Prehospital management of ST-segment elevation myocardial infarction during COVID-19 lockdown. A single centre experience

Jimenez Melo, O; Meseguer Gonzalez, D; Linares Vicente, JA; Rio Sanchez, S; Lukic Otanovic, A; Simo Sanchez, B; Lopez Cuartero, P; Jimenez Agesta, Y; Ruiz Arroyo, JR

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: The workflow and reperfusion time in STEMI patients are associated with morbidity-mortality. COVID19 lockdown restrictions could impact on routine prehospital management of STEMI. METHODS AND PURPOSE: Retrospective study comparing patients treated for STEMI during the period of lockdown in Spain (03/15/2020 to 05/31/2020) and patients with STEMI treated in the same period of the previous year (2019). The aim is to present our experience comparing the two periods attending to the prehospital flow of patients, the reperfusion strategy of choice, the prehospital complications and the "patient delay time" for reperfusion. RESULTS: We included 73 patients from the pre-COVID period and 67 patients from the lockdown. Baseline characteristics are shown in table 1. During the lockdown, there was a significant increase in the number of patients who activated the emergency medical system (emergency number 112) bypassing an outpatient medical center. In addition and possibly due to patients’ preference for keeping social distance, there was an increase in the number of self-referred patients to the emergency department (ED), decreasing number of patients attended by ambulance system (table 1). There were no significant differences neither in the choice of reperfusion strategy nor in the occurrence of complications (image 1). The mean time from symptom onset to first medical contact (patient delay time) was not significantly prolonged (table 1). CONCLUSION: During COVID-19 lockdown, the flow of STEMI patients to the ED was modified because of patients preferences. It did not mean longer times to first medical attention or increase in the number of complications.