Investigation of changes in young cardiac pathology cases before and during the pandemic process

Yıl 2023, Cilt: 6 Sayı: 1, 40 - 45, 12.01.2023

Burak Demirci

https://doi.org/10.32322/jhsm.1196920

Öz

Aim: It was aimed to evaluate the effect of pandemic in cardiac pathologies, especially acute coronary syndrome in young cases.
Material and Method: Between January 2019-May 2021, 510 young patients aged between 18-50 years with acute coronary syndrome, arrhythmia or pericarditis were evaluated. The patients were divided into two groups as pre-pandemic and pandemic period, and the pandemic period was divided into two groups as Coronavirus Disesase 2019 (COVID) (-)/(+). In addition, patients were divided into groups according to their diagnosis. Demographic data, diagnostic classifications, COVID-PCR results, white blood cell, mean corpuscular volume, neutrophil, lymphocyte, neutrophil lymphocyte ratio, platelet, platelet lymphocyte ratio, C reactive protein, glucose, troponin values and survival data of the patients were recorded.
Results: The median age of 510 patients included in the study was 44(39-48) years, 395(77.5%) were male. When the diagnoses were put into groups by time, unstable angina was the most common diagnosis in each group. In the COVID(+) group, 39(23.8%) non-ST-elevation myocardial infarction (NSTEMI), 17(10.4%) inferior MI, and 14(8.5%) anterior MI were found. Twenty three (4.5%) of all cases resulted in mortality. According to the diagnoses, the most common mortality was in the inferior MI group with 10(28.6%) cases (p<0.001). During the pandemic period, 13(7.9%) of the COVID(+) patients resulted in mortality (p=0.016).
Conclusion: Acute coronary syndrome cases and cardiac pathologies other than unstable angina increased in young cases during the pandemic process. Mortality rates in all groups increased significantly during the pandemic and especially in COVID(+) cases compared to pre-pandemic.

Anahtar Kelimeler

Emergency department, COVID-19, acute coronary syndrome, mortality, pandemic

Destekleyen Kurum

None

Kaynakça

• Kumar A, Cannon CP. Acute coronary syndromes: diagnosis and management, part I. Mayo Clin Proc 2009; 84: 917-38.
• Egred M, Viswanathan G, Davis GK. Myocardial infarction in young adults. Postgrad Med J 2005; 81: 741-5. 
• Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and Multiorgan Response. Curr Probl Cardiol 2020; 45: 100618.
• Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62. 
• Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol 2020; 17: 259-60. 
• Becker RC. Toward understanding the 2019 Coronavirus and its impact on the heart. J Thromb Thrombolysis 2020; 50: 33-42. 
• Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med 2020; 46: 586-90. 
• Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor Recognition by the Novel Coronavirus from Wuhan: an Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. J Virol 2020; 17: 94:e00127-20.
• Kaur P, Patel P, Singh B, et al. ST-Segment Elevation in Patients with COVID-19: A Late Complication. Am J Med Sci 2021; 361: 403-5. 
• Choudry FA, Hamshere SM, Rathod KS, et al. High Thrombus Burden in Patients With COVID-19 Presenting With ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol 2020; 76: 1168-76.
• Stefanini GG, Montorfano M, Trabattoni D, et al. ST-Elevation Myocardial Infarction in Patients With COVID-19: Clinical and Angiographic Outcomes. Circulation 2020; 141: 2113-6. 
• Chapman AR, Shah AS, Lee KK, et al. Long-Term Outcomes in Patients With Type 2 Myocardial Infarction and Myocardial Injury. Circulation 2018; 137: 1236-45.
• Hamadeh A, Aldujeli A, Briedis K, et al. Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction. Am J Cardiol 2020; 131: 1-6.
• Baldi E, Sechi GM, Mare C, et al. Lombardia CARe Researchers. Out-of-Hospital Cardiac Arrest during the Covid-19 Outbreak in Italy. N Engl J Med 2020; 383: 496-8.
• Showkathali R, Yalamanchi R, Sankeerthana MP, et al. Acute Coronary Syndrome admissions and outcome during COVID-19 Pandemic-Report from large tertiary centre in India. Indian Heart J 2020; 72: 599-602.
• Braiteh N, Rehman WU, Alom M, et al. Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York. Am Heart J 2020; 226: 147-51.
• Mimoso J. The impact of Covid-19 pandemic on acute coronary syndrome admissions at a tertiary care hospital in Portugal. Rev Port Cardiol 2022; 41: 153-4.
• Zachariah G, Ramakrishnan S, Das MK, et al. CSI-AMI Study group. Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic. Indian Heart J 2021; 73: 413-23.
• Alhogbani T. Acute myocarditis associated with novel Middle east respiratory syndrome coronavirus. Ann Saudi Med 2016; 36: 78-80.
• Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol 2020; 75: 2352–71.
• Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020; 130: 2620-9.
• Liu K, Fang YY, Deng Y, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl) 2020; 133: 1025-31.
• Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323: 1061-9. 
• Inciardi RM, Adamo M, Lupi L, et al. Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J 2020; 41: 1821-9.
• Romiti GF, Corica B, Lip GYH, Proietti M. Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10: 2490.