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Impact of COVID-19 Pandemic on Critical Care Transfers for ST-Elevation Myocardial Infarction, Stroke, and Aortic Emergencies

By Currents Editor posted 07-01-2020 10:23


Circulation: Cardiovascular Quality and Outcomes (06/11/20) doi: 10.1161/CIRCOUTCOMES.120.006938

Khot, Umesh N.; Reimer, Andrew P.; Brown, Abigail; et al.

New research shows a reduction in emergency transfers for serious cardiovascular and neurologic diseases coinciding with the COVID-19 pandemic. A team from the Cleveland Clinic, in Cleveland, OH, compared daily emergency transfers for patients experiencing ST-elevation myocardial infarction (STEMI), acute stroke, and aortic emergencies before and after a COVID-related state of emergency was declared in Ohio. The early weeks of the pandemic (March 9, 2020–May 6, 2020) were compared with three periods: first baseline (January 1, 2019–March 8, 2020), second baseline (March 9, 2019–May 6, 2019), and third baseline (January 1, 2020–March 8, 2020). The mean daily transfer volume for STEMI, acute stroke, and aortic emergencies dropped 39% from the first baseline period to the pandemic period, 38% from the second baseline period, and 44% from the third baseline period. There were similar reductions in transfer volume for the three conditions in subgroup analysis, though the decline for aortic emergencies did not reach statistical significance. The researchers note the reductions occurred despite a lack of changes to the “auto launch” process for emergency transfers. Furthermore, they occurred in a region that was not as hard hit in the early weeks of the pandemic as hotspots in China, New York City, and Italy. Concerned that patients may be hesitant to seek care during the pandemic—due to fears of becoming infected or that there is no care available—the authors stress “the importance of education to the public to continue to seek emergency care for serious symptoms such as chest pain and those associated with stroke during the COVID-19 pandemic.”


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Claiborne Johnston, Pierre Amarenco, et al. for the THALES investigators.Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. N Engl J Med   2020;383:207-17.
DOI: 10.1056/NEJMoa1916870
 Reviewed by Sanjeev Sivakumar,MD Read the article .*   *You will need to log in ...