• Karl Heinrich Scholz, Björn Lengenfelder, Christian Thilo, Andreas Jeron, Stefan Stefanow, Uwe Janssens, Johann Bauersachs, P Christian Schulze, Klaus Dieter Winter, Jörg Schröder, Jürgen Vom Dahl, Nicolas von Beckerath, Karlheinz Seidl, Tim Friede, and Thomas Meyer.
• Department of Cardiology, Medizinische Klinik I, St. Bernward Hospital, Treibestraße 9, 31134, Hildesheim, Germany. k.scholz@bernward-khs.de.
• Clin Res Cardiol. 2020 Dec 1; 109 (12): 1511-1521.

AimsTo assess the impact of the lockdown due to coronavirus disease 2019 (COVID-19) on key quality indicators for the treatment of ST-segment elevation myocardial infarction (STEMI) patients.MethodsData were obtained from 41 hospitals participating in the prospective Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) study, including 15,800 patients treated for acute STEMI from January 2017 to the end of March 2020.ResultsThere was a 12.6% decrease in the total number of STEMI patients treated at the peak of the pandemic in March 2020 as compared to the mean number treated in the March months of the preceding years. This was accompanied by a significant difference among the modes of admission to hospitals (p = 0.017) with a particular decline in intra-hospital infarctions and transfer patients from other hospitals, while the proportion of patients transported by emergency medical service (EMS) remained stable. In EMS-transported patients, predefined quality indicators, such as percentages of pre-hospital ECGs (both 97%, 95% CI = - 2.2-2.7, p = 0.846), direct transports from the scene to the catheterization laboratory bypassing the emergency department (68% vs. 66%, 95% CI = - 4.9-7.9, p = 0.641), and contact-to-balloon-times of less than or equal to 90 min (58.3% vs. 57.8%, 95%CI = - 6.2-7.2, p = 0.879) were not significantly altered during the COVID-19 crisis, as was in-hospital mortality (9.2% vs. 8.5%, 95% CI = - 3.2-4.5, p = 0.739).ConclusionsClinically important indicators for STEMI management were unaffected at the peak of COVID-19, suggesting that the pre-existing logistic structure in the regional STEMI networks preserved high-quality standards even when challenged by a threatening pandemic.Clinical Trial RegistrationNCT00794001.

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