Specialties: Acute and critical illnesses                                                                                                            

     This in-hospital study at Far Eastern Memorial Hospital (FEMH) integrates insights from the Cardiology, Cardiovascular Surgery, Emergency Medicine, and Research departments to investigate the impact of the COVID-19 pandemic on emergency percutaneous coronary intervention (pPCI) for patients with acute myocardial infarction (AMI) over three years before and after the pandemic. Timely and effective catheterization procedures can restore blood flow and reduce myocardial damage, making the time from the patient's arrival at the emergency department (ED) to the successful reopening of the occluded vessel—the Door-to-Device (D2D) time—a crucial predictor of patient prognosis.

       The study highlights that during the COVID-19 pandemic, stringent infection control measures implemented to curb virus transmission significantly influenced hospital workflows. To prevent viral spread, hospitals required patients to undergo PCR testing, while medical staff had to wear full personal protective equipment (PPE). Although these precautions were essential for infection prevention, they also led to slight delays in the initial phase of emergency catheterization procedures after patients arrived at the ED.

       However, the study also found that once patients reached the catheterization lab, the medical team performed the procedure more efficiently. This improvement in procedural efficiency was largely attributed to a reduction in the number of elective procedures during the pandemic, leading to less congestion in catheterization labs. As a result, healthcare teams could allocate resources more effectively and expedite the treatment of AMI patients.

      Despite an average 10-minute increase in overall D2D time during the pandemic peak and a decline in the proportion of procedures completed within 90 minutes, patient clinical outcomes—such as ICU length of stay, total hospital stay, in-hospital mortality, and 30-day readmission rates—did not show signs of deterioration. These findings are encouraging, demonstrating that despite the significant challenges posed by the pandemic, FEMH’s medical team successfully adapted their strategies to ensure patient care quality and safety remained uncompromised.

        Nonetheless, the study also identified another critical concern: a nearly 30% decrease in the number of AMI patients seeking emergency care during the peak of the pandemic. This decline may have been due to patients' fear of COVID-19 infection, leading them to delay or avoid seeking medical attention. Such delays pose a severe risk to AMI patients, as postponed treatment can result in more severe complications or even fatal outcomes. We strongly urge the public to seek immediate medical attention if they experience chest pain or discomfort, regardless of the pandemic situation, to prevent delays in life-saving treatment.

        Overall, this study showcases the hospital’s resilience and rapid adaptability in responding to the challenges of the pandemic. By strategically reallocating resources and modifying procedures, the medical team successfully maintained high-quality acute cardiac care during this crisis. Moving forward, the insights and data from this study can serve as a valuable reference for other healthcare institutions in managing future public health crises, ensuring timely and effective medical interventions while maintaining robust infection control measures.