ACUTE CORONARY SYNDROME / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Due to the SARS-CoV-2 pandemic, there have been fundamental changes to the delivery and operation of healthcare facilities across the world, significantly impacting how patients with a variety of diseases are treated. We aimed to assess the impact of the COVID-19 pandemic on patient management outcomes among patients with acute coronary syndromes (ACS) and explore the differences in patients who were treated within and outside the coordinated care programme for patients after ACS (KOS-Zawal).

Material and methods:
We analysed 472,996 medical records of patients after ACS from 2017 to 2022. The study examined information on deaths in two groups of patients: those included and those not included in the KOS-Zawal programme.

Results:
Before the COVID-19 pandemic a significantly higher mortality rate was observed in the group of patients not covered by the KOS-Zawal benefit compared with covered patients (25.5% vs. 15.8%; p < 0.0001). During the COVID-19 pandemic a significantly higher incidence of death was noted in the group of patients not covered by KOS-Zawal compared with patients covered by the programme (18% vs. 7.9%; p < 0.0001). Compared to the time before and during COVID-19, the number of deaths among patients not covered (25.5% vs. 18%; p < 0.0001) and covered by KOS-Zawal (15.8% vs. 7.9%, p < 0.0001) decreased significantly.

Conclusions:
Patients not covered by KOS-Zawal had a significantly higher mortality rate compared to those covered by the programme during the pandemic. The pandemic significantly affected patients under KOS-Zawal care, with a reduced mortality rate.
REFERENCES (28)
1.
Raisi-Estabragh Z, Mamas MA. Cardiovascular health care implications of the COVID-19 pandemic. Cardiol Clin 2022; 40: 389-96.
 
2.
Orlewska K, Wierzba W, Śliwczynski A. Cost-effectiveness analysis of COVID-19 vaccination in Poland. Arch Med Sci 2022; 18: 1021-31.
 
3.
Erdem I, Ardic E, Turker E, Kardan ME, Demirkapu MJ. Comparison of antibiotic use in the COVID-19 pandemic with the pre-pandemic period in a university hospital. Arch Med Sci 2022; 18: 1392-4.
 
4.
Nunez-Villaveiran T, González-Castro A, Nevado-Losada E, García-de-Lorenzo A, Garro P. All for one and one for all: voluntary physicians in the intensive medicine units during the COVID-19 outbreak in Spain. Disaster Med Public Health Prep 2022; 16: 612-8.
 
5.
Melman GJ, Parlikad AK, Cameron EAB. Balancing scarce hospital resources during the COVID-19 pandemic using discrete-event simulation. Health Care Manag Sci 2021; 24: 356-74.
 
6.
Winkelmann J, Webb E, Williams GA, Hernández-Quevedo C, Maier CB, Panteli D. European countries’ responses in ensuring sufficient physical infrastructure and workforce capacity during the first COVID-19 wave. Health Policy Amst Neth 2022; 126: 362-72.
 
7.
Artiga-Sainz LM, Sarria-Santamera A, Martínez-Alés G, Quintana-Díaz M. New approach to managing the COVID-19 pandemic in a Complex Tertiary Care Medical Center in Madrid, Spain. Disaster Med Public Health Prep 2022; 16: 2097-102. 3.
 
8.
Rosenbäck R, Lantz B, Rosén P. Hospital staffing during the COVID-19 pandemic in Sweden. Healthcare 2022; 10: 2116.
 
9.
www.ideo.pl. Provision of health care services in relation to the prevention, counteraction and eradication of COVID-19 - recommendations. National Health Fund (NFZ) - we finance the health of Poles. Accessed April 14, 2024. https://www.nfz.gov.pl/aktualn....
 
10.
Ferraro CF, Findlater L, Morbey R, et al. Describing the indirect impact of COVID-19 on healthcare utilisation using syndromic surveillance systems. BMC Public Health 2021; 21: 2019.
 
11.
Jankowska-Sanetra J, Sanetra K, Synak M, Milewski K, Gerber W, Buszman PP. The impact of the coronavirus pandemic on patients hospitalized due to acute coronary syndrome. Adv Interv Cardiol 2023; 19: 86-98.
 
