Out-of-Hospital Cardiac Arrest and Acute Coronary Syndrome Hospitalizations During the COVID-19 Surge

Mountantonakis, Stavros; Saleh, Moussa; Coleman, Kristie; Kuvin, Jeffrey T.; Singh, Varinder; Jauhar, Rajiv; Ong, Lawrence; Qiu, Michael; Epstein, Laurence M.

doi:10.1016/j.jacc.2020.07.021

Cited by 44 publications

(49 citation statements)

References 3 publications

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“…ECG alterations have been described during hospitalization for COVID-19, reflecting several CV complications ranging from ST-T changes to acute coronary syndrome (ACS), acute peri-myocarditis, pulmonary embolism or rhythm disorders [ 15 – 19 ]. Although these findings confirm that ECG changes during hospitalization may express a wide broad of CV complications with a potential significant clinical impact on outcome, our results highlighted the importance of ECG abnormalities at admission to stratify mortality risk for COVID-19 patients, deserving a closer monitoring and dedicated therapies.…”

Section: Discussionmentioning

confidence: 99%

Clinical and electrocardiographic characteristics at admission of COVID-19/SARS-CoV2 pneumonia infection

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Clinical and electrocardiographic characteristics at admission of COVID-19/SARS-CoV2 pneumonia infection

et al. 2021

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“…The COVID-19 pandemic has overwhelmed the healthcare systems capacity from almost all countries, particularly the hospital care of emergency conditions. Several studies have shown that the number of patients with acute coronary syndrome admitted to the emergency departments has decreased significantly over the last months, especially after lockdown policies have been implemented [ 3 , 4 ]. As a result, many of these patients may not receive optimal care, which is very important for time-dependent conditions with high morbidity and mortality such as ST-segment elevation myocardial infarction (STEMI).…”

Section: Introductionmentioning

confidence: 99%

ST-segment elevation in patients with COVID-19: a systematic review

Diaz‐Arocutipa

Torres-Valencia

Saucedo-Chinchay

et al. 2021

J Thromb Thrombolysis

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Coronavirus disease 2019 (COVID-19) can cause a wide range of cardiovascular diseases, including ST-segment elevation myocardial infarction (STEMI) and STEMI-mimickers (such as myocarditis, Takotsubo cardiomyopathy, among others). We performed a systematic review to summarize the clinical features, management, and outcomes of patients with COVID-19 who had ST-segment elevation. We searched electronic databases from inception to September 30, 2020 for studies that reported clinical data about COVID-19 patients with ST-segment elevation. Differences between patients with and without obstructive coronary artery disease (CAD) on coronary angiography were evaluated. Forty-two studies (35 case reports and seven case series) involving 161 patients were included. The mean age was 62.7 ± 13.6 years and 75% were men. The most frequent symptom was chest pain (78%). Eighty-three percent of patients had obstructive CAD. Patients with non-obstructive CAD had more diffuse ST-segment elevation (13% versus 1%, p = 0.03) and diffuse left ventricular wall-motion abnormality (23% versus 3%, p = 0.02) compared to obstructive CAD. In patients with previous coronary stent (n = 17), the 76% presented with stent thrombosis. In the majority of cases, the main reperfusion strategy was primary percutaneous coronary intervention instead of fibrinolysis. The in-hospital mortality was 30% without difference between patients with (30%) or without (31%) obstructive CAD. Our data suggest that a relatively high proportion of COVID-19 patients with ST-segment elevation had non-obstructive CAD. The prognosis was poor across groups. However, our findings are based on case reports and case series that should be confirmed in future studies. Supplementary Information The online version contains supplementary material available at 10.1007/s11239-021-02411-9.

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“…Similarly, in the area of Paris the proportion of patients admitted alive after OHCA was decreased during the pandemic ( Marijon et al, 2020 ). Interestingly, Mountantonakis et al also reported a 4.97-fold increased incidence in OHCA and almost doubling of deaths at home after OHCA (71% vs 38%) in New York Metropolitan Area, in comparison with the corresponding period in 2019 ( Mountantonakis et al, 2020 ). The lower incidence of shockable rhythm both in in-hospital CA (IHCA) ( Sheth et al, 2020 ) and OHCA ( Lai et al, 2020 ), longer times of arrival of emergency medical care, less frequent CPR offered by bystanders compared to the previous years may partially explain these findings ( Baldi et al, 2020a , 2020b ; Marijon et al, 2020 ; Waalewijn et al, 2002 ).…”

Section: Epidemiologymentioning

confidence: 97%

“…Despite a reduction of patients presenting with acute myocardial infarction during the pandemic ( Mountantonakis et al, 2020 ; Stefanini et al, 2020 ; Garcia et al, 2020 ), severe Covid-19 infection may be associated with higher incidence of acute coronary syndromes (ACS) which is a major condition leading to CA. ( Chen et al, 2018 ; Stefanini et al, 2020 ; Bilaloglu et al, 2020 ) Because ACS may be the first clinical presentation of Covid-19 infection ( Stefanini et al, 2020 ), further research should clarify the prevalence of OHCA due to ACS as an early complication of Covid-19 infection.…”

Section: Mechanisms Linking Cardiac Arrest With Covid-19 Diseasementioning

confidence: 99%

Cardiac arrest and drug-related cardiac toxicity in the Covid-19 era. Epidemiology, pathophysiology and management

Mavraganis

Aivalioti

Chatzidou

et al. 2020

Food and Chemical Toxicology

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SARS-CoV-2 (Covid-19) infection has recently become a worldwide challenge with dramatic global economic and health consequences. As the pandemic is still spreading, new data concerning Covid-19 complications and related mechanisms become increasingly available. Accumulating data suggest that the incidence of cardiac arrest and its outcome are adversely affected during the Covid-19 period. This may be further exacerbated by drug-related cardiac toxicity of Covid-19 treatment regimens. Elucidating the underlying mechanisms that lead to Covid-19 associated cardiac arrest is imperative, not only in order to improve its effective management but also to maximize preventive measures. Herein we discuss available epidemiological data on cardiac arrest during the Covid-19 pandemic as well as possible associated causes and pathophysiological mechanisms and highlight gaps in evidence warranting further investigation. The risk of transmission during cardiopulmonary resuscitation (CPR) is also discussed in this review. Finally, we summarize currently recommended guidelines on CPR for Covid-19 patients including CPR in patients with cardiac arrest due to suspected drug-related cardiac toxicity in an effort to underscore the most important common points and discuss discrepancies proposed by established international societies.

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Out-of-Hospital Cardiac Arrest and Acute Coronary Syndrome Hospitalizations During the COVID-19 Surge

Cited by 44 publications

References 3 publications

Clinical and electrocardiographic characteristics at admission of COVID-19/SARS-CoV2 pneumonia infection

Clinical and electrocardiographic characteristics at admission of COVID-19/SARS-CoV2 pneumonia infection

ST-segment elevation in patients with COVID-19: a systematic review

Cardiac arrest and drug-related cardiac toxicity in the Covid-19 era. Epidemiology, pathophysiology and management

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