Toscano Olga, Cosentino Nicola, Campodonico Jeness, Bartorelli Antonio L, Marenzi Giancarlo
Centro Cardiologico Monzino, I.R.C.C.S., Milan, Italy.
Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
Front Cardiovasc Med. 2021 Dec 23;8:648290. doi: 10.3389/fcvm.2021.648290. eCollection 2021.
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic. On top of respiratory complications, COVID-19 is associated with major direct and indirect cardiovascular consequences, with the latter probably being even more relevant, especially in the setting of time-dependent cardiovascular emergencies. A growing amount of data suggests a dramatic decline in hospital admissions for acute myocardial infarction (AMI) worldwide during the COVID-19 pandemic, mostly since patients did not activate emergency medical systems because hospitals were perceived as dangerous places regarding the infection risk. Moreover, during the COVID-19 pandemic, patients with AMI had a significantly higher in-hospital mortality compared to those admitted before COVID-19, potentially due to late arrival to the hospital. Finally, no consensus has been reached regarding the most adequate healthcare management pathway for AMI and shared guidance on how to handle patients with AMI during the pandemic is still needed. In this review, we will provide an update on epidemiology, clinical characteristics, and outcomes of patients with AMI during the COVID-19 pandemic, with a special focus on its collateral cardiac impact.
2019年冠状病毒病(COVID-19)疫情迅速演变成一场全球大流行。除了呼吸系统并发症外,COVID-19还会引发重大的直接和间接心血管后果,后者可能更为突出,尤其是在与时间相关的心血管急症情况下。越来越多的数据表明,在COVID-19大流行期间,全球急性心肌梗死(AMI)的住院人数急剧下降,主要原因是患者认为医院存在感染风险,因而未启动紧急医疗系统。此外,在COVID-19大流行期间,与COVID-19之前入院的患者相比,AMI患者的院内死亡率显著更高,这可能是由于患者到院延迟所致。最后,对于AMI最适当的医疗管理途径尚未达成共识,仍然需要关于在大流行期间如何处理AMI患者的共同指导意见。在本综述中,我们将提供COVID-19大流行期间AMI患者的流行病学、临床特征和结局的最新情况,特别关注其对心脏的附带影响。