Primary percutaneous coronary intervention (PPCI), a key therapeutic procedure for ST-segment elevation myocardial infarction (STEMI), experienced major disruption during the COVID-19 crisis. This study investigated how the pandemic influenced both the frequency of PPCI procedures and the short-term hospital outcomes of STEMI patients. Using a retrospective observational approach, data were collected from consecutive patients admitted to the International Cardiac Center (ICC) in Alexandria, Egypt, between February 1 and October 31, 2020. For comparison, records from an equivalent period in 2019 were analyzed as a control group. Patients with a confirmed STEMI diagnosis requiring PPCI were included. In total, 634 cases were examined. The number of PPCI interventions fell by 25.7% during the pandemic period (average 30.0 ± 4.01 vs. 40.4 ± 5.3 cases monthly), and the delay between initial medical contact and needle time (FMC-to-N) increased significantly (125.0 ± 53.6 vs. 52.6 ± 22.8 minutes, p = 0.001). Furthermore, the COVID-19 group exhibited higher in-hospital mortality (7.4% vs. 4.6 percent, p = 0.036), greater re-infarction frequency (12.2% vs. 7.7 percent, p = 0.041), and increased revascularization needs (15.9% vs. 10.7 percent, p = 0.046). Although rates of heart failure, stroke, and bleeding did not differ significantly between groups, hospitalization duration was considerably longer during the pandemic (6.85 ± 4.22 vs. 3.5 ± 2.3 days, p = 0.0025). In summary, the COVID-19 outbreak led to substantial challenges in PPCI management at the ICC, including reduced case volumes, delayed interventions, and worsened in-hospital outcomes such as elevated mortality, recurrent infarction, greater revascularization demand, and prolonged recovery time.
