Impact of COVID-19 on admission and in-hospital mortality of patients with acute myocardial infarction in Korea: An interrupted time series analysis.

Soo-Hee Hwang, Youngs Chang, Haibin Bai, Jieun Yun, Hyejin Lee, Jin Yong Lee
Author Information
  1. Soo-Hee Hwang: HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju-si, Gangwon-do, Republic of Korea.
  2. Youngs Chang: Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, Republic of Korea.
  3. Haibin Bai: Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea. ORCID
  4. Jieun Yun: Department of Pharmaceutical Engineering, Cheongju University, Cheongju, Chungcheongbuk-do, Republic of Korea.
  5. Hyejin Lee: Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
  6. Jin Yong Lee: Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea. ORCID

Abstract

OBJECTIVES: The purpose of this study is to investigate the impact of COVID-19 on admission and in-hospital mortality of patients with acute myocardial infarction (AMI).
METHODS: We constructed a dataset of monthly hospitalizations and mortality of inpatients with AMI from January 2017 to December 2021 utilizing the National Health Insurance Claims Data which covers nearly the entire population. Using an interrupted time series (ITS), we investigated how COVID-19 affected hospitalizations and in-hospital deaths of patients with AMI.
RESULTS: During the study period, the average age of patients with AMI was 65.2-65.8 years, and the ratio of men to women was higher, with 73.0-75.3% of patients being men and 24.7-27.0% being women. ITS analysis showed that admission rates of patients with AMI decreased one per 100,000 population due to COVID-19 (P<0.001). Reductions in admission rates were greatest among men, those aged 55 and older, and people with medical aid. COVID-19 did not affect inpatient mortality (p = 0.9608), but in-hospital mortality decreased from 12% to 7% in the medical aid group.
CONCLUSION: Overall, we found that COVID-19 had an impact on admission rates of patients with AMI but did not have a significant impact on in-hospital mortality. However, we also found differential impacts by sex, age, and socioeconomic status, indicating some may be more vulnerable. This highlights the importance of identifying and supporting these vulnerable populations to prevent poorer health outcomes.

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MeSH Term

Humans
COVID-19
Male
Female
Hospital Mortality
Myocardial Infarction
Aged
Republic of Korea
Middle Aged
Interrupted Time Series Analysis
Hospitalization
SARS-CoV-2
Patient Admission
Aged, 80 and over
Adult

Word Cloud

Created with Highcharts 10.0.0patientsCOVID-19mortalityAMIadmissionin-hospitalimpactmenratesstudyacutemyocardialinfarctionhospitalizationspopulationinterruptedtimeseriesITSagewomenanalysisdecreasedmedicalaidfoundvulnerableOBJECTIVES:purposeinvestigateMETHODS:constructeddatasetmonthlyinpatientsJanuary2017December2021utilizingNationalHealthInsuranceClaimsDatacoversnearlyentireUsinginvestigatedaffecteddeathsRESULTS:periodaverage652-658yearsratiohigher730-753%247-270%showedoneper100000dueP<0001Reductionsgreatestamongaged55olderpeopleaffectinpatientp=0960812%7%groupCONCLUSION:OverallsignificantHoweveralsodifferentialimpactssexsocioeconomicstatusindicatingmayhighlightsimportanceidentifyingsupportingpopulationspreventpoorerhealthoutcomesImpactKorea:

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