Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis

Introduction: There has been a concern whether the decrease in ST-segment elevation myocardial infarction (STEMI) cases during the COVID-19 pandemic era is related to unsatisfactory performance of STEMI systems of care as well as worsening of the clinical outcomes in STEMI patients. Thus, our meta-a...

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Main Authors: William Kamarullah, Adelia Putri Sabrina, Marthin Alexander Rocky, Darius Revin Gozali
Format: Article
Language:English
Published: Elsevier 2021-07-01
Series:Indian Heart Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0019483221001322
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spelling doaj-65b2ae0860184ecd9fa995660f9440672021-09-01T04:20:07ZengElsevierIndian Heart Journal0019-48322021-07-01734404412Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysisWilliam Kamarullah0Adelia Putri Sabrina1Marthin Alexander Rocky2Darius Revin Gozali3Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia; Corresponding author.Faculty of Medicine, YARSI University, Jakarta, IndonesiaFaculty of Medicine, Udayana University, Bali, IndonesiaFaculty of Medicine, Christian University of Indonesia, Jakarta, IndonesiaIntroduction: There has been a concern whether the decrease in ST-segment elevation myocardial infarction (STEMI) cases during the COVID-19 pandemic era is related to unsatisfactory performance of STEMI systems of care as well as worsening of the clinical outcomes in STEMI patients. Thus, our meta-analysis was conducted to evaluate this matter. Methods: We compared the predetermined variables in this meta-analysis during the early and late pandemic. Using a combination of adapted search terms to fit the requirements of several search engines (PubMed, EuropePMC, SCOPUS, ProQuest, and EBSCOhost), we reviewed all observational studies citing our outcomes of interest before and during the outbreak. Results: Thirty-five records comprising a total of 62,247 participants were identified. Overall, our meta-analysis showed that there was a huge reduction of nearly 80% for STEMI admission during the outbreak (n = 10,263) in contrast to before the outbreak period (n = 51,984). STEMI patients who were admitted during the outbreak received less primary PCI and had longer symptom-to-FMC (first medical contact) time along with prolonged door-to-balloon (DTB) time. A decrease in the achievement of final TIMI (thrombolysis in myocardial infarction) 3 flow after primary PCI was also observed in this study. However, the number of in-hospital mortality was similar between two groups. Conclusion: There was a decrease in the STEMI care performance and worsening of clinical outcomes in STEMI patients, especially in the early pandemic period. Overall, concise health services must be implemented following a responsibility to obey health protocols to deliver high-quality services related to STEMI systems of care amidst the global pandemic.http://www.sciencedirect.com/science/article/pii/S0019483221001322STEMISystems of carePerformanceOutcomesCOVID-19Pandemic
collection DOAJ
language English
format Article
sources DOAJ
author William Kamarullah
Adelia Putri Sabrina
Marthin Alexander Rocky
Darius Revin Gozali
spellingShingle William Kamarullah
Adelia Putri Sabrina
Marthin Alexander Rocky
Darius Revin Gozali
Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis
Indian Heart Journal
STEMI
Systems of care
Performance
Outcomes
COVID-19
Pandemic
author_facet William Kamarullah
Adelia Putri Sabrina
Marthin Alexander Rocky
Darius Revin Gozali
author_sort William Kamarullah
title Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis
title_short Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis
title_full Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis
title_fullStr Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis
title_full_unstemmed Investigating the implications of COVID-19 outbreak on systems of care and outcomes of STEMI patients: A systematic review and meta-analysis
title_sort investigating the implications of covid-19 outbreak on systems of care and outcomes of stemi patients: a systematic review and meta-analysis
publisher Elsevier
series Indian Heart Journal
issn 0019-4832
publishDate 2021-07-01
description Introduction: There has been a concern whether the decrease in ST-segment elevation myocardial infarction (STEMI) cases during the COVID-19 pandemic era is related to unsatisfactory performance of STEMI systems of care as well as worsening of the clinical outcomes in STEMI patients. Thus, our meta-analysis was conducted to evaluate this matter. Methods: We compared the predetermined variables in this meta-analysis during the early and late pandemic. Using a combination of adapted search terms to fit the requirements of several search engines (PubMed, EuropePMC, SCOPUS, ProQuest, and EBSCOhost), we reviewed all observational studies citing our outcomes of interest before and during the outbreak. Results: Thirty-five records comprising a total of 62,247 participants were identified. Overall, our meta-analysis showed that there was a huge reduction of nearly 80% for STEMI admission during the outbreak (n = 10,263) in contrast to before the outbreak period (n = 51,984). STEMI patients who were admitted during the outbreak received less primary PCI and had longer symptom-to-FMC (first medical contact) time along with prolonged door-to-balloon (DTB) time. A decrease in the achievement of final TIMI (thrombolysis in myocardial infarction) 3 flow after primary PCI was also observed in this study. However, the number of in-hospital mortality was similar between two groups. Conclusion: There was a decrease in the STEMI care performance and worsening of clinical outcomes in STEMI patients, especially in the early pandemic period. Overall, concise health services must be implemented following a responsibility to obey health protocols to deliver high-quality services related to STEMI systems of care amidst the global pandemic.
topic STEMI
Systems of care
Performance
Outcomes
COVID-19
Pandemic
url http://www.sciencedirect.com/science/article/pii/S0019483221001322
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