12.
Gziut AI. Kompleksowa Opieka Specjalistyczna pacjentów po zawale serca (KOS-Zawal) w czasie pandemii COVID-19 – porównanie doświadczeń ośrodków w zależności od ich trybu pracy. Kardiol Inw 2021; 16: 141-3.
 
13.
Kubielas G, Diakowska D, Uchmanowicz I. Survival analysis of patients with acute coronary syndrome receiving comprehensive coordinated care after myocardial infarction (KOS-Zawal). Pol Heart J 2022; 80: 315-21.
 
14.
Wita K, Kułach A, Sikora J, et al. Managed Care after Acute Myocardial Infarction (MC-AMI) reduces total mortality in 12-month follow-up-results from a Poland’s National Health Fund Program of comprehensive post-MI care-a population-wide analysis. J Clin Med 2020; 9: 3178.
 
15.
Feusette P, Gierlotka M, Krajewska-Redelbach I, et al. Comprehensive coordinated care after myocardial infarction (KOS Zawal): a patient’s perspective. Kardiol Pol 2019; 77: 568-70.
 
16.
NFZ on health. Ischaemic heart disease – ezdrowie.gov.pl. Accessed April 14, 2024. https://ezdrowie.gov.pl/portal....
 
17.
Wita K, Kułach A, Wita M, et al. Managed Care after Acute Myocardial Infarction (KOS-Zawal) reduces major adverse cardiovascular events by 45% in 3-month follow-up – single-center results of Poland’s National Health Fund program of comprehensive post-myocardial infarction care. Arch Med Sci 2020; 16: 551-8.
 
18.
Miralles O, Sanchez-Rodriguez D, Marco E, et al. Unmet needs, health policies, and actions during the COVID-19 pandemic: a report from six European countries. Eur Geriatr Med 2021; 12: 193-204.
 
19.
Mengal N, Saghir T, Hassan Rizvi SN, et al. Acute ST-elevation myocardial infarction before and during the COVID-19 pandemic: what is the clinically significant difference? Cureus 2020; 12: e10523.
 
20.
Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, Dimian M, Savage WK. Global challenges to Public Health Care Systems during the COVID-19 pandemic: a review of pandemic measures and problems. J Pers Med 2022; 12: 1295.
 
21.
Pessoa-Amorim G, Camm CF, Gajendragadkar P, et al. Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology. Eur Heart J Qual Care Clin Outcomes 2020; 6: 210-6.
 
22.
Tam CCF, Cheung KS, Lam S, et al. Impact of Coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes 2020; 13: e006631.
 
23.
De Filippo O, D’Ascenzo F, Angelini F, et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in Northern Italy. N Engl J Med 2020; 383: 88-9.
 
24.
Nadarajah R, Wu J, Hurdus B, et al. The collateral damage of COVID-19 to cardiovascular services: a meta-analysis. Eur Heart J 2022; 43: 3164-78.
 
25.
Sofi F, Dinu M, Reboldi G, et al. Worldwide differences of hospitalization for ST-segment elevation myocardial infarction during COVID-19: a systematic review and meta-analysis. Int J Cardiol 2022; 347: 89-96.
 
26.
Sarker MNI, Raihan L, Peng Y, et al. COVID-19: access to information, health service, daily life facility and risk perception of foreigners during the coronavirus pandemic in South Korea. Arch Med Sci 2021. doi:10.5114/aoms/141164.
 
27.
Mohammadinia L, Saadatmand V, Khaledi Sardashti H, et al. Hospital response challenges and strategies during COVID-19 pandemic: a qualitative study. Front Public Health 2023; 11: 1167411.
 
28.
Antoniewicz AA, Niemczyk W, Regulski PA, Niezgodka M. The impact of the COVID-19 pandemic on urological care in Poland - post-COVID resilience scenarios and recommendations for healthcare system: a national population-based modelling study. Arch Med Sci 2021. doi:10.5114/aoms/144310.
 
eISSN:1896-9151
ISSN:1734-1922
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