Impact of the COVID-19 pandemic on acute Cardiology and Neurology services in a secondary peripheral hospital

Abstract The indirect impact of the COVID-19 pandemic on clinical services in peripheral hospitals is not fully described. We compared the impact of COVID-19 on Cerebral Vascular Accident (CVA) and ST-elevation myocardial infarction (STEMI) management and outcome in an Israeli peripheral hospital. We included 1029 CVA and 497 STEMI patients. Those who arrived during (15/3/2020-15/4/2022) and before (1/1/2018-14/3/2020) the pandemic were demographically comparable. During the pandemic, median time for CVA patients from arrival to imaging was longer (23 vs. 19 minutes, p = 0.001); timing from arrival to tissue Plasminogen Activator administration was similar (49 vs. 45 min, p = 0.61); transfer to another hospital was more common (20.3% vs. 14.4% p = 0.01) and median length of stay (LOS) was shorter (3 vs. 4 days, p < 0.05). Among STEMI patients, median time from arrival to intervention intra- pandemic was shorter (45 vs. 50 minutes p = 0.02); Mean LOS shorter (3.86 vs. 4.48 p = 0.01), and unplanned re-admission less frequent (7.8% vs. 14.6% p = 0.01). Mortality didn’t significantly change. Our data shows no major negative impact of the COVID-19 pandemic on CVA outcomes, and possibly improved care for STEMI patients. Follow-up qualitative studies with neurology and cardiology staff will inform how quality of care was maintained during the crises.