摘要
Lockdown and re-opening may become cyclical due to the recurrent waves of the COVID-19 epidemic.Few studies have examined temporal trends and determinants of in-hospital mortality among patients with ST-segment elevation myocardial infarction(STEMI),a life-threatening condition that requires emergency medical care.Using nation-wide data before,during and after the Wuhan lockdown,we aimed to depict temporal patterns and major determinants of STEMI in-hospital mortality in China across five time periods of the COVID-19 epidemic.We analyzed the data of 283,661 STEMI patients who were admitted to 4,487 chest-pain-centers across China,from January 1,2019 to May 31,2020.Compared with the period before the lockdown,STEMI in-hospital mortality increased by 25%(OR 1.25,95%CI 1.16–1.34)during Early Lockdown,by 12%(OR 1.12,95%CI 1.03–1.22)during Later Lockdown,by 35%(OR 1.35,95%CI 1.21–1.50)during Early Lift,and returned to pre-COVID risk(OR 1.04,95%CI 0.95–1.14)during Later Lift.For each time-period,we observed a clear mortality gradient by timing and types of revascularization procedure.In conclusion,the COVID-19 epidemic had a significant adverse impact on STEMI in-hospital mortality,with bimodal peaks during early lockdown and early lift periods and clear mortality gradients by timing and types of revascularization procedure,independent of the time periods.
