SARS-CoV-2 infection: A predisposing factor for acute coronary syndrome

Abstract

Introduction Several case series of ACS have been reported in COVID 19 patients. We aim to study its incidence, characteristics, and three-month prognosis. To put this incidence in perspective we compared it with the incidence of in-hospital ACS during the same period of 2019. Methods Observational multicenter cohort study of 3.108 COVID-19 patients admitted to two hospitals in Madrid between March 1st and May 15th, 2020. Ten patients suffered an ACS while being hospitalized for COVID 19 and were followed for three months. The ACS incidence in hospitalized patients during the same period of 2019 was also studied. Results The incidence of ACS in COVID-19 patients was 3.31‰, significantly higher than in the 2019 period, 1.01‰ (p = 0.013). COVID-19 patients that suffered and ACS frequently had a severe infection, presented with STEMI (80%), and had multivessel disease (67%). Mortality rate (30%) and hospital readmissions at three months (20%) were very high. Conclusions Severe COVID-19 patients develop ACS more frequently than expected. Although the overall incidence was low, it carried a poor immediate and three-month prognosis.

Symptomatology, prognosis and clinical findings of STEMI as a ramification of COVID-19: A systematic review and proportion meta-analysis

“…[ 36 ]; [ 37 ]; [ 38 ]; [ 39 ]; [ 40 ]; [ 41 ]; [ 42 ]; [ 43 ]; [ 44 ]; [ 45 ]; [ 46 ]; [ 47 ]; [ 48 ].…”

Complicaciones Cardiovasculares asociadas a infección por SARS-CoV-2. Revisión Sistemática

“…La infección por dicho virus podría actuar como un factor desencadenante para empeorar la afección y provocar la muerte (17,51) . Los mecanismos subyacentes al SCA inducido por COVID-19 pueden incluir rotura de placa, espasmo coronario o microtrombos, debido a inflamación sistémica y tormenta de citocinas (52) .…”

Acute Coronary Syndrome in the COVID-19 Era—Differences and Dilemmas Compared to the Pre-COVID-19 Era

“…Studies have shown that 7–36% of patients with COVID-19 infection develop myocardial injury [ 15 , 16 , 17 ]. The results of an observational multicenter cohort study (performed on 3108 COVID-19 patients) also showed an increase in the incidence of ACS in the COVID-19 era, compared to before the COVID-19 era (3.31% in 2020 and 1.01% in 2019) ( p < 0.013) [ 18 ]. Katsoularis I. et al suggested that the results of their study (86,742 patients with COVID-19 in the self-controlled case series and 348 481 matched control individuals in the matched cohort study) indicate that COVID-19 is a risk factor for AMI and ischemic stroke.…”

“…COVID-19 patients with ACS are more likely to have a more severe form of infection, and they have a mortality rate of up to 30%. The rehospitalization rate is very high (up to 20%) within the three months of follow-up [ 18 ]. The results of an observational cohort study (12,958 AMI patients) (519 COVID-19 positive) also showed that patients with COVID-19 and ACS had higher in-hospital (OR: 3.27; 95% (CI): 2.41–4.42) and thirty-day (OR: 6.53, 95% CI: 5.1–8.36) mortality, compared to patients with ACS without a diagnosis of COVID-19 [ 101 ].…”