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Objective: There is an increasing recognition of the burden of cardiovascular disease in Africa. However, little is known about the pooled prevalence of acute coronary syndrome (ACS)-associated in-hospital mortality and contributing factors. Methods: PubMed, Medline, Embase, Web of Science (Core Collection), and supplementary sources including Google Scholar, World Cat, Research Gate, and Cochrane Library were searched. Chi-square test and I2-statistic were used to assess heterogeneity. Egger’s and Begg’s tests and funnel plots were used to assess publication bias. Data were analyzed using Stata software (version 15.0). Result: Twenty nine studies with a total sample of 11,788 were included. The pooled estimate of all-cause in-hospital mortality was 22% (pooled proportion (PP) = 0.22; 95% confidence interval (CI): 0.17–0.27. The In-hospital mortality rate was lower at the cardiac centers (PP = 0.14; CI: 0.05–0.23) compared to referral hospitals (PP = 0.24; CI: 0.17–0.31]) The mortality rate was comparable in Eastern (PP = 0.23; CI: 0.19–0.27) and Northern Africa (PP = 0.22; CI: 0.16–0.28). The incidence of in-hospital heart failure, cardiogenic shock, arrhythmia, bleeding, acute stroke, and reinfarction were 42, 17.0, 20.0, 16.0, 4.0, and 5.0%, respectively. Conclusion: All-cause in-hospital mortality rate associated with ACS is high in Africa. The mortality rate at cardiac centers was 10% lower when compared with referral hospitals. Establishing coronary units, strengthening existing cardiac services, and improving availability and access to cardiovascular medicines could help in reducing the burden of ACS in the continent.

COVID-19 is a multisystemic infectious disease that primarily affects the respiratory system. However, the involvement of extra-pulmonary systems has also been reported. We report a 25-year-old female patient who visited the emergency department with a four-day history of severe burning epigastric pain associated with vomiting. The patient was later diagnosed with severe acute pancreatitis with concomitant severe COVID-19 based on clinical, biochemical, and imaging findings. The patient was managed with antibiotics, anticoagulation, and ventilatory support. Despite aggressive treatment efforts, the patient sustained cardiac arrest in the setting of refractory hypoxemia and passed away on day three of her hospitalization.