Impact of the COVID-19 Pandemic on STEMI Presentation and Clinical Outcomes: A SingleCenter Experience from Tripoli, Libya
الكلمات المفتاحية:
STEMI Treatment guideline; COVID-19 Pandemic; Patient delay; Epidemiological shift; Time delayالملخص
The COVID-19 pandemic disrupted healthcare systems worldwide, potentially overshadowing other medical emergencies,
including ST-elevation myocardial infarction (STEMI).
This single-center observational study aims to assess changes in STEMI incidence, clinical presentation, risk factors, and the
timing of presentation (from symptom onset to first medical contact [FMC]). Additionally, it evaluates treatment guidelines and
in-hospital events between the pre-COVID-19 and post-COVID-19 periods. Acute STEMI cases were retrospectively identified
at the National Heart Center in Tripoli. The post-COVID-19 period (April 1, 2020, to December 31, 2021) was compared to the
pre-COVID-19 period (January 1, 2019, to March 31, 2020).
A total of 124 patients were enrolled: 76.6% were male, and 23.4% were female. Over half of the participants (52.4%) were
under age 60. This younger demographic was more prevalent in the post-COVID-19 period compared to the pre-COVID-19
period (60.6% vs. 43.1%; P=.07), which contrasts with the common association of STEMI with older age. Regarding the time
from symptom onset to FMC, only 36.2% of patients arrived after 12 hours in the pre-COVID-19 period, whereas 54.5% faced
similar delays post-COVID-19 a statistically significant increase (P=.02).
Conclusion: While there was a significant delay in seeking medical contact, admission trends, clinical parameters, risk factors,
and mortality rates showed no significant differences between the two periods. Our data suggests that the standard of care for
STEMI was maintained during the pandemic, resulting in non-significant changes in patient outcomes
