Epidemiological, clinical, and economic burden of myocardial infarction patients in Iran during the COVID-19 pandemic.

Publication date: Dec 01, 2023

To define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches, in-hospital outcomes, and the economic burden of COVID-19 during the pandemic. We conducted a multicenter, observational survey with selected hospitals from three medical universities in Tehran city. A data collection tool consisting of three parts. The first part included socio-demographic information, and the second part included clinical information, major complications, and in-hospital mortality. Finally, the third part was related to the direct medical costs generated by AMI in COVID-19 and non-COVID-19 patients. The study cohort comprised 4,560 hospitalizations for AMI (2,935 for STEMI [64%] and 1,625 for NSTEMI [36%]). Of those hospitalized for AMI, 1,864 (76. 6 %) and 1,659 (78 %) were male before the COVID-19 outbreak and during the COVID-19 era, respectively. The length of stay (LOS), was significantly lower during the COVID-19 pandemic era (4. 27 +/- 3. 63 vs 5. 24 +/- 5. 17, p = 0. 00). Results showed that there were no significant differences in terms of patient risk factors across periods. A total of 2,126 AMIs were registered during the COVID-19 era, with a 12. 65 % reduction (95 % CI 1. 5-25. 1) compared with the equivalent time in 2019 (P = 0. 179). The risk of in-hospital mortality rate for AMI patients increased from 4. 9 % in 2019 to 7. 0 % in the COVID-19 era (OR = 1. 42; 95 % CI 1. 11-1. 82; P = 0. 004). Major complications were registered in 9. 7 % of cases in 2020, which is higher than the rate of 6. 6 % reported in 2019 (OR = 1. 46, 95 % CI 1. 11-1. 82; P = 0. 000). Total costs in hospitalized AMI-COVID patients averaged $188 more than in AMI patients (P = 0. 020). This cross-sectional study found important changes in AMI hospitalization rates, worse outcomes, and higher costs during the COVID-19 periods. Future studies are recommended to examine the long-term outcomes of hospitalized AMI patients during the COVID-19 era.

Concepts Keywords
Hospitalizations Acute myocardial infarction
Iran Cardiac care units
Pandemic COVID-19
Economic burden

Semantics

Type Source Name
disease MESH myocardial infarction
disease MESH COVID-19 pandemic
drug DRUGBANK Azelaic acid
disease MESH complications
disease MESH STEMI
disease MESH NSTEMI
disease VO time

Original Article

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