Bruoha S, Yosefy C, Gallego-Colon E, et al. - In developed countries, cardiovascular disease remained the main cause of death even during the COVID-19 pandemic. Reduction in the time from symptom onset until reperfusion or total ischemic time (TIT) is emphasized to achieve improvement in the outcomes related with acute coronary syndromes (ACS), which accounts for a substantial percentage of deaths outcomes. Based on the date and timing of admissions, delays in TIT were evaluated in patients with ST-segment elevation myocardial infarction (STEMI), by a timeline follow-up form, before and during the current COVID-19 pandemic. Admission of 212 patients diagnosed with STEMI occurred at their medical center between July 2018 and June 2020. A timeline report sheet was assigned to the cases upon presentation and documentation of each time interval, from onset of symptoms to the catheterization lab, was done. Evaluation of the information revealed that during the pandemic, there was a decrease in ACS admissions that accompanied with longer in-hospital TIT due to additional tests, triage, protocols to protect and prevent infection within hospital staff, and maintenance of adequate standards of care. However, time period remained maintained under 90 min for door-to-balloon time.