STEMI hospitalizations down during pandemic

There was a significant drop in hospitalizations for ST-segment elevation myocardial infarction (STEMI) during the coronavirus disease 2019 (COVID-19) pandemic, a recent study has found.

The researchers conducted a systematic review and meta-analysis, drawing studies from the online databases of Medline, Embase, Web of Science, Scopus, and the Cochrane Register of Controlled Trials. A total of 79 studies were ultimately included, comprising 111,557 STEMI cases from 57 countries.

Random-effects modelling found a significant drop in STEMI hospitalizations during the peak of the COVID-19 pandemic as compared with a reference period (incidence rate ratio [IRR], 0.80, 95 percent confidence interval [CI], 0.76–0.84; p<0.0001). Reference periods were set according to the definitions of the included studies.

Region-specific analyses found that STEMI admissions dropped by around 20 percent in Europe (IRR, 0.81, 95 percent CI, 0.76–0.86), Asia-Pacific and the Middle East (IRR, 0.83, 95 percent CI, 0.75–0.91), and North, Central, and South America (IRR, 0.76, 95 percent CI, 0.66–0.86; p<0.0001 for all). Latin American countries saw >50-percent drop in admissions, while no notable changes were reported for Southeast Asia.

Notably, the researchers found no statistical evidence that COVID-19 positivity or deaths, SARS-CoV-2 reproduction rate, and the stringency of lockdown measures were linked to changes in STEMI admissions. Instead, hospital bed availability seemed to be an inverse indicator of such endpoint.

In terms of quality, 54.4 percent of included studies were deemed high-quality by the STROBE checklist, while 10.1 percent and 35.4 percent were moderate and low in quality, respectively.

“Large variability emerged across countries, unrelated to COVID-related epidemiology or social containment measures. Disparities in healthcare organization likely contributed, indicating that proper organization of emergency medicine should be preserved during pandemics,” the researchers said.