Sistema de Salut de Catalunya
[Alquézar-Arbé A] Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Miró Ò, Jiménez S] Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain. [González Del Castillo J] Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. [Llorens P] Emergency Department, Hospital General de Alicante, University Miguel Hernández, Alicante, Spain. [Martín A] Emergency Department, Hospital Universitario de Móstoles, Madrid, Spain. [Tost J] Servei d’Urgències, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain
Consorci Sanitari de Terrassa
2023-04-21T12:48:43Z
2023-04-21T12:48:43Z
2022-04
COVID-19; SARS-Cov-2; Síndrome coronari agut
COVID-19; SARS-Cov-2; Síndrome coronario agudo
COVID-19; SARS-Cov-2; Acute coronary syndrome
Background: There is a lack of knowledge about the real incidence of acute coronary syndrome (ACS) in patients with COVID-19, their clinical characteristics, and their prognoses. Objective: We investigated the incidence, clinical characteristics, risk factors, and outcomes of ACS in patients with COVID-19 in the emergency department. Methods: We retrospectively reviewed all COVID-19 patients diagnosed with ACS in 62 Spanish emergency departments between March and April 2020 (the first wave of COVID-19). We formed 2 control groups: COVID-19 patients without ACS (control A) and non-COVID-19 patients with ACS (control B). Unadjusted comparisons between cases and control subjects were performed regarding 58 characteristics and outcomes. Results: We identified 110 patients with ACS in 74,814 patients with COVID-19 attending the ED (1.48% [95% confidence interval {CI} 1.21-1.78%]). This incidence was lower than that observed in non-COVID-19 patients (3.64% [95% CI 3.54-3.74%]; odds ratio [OR] 0.40 [95% CI 0.33-0.49]). The clinical characteristics of patients with COVID-19 associated with a higher risk of presenting ACS were: previous coronary artery disease, age ≥60 years, hypertension, chest pain, raised troponin, and hypoxemia. The need for hospitalization and admission to intensive care and in-hospital mortality were higher in cases than in control group A (adjusted OR [aOR] 6.36 [95% CI 1.84-22.1], aOR 4.63 [95% CI 1.88-11.4], and aOR 2.46 [95% CI 1.15-5.25]). When comparing cases with control group B, the aOR of admission to intensive care was 0.41 (95% CI 0.21-0.80), while the aOR for in-hospital mortality was 5.94 (95% CI 2.84-12.4). Conclusions: The incidence of ACS in patients with COVID-19 attending the emergency department was low, around 1.48%, but could be increased in some circumstances. Patients with COVID-19 with ACS had a worse prognosis than control subjects with higher in-hospital mortality
Article
Published version
English
COVID-19 (Malaltia); Cor - Malalties; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections; DISEASES::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Acute Coronary Syndrome; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::isquemia miocárdica::síndrome coronario agudo
Elsevier
The Journal of Emergency Medicine;62(4)
https://doi.org/10.1016/j.jemermed.2021.10.046
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
