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)
Abstract 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...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-12-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12245-022-00473-x |
| _version_ | 1797973777240293376 |
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| author | Carlo Pegani Giovanni Buttignon Annarita Tullio Marcello Naccarato Paolo Manganotti Serena Rakar Enrico Fabris Federico Nadalin Vincenzo Mione Gian Luigi Gigli Simone Lorenzut Leonardo Spedicato Paolo Passadore Daniela Pavan Cristina Lutman Manila Andrian Massimo Borelli Stefano Novello Rita Belfiore Chiara Daneluzzi Gianfranco Sinagra Alberto Peratoner |
| author_facet | Carlo Pegani Giovanni Buttignon Annarita Tullio Marcello Naccarato Paolo Manganotti Serena Rakar Enrico Fabris Federico Nadalin Vincenzo Mione Gian Luigi Gigli Simone Lorenzut Leonardo Spedicato Paolo Passadore Daniela Pavan Cristina Lutman Manila Andrian Massimo Borelli Stefano Novello Rita Belfiore Chiara Daneluzzi Gianfranco Sinagra Alberto Peratoner |
| author_sort | Carlo Pegani |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-11T04:09:36Z |
| format | Article |
| id | doaj.art-656d88bab926410c9ddc6ef837d3306a |
| institution | Directory Open Access Journal |
| issn | 1865-1372 1865-1380 |
| language | English |
| last_indexed | 2024-04-11T04:09:36Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-656d88bab926410c9ddc6ef837d3306a2023-01-01T12:12:20ZengBMCInternational Journal of Emergency Medicine1865-13721865-13802022-12-011511710.1186/s12245-022-00473-xThe 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)Carlo Pegani0Giovanni Buttignon1Annarita Tullio2Marcello Naccarato3Paolo Manganotti4Serena Rakar5Enrico Fabris6Federico Nadalin7Vincenzo Mione8Gian Luigi Gigli9Simone Lorenzut10Leonardo Spedicato11Paolo Passadore12Daniela Pavan13Cristina Lutman14Manila Andrian15Massimo Borelli16Stefano Novello17Rita Belfiore18Chiara Daneluzzi19Gianfranco Sinagra20Alberto Peratoner21Azienda Sanitaria Universitaria Giuliano IsontinaAzienda Sanitaria Universitaria Giuliano IsontinaAzienda Sanitaria Universitaria Friuli CentraleAzienda Sanitaria Universitaria Giuliano IsontinaAzienda Sanitaria Universitaria Giuliano IsontinaAzienda Sanitaria Universitaria Giuliano IsontinaAzienda Sanitaria Universitaria Giuliano IsontinaAzienda Regionale di Coordinamento della SaluteAzienda Regionale di Coordinamento della SaluteAzienda Sanitaria Universitaria Friuli CentraleAzienda Sanitaria Universitaria Friuli CentraleAzienda Sanitaria Universitaria Friuli CentraleAzienda Sanitaria Friuli OccidentaleAzienda Sanitaria Friuli OccidentaleAzienda Sanitaria Universitaria Friuli CentraleAzienda Regionale di Coordinamento della SaluteUMG School of PhD Programmes, University Magna Graecia of CatanzaroAzienda Sanitaria Friuli OccidentaleAzienda Sanitaria Friuli OccidentaleAzienda Sanitaria Friuli OccidentaleAzienda Sanitaria Universitaria Giuliano IsontinaAzienda Sanitaria Universitaria Giuliano IsontinaAbstract 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.https://doi.org/10.1186/s12245-022-00473-xCOVID-19MortalityAcute myocardial infarctionStrokeCardiopulmonary arrestEmergency medical service (EMS) |
| spellingShingle | Carlo Pegani Giovanni Buttignon Annarita Tullio Marcello Naccarato Paolo Manganotti Serena Rakar Enrico Fabris Federico Nadalin Vincenzo Mione Gian Luigi Gigli Simone Lorenzut Leonardo Spedicato Paolo Passadore Daniela Pavan Cristina Lutman Manila Andrian Massimo Borelli Stefano Novello Rita Belfiore Chiara Daneluzzi Gianfranco Sinagra Alberto Peratoner 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 COVID-19 Mortality Acute myocardial infarction Stroke Cardiopulmonary arrest Emergency medical service (EMS) |
| title | 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) |
| title_full | 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) |
| title_fullStr | 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) |
| title_full_unstemmed | 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) |
| title_short | 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) |
| title_sort | 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 |
| topic | COVID-19 Mortality Acute myocardial infarction Stroke Cardiopulmonary arrest Emergency medical service (EMS) |
| url | https://doi.org/10.1186/s12245-022-00473-x |
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