TY - JOUR
T1 - Impact of COVID-19 pandemic and infection on in hospital survival for patients presenting with acute coronary syndromes
T2 - A multicenter registry
AU - D'Ascenzo, Fabrizio
AU - De Filippo, Ovidio
AU - Borin, Andrea
AU - Barbieri, Lucia
AU - Adamo, Marianna
AU - Morici, Nuccia
AU - Truffa Giachet, Alessandra
AU - Iannaccone, Mario
AU - Crimi, Gabriele
AU - Gaido, Luca
AU - Bocchino, Pier Paolo
AU - Pivato, Carlo Andrea
AU - Campo, Gianluca
AU - Trabattoni, Daniela
AU - Chieffo, Alaide
AU - Gaibazzi, Nicola
AU - Angelini, Filippo
AU - Rubboli, Andrea
AU - Rognoni, Andrea
AU - Musumeci, Giuseppe
AU - Ugo, Fabrizio
AU - Gili, Sebastiano
AU - Cortese, Bernardo
AU - Vadalà, Paolo
AU - Dusi, Veronica
AU - Gallone, Guglielmo
AU - Patti, Giuseppe
AU - de Ferrari, Gaetano Maria
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021
Y1 - 2021
N2 - Introduction: The impact of Covid-19 on the survival of patients presenting with acute coronary syndrome (ACS) remains to be defined. Methods: Consecutive patients presenting with ACS at 18 Centers in Northern-Italy during the Covid-19 outbreak were included. In-hospital all-cause death was the primary outcome. In-hospital cardiovascular death along with mechanical and electrical complications were the secondary ones. A case period (February 20, 2020-May 3, 2020) was compared vs. same-year (January 1–February 19, 2020) and previous-year control periods (February 20–May 3, 2019). ACS patients with Covid-19 were further compared with those without. Results: Among 779 ACS patients admitted during the case period, 67 (8.6%) tested positive for Covid-19. In