Cameli Matteo, Pastore Maria Concetta, Mandoli Giulia Elena, D'Ascenzi Flavio, Focardi Marta, Biagioni Giulia, Cameli Paolo, Patti Giuseppe, Franchi Federico, Mondillo Sergio, Valente Serafina
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy.
Front Cardiovasc Med. 2021 Jan 28;7:593496. doi: 10.3389/fcvm.2020.593496. eCollection 2020.
Coronavirus disease-2019 (COVID-19) pandemic is a global healthcare burden, characterized by high mortality and morbidity rates all over the world. During the outbreak period, the topic of acute coronary syndromes (ACS) has raised several clinical issues, due to the risks of COVID-19 induced myocardial injury and to the uncertainties about the management of these cardiologic emergency conditions, which should be organized optimizing the diagnostic and therapeutic resources and ensuring the maximum protection to healthcare personnel and hospital environment. COVID-19 status should be assessed as soon as possible. Moreover, considerably lower rates of hospitalization for ACS have been reported all over the world, due to patients' hesitations to refer to hospital and to missed diagnosis. As a result, short- and long-term complications of myocardial infarction are expected in the near future; therefore, great efforts of healthcare providers will be required to limit the effects of this issue. In the present review we discuss the impact of COVID-19 pandemic on ACS diagnosis and management, with possible incoming consequences, providing an overview of the available evidence and suggesting future changes in social and clinical approach to ACS.
2019冠状病毒病(COVID-19)大流行是一项全球性的医疗负担,其特征是世界各地的死亡率和发病率都很高。在疫情爆发期间,急性冠状动脉综合征(ACS)这一话题引发了若干临床问题,这是由于COVID-19诱发心肌损伤的风险以及这些心脏急症管理方面的不确定性,对此应优化诊断和治疗资源的组织,并确保对医护人员和医院环境提供最大程度的保护。应尽快评估COVID-19状态。此外,世界各地报告的ACS住院率显著降低,原因是患者不愿前往医院就诊以及漏诊。因此,预计在不久的将来会出现心肌梗死的短期和长期并发症;因此,医疗服务提供者需要付出巨大努力来限制这一问题的影响。在本综述中,我们讨论了COVID-19大流行对ACS诊断和管理的影响以及可能产生的后果,概述了现有证据,并提出了未来社会和临床应对ACS方法的变化建议。