Adverse Effects of Coronavirus Disease 2019 (COVID-19) on First Medical Contact to Reperfusion Time in Urban ST-Segment Elevation Myocardial Infarction Patients and Advantage of Prehospital Electrocardiography.

Background: We have previously reported the advantages of a prehospital 12-lead electrocardiography system (P-ECG) for ST-segment elevation myocardial infarction (STEMI) patients ( Methods and Results: Recent urban STEMI patients who received primary percutaneous coronary intervention (PCI) using P-ECG were assigned to a P-ECG group (n=87; age 69±14 years), and comparable urban STEMI patients not using P-ECG were assigned to a Conventional group (n=87; age 71±13 years). The pre-COVID-19 period is defined as the period before the pandemic began, and the COVID-19 period is the time thereafter. In the Conventional group, first medical contact (FMC)-to-reperfusion time (110±45 vs. 90±31 min; P=0.025) and door-to-reperfusion time (89±41 vs. 70±29 min; P=0.015) in the COVID-19 period were significantly longer than in the pre-COVID-19 period. However, in the P-ECG group, there was no difference in FMC-to-reperfusion time and door-to-reperfusion time between the 2 periods. In the Conventional group, Killip class (2.0±1.3 vs. 1.1±0.5; P=0.001) and left ventricular ejection fraction (49±12 vs. 57±9.0%; P=0.002) were significantly poorer in the COVID-19 period than in the pre-COVID-19 period. However, in the P-ECG group, there was no significant difference between the 2 periods. Conclusions: During the COVID-19 pandemic, P-ECG might have provided advantages for patient transport and outcomes in urban STEMI patients.