Acute coronary syndromes and COVID-19 pandemic

ABSTRACT

The COVID-19 pandemic poses a threat to patients with acute coronary syndromes (ACS) and interventional cardiologists as well as other healthcare workers. The number of COVID-19 positive or suspected positive patients requiring hospital admission has overwhelmed many health systems and negatively affected standard of care for ACS patients in these countries. This manuscript aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. Modified diagnostic and treatment algorithms, which have been developed in countries heavily beaten by this unpredictable challenge, are discussed as are various clinical scenarios and management algorithms for patients with a confirmed or suspected COVID-19 infection presenting with ST segment elevation myocardial infarction (STEMI) or non-ST elevation ACS (NSTE-ACS). Further described topics include the need for re-organization of pre-hospital (STEMI networks) and in-hospital structures (emergency rooms and cardiac units), with examples coming from multiple European countries. Finally, this manuscript aims to help re-organizing of catheterization laboratory structures and personnel and to discuss measures for protection of healthcare providers involved with invasive procedures.