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Epidemiological, Clinical, and Economic Burden of Myocardial Infarction Patients in Iran During the Covid-19 Pandemic Publisher



Pourasghari H1 ; Kolivand P2 ; Azari S1 ; Saberian P3 ; Behzadifar M4 ; Omidi N5 ; Salehbeigi S5 ; Raei B6 ; Rajaie S7 ; Luigi Bragazzi N1 ; Golpira R8 ; Khorgami MR8 ; Khani M9 ; Montazerinamin S5 Show All Authors
Authors
  1. Pourasghari H1
  2. Kolivand P2
  3. Azari S1
  4. Saberian P3
  5. Behzadifar M4
  6. Omidi N5
  7. Salehbeigi S5
  8. Raei B6
  9. Rajaie S7
  10. Luigi Bragazzi N1
  11. Golpira R8
  12. Khorgami MR8
  13. Khani M9
  14. Montazerinamin S5
  15. Lotfi F10
  16. Tajdini M5
Show Affiliations
Authors Affiliations
  1. 1. Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Health Economics, Faculty of Medicine, Shahed University, Tehran, Iran
  3. 3. Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  5. 5. Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Razi Educational and Therapeutic Center, Tabriz University of Medical Science, Tabriz, Iran
  7. 7. Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
  8. 8. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  9. 9. Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  10. 10. National Center for Health Insurance Research, Tehran, Iran

Source: IJC Heart and Vasculature Published:2023


Abstract

Background: To define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches, in-hospital outcomes, and the economic burden of COVID-19 during the pandemic. Methods: We conducted a multicenter, observational survey with selected hospitals from three medical universities in Tehran city. A data collection tool consisting of three parts. The first part included socio-demographic information, and the second part included clinical information, major complications, and in-hospital mortality. Finally, the third part was related to the direct medical costs generated by AMI in COVID-19 and non-COVID-19 patients. The study cohort comprised 4,560 hospitalizations for AMI (2,935 for STEMI [64%] and 1,625 for NSTEMI [36%]). Results: Of those hospitalized for AMI, 1,864 (76.6 %) and 1,659 (78 %) were male before the COVID-19 outbreak and during the COVID-19 era, respectively. The length of stay (LOS), was significantly lower during the COVID-19 pandemic era (4.27 ± 3.63 vs 5.24 ± 5.17, p = 0.00). Results showed that there were no significant differences in terms of patient risk factors across periods. A total of 2,126 AMIs were registered during the COVID-19 era, with a 12.65 % reduction (95 % CI 1.5–25.1) compared with the equivalent time in 2019 (P = 0.179). The risk of in-hospital mortality rate for AMI patients increased from 4.9 % in 2019 to 7.0 % in the COVID-19 era (OR = 1.42; 95 % CI 1.11–1.82; P = 0.004). Major complications were registered in 9.7 % of cases in 2020, which is higher than the rate of 6.6 % reported in 2019 (OR = 1.46, 95 % CI 1.11–1.82; P = 0.000). Total costs in hospitalized AMI-COVID patients averaged $188 more than in AMI patients (P = 0.020). Conclusion: This cross-sectional study found important changes in AMI hospitalization rates, worse outcomes, and higher costs during the COVID-19 periods. Future studies are recommended to examine the long-term outcomes of hospitalized AMI patients during the COVID-19 era. © 2023 The Author(s)
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1. Hospitalization, Major Complications and Mortality in Acute Myocardial Infarction Patients During the Covid-19 Era: A Systematic Review and Meta-Analysis, IJC Heart and Vasculature (2022)
2. Corona and Misery: Sixth Epidemiologic Transition by Covid-19 and Its Consequent Cardiovascular Complications, Journal of Iranian Medical Council (2022)
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