Confronting the Dual Challenge: The Impact of the Covid-19 Pandemic on the Management of Acute Coronary Syndromes in a Leading Tertiary Hospital in Turkey

INTRODUCTION: In this study, we aimed to determine the impact of the SARS-CoV-2 pandemic (COVID-19) on the number, morbidity and mortality of acute myocardial infarction patients in Ankara Bilkent City Hospital, which has the largest patient capacity in the European region.
METHODS: A total of 1173 patients who were hospitalized with the diagnosis of acute myocardial infarction in Ankara Bilkent City Hospital between December 2019 to July 2020 were included in this study. These patients were divided into two groups according to the admission date. In this study, in light of the measures taken with the onset of the COVID-19 pandemic in Turkey, the effect of the pandemic on hospital admissions, application types, number of patients, laboratory, echocardiography, and angiography parameters of patients diagnosed with acute myocardial infarction (AMI) was investigated.
RESULTS: The month with the highest number of patients admitted to the emergency department was December, and the month with the lowest number was April. Compared to pre-COVID-19, an approximately 19% decrease was observed in hospital admissions after COVID-19. Also, medical treatment was more common than revascularization after the pandemic (73.43% vs. 26.56%, respectively, p <0.001). The frequency of non-culprit lesion intervention was significantly decreased after the COVID-19 pandemic compared to the time before the pandemic. (39.24% vs 60.75%, respectively, p= 0.002).
DISCUSSION AND CONCLUSION: Coronavirus-19 pandemic reduced not only the admission of AMI patients to hospitals but also the frequency of revascularization and intervention in the non-culprit artery before discharge. All of these factors led to low ejection fraction and high troponin values in these patients.