Impact of the COVID-19 pandemic on acute cardiology and neurology services in a secondary peripheral hospital

Abstract

Abstract The indirect impact of the COVID-19 pandemic on clinical services in peripheral hospitals has not been fully described. We compared the impact of COVID-19 on Cerebral Vascular Accident (CVA) and ST-elevation myocardial infarction (STEMI) management and outcome in an Israeli peripheral hospital. We included 1029 CVA and 495 STEMI patients. Patients who arrived during (15/3/2020–15/4/2022) and before (1/1/2018–14/3/2020) the pandemic, were demographically comparable. During the pandemic, median time for CVA patients from arrival to imaging was longer (23 vs. 19 min, p = 0.001); timing from arrival to tissue Plasminogen Activator administration was similar (49 vs. 45 min, p = 0.61); transfer to another hospital was more common (20.3% vs. 14.4% p = 0.01) and median length of stay (LOS) was shorter (3 vs. 4 days, p < 0.05). Among STEMI patients, median time from arrival to intervention intra- pandemic was shorter (45 vs. 50 min p = 0.02); Mean LOS shorter (3.86 vs. 4.48 p = 0.01), and unplanned re-admission less frequent (7.8% vs. 14.6% p = 0.01). Mortality did not change significantly. Our data shows no major negative impact of the COVID-19 pandemic on CVA outcomes, and improved care for STEMI patients. Interviews with the neurology and cardiology staff are performed to investigate how quality of care was maintained during the crises.

Keywords

• COVID-19
• ST Elevation Myocardial Infarction
• Stroke
• Treatment Outcome
• Length of Stay