Incidence, Morbidity-Mortality and Management of Acute Coronary Syndrome During the Covid-19 Pandemic

Abstract

Background and objective: A decrease in the number of admissions due to acute coronary syndrome (ACS) was observed during the COVID-19 pandemic. A study is made of the impact of the pandemic upon the incidence, morbidity-mortality and management of ACS. Materials and methods: A retrospective multicenter study was carried out with data from patients admitted due to ACS between 14 February and 24 June 2020. The following groups were established according to the period of admission: A) one month before strict lockdown; B) during lockdown; and C) one month after lockdown. The primary objective of the study was to assess differences in mortality among the three periods. Differences in the time from symptoms onset to the first medical contact (FMC) were also evaluated. Results: A total of 634 patients were included in the study (group A: 205, group B: 303, group C: 126). A 41% decrease in the number of admissions due to ACS was recorded in the first month of lockdown. A diagnostic delay was observed during lockdown (A: 65 minutes (range 38-112) vs B: 120 minutes (60-300) vs C: 120 minutes (60-360), p < 0.001); this period was not associated to increased mortality, however (HR 1.26; 95%CI 0.53-2.97; p = 0.60). Conclusions: A decrease in the number of admissions due to ACS was recorded during lockdown, with an increase in the time from symptoms onset to FMC in patients with STEACS. This was not associated to an increase in mortality during this period, however.