in Germany
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Published:2022-10-06
Issue:4
Volume:112
Page:550-557
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ISSN:1861-0684
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Container-title:Clinical Research in Cardiology
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language:en
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Short-container-title:Clin Res Cardiol
Author:
Oettinger VeraORCID, Stachon PeterORCID, Hilgendorf IngoORCID, Heidenreich Adrian, Zehender Manfred, Westermann DirkORCID, Kaier KlausORCID, von zur Mühlen ConstantinORCID
Abstract
Abstract
Background
The COVID-19 pandemic led to extensive restrictions in Germany in 2020, including the postponement of elective interventions. We examined the impact on ST-elevation myocardial infarction (STEMI) as an acute and non-postponable disease.
Methods
Using German national records, all STEMI between 2017 and 2020 were identified. Using the number of STEMI cases between 2017 and 2019, we created a forecast for 2020 and compared it with the observed number of STEMI in 2020.
Results
From 2017 to 2020, 248,062 patients were treated for STEMI in Germany. Mean age was 65.21 years and 28.36% were female. When comparing forecasted and observed STEMI in 2020, a correlation can be seen: noticeable fewer STEMI were treated in those weeks respectively months with an increasing COVID-19 hospitalization rate (monthly percentage decrease in STEMI: March − 14.85%, April − 13.39%, November − 11.92%, December − 22.95%). At the same time, the crude in-hospital mortality after STEMI increased significantly at the peaks of the first and second waves (relative risk/RR of monthly in-hospital mortality: April RR = 1.11 [95% CI 1.02; 1.21], November RR = 1.13 [1.04; 1.24], December RR = 1.16 [1.06; 1.27]).
Conclusion
The COVID-19 pandemic led to a noticeable decrease in the number of STEMI interventions in Germany at the peaks of the first and second waves in 2020, corresponding to an increase in COVID-19 hospitalizations. At the same time, in-hospital mortality after STEMI increased significantly in these phases.
Graphical abstract
Impact of the COVID-19 pandemic on STEMI numbers and in-hospital mortality in Germany. Relative difference between forecasted and observed STEMI numbers (above figure), the relative risk of in-hospital mortality (middle figure) as well as number of new hospital admissions for COVID-19 per million inhabitants according to Roser et al.27 (bottom figure).
Funder
Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,General Medicine
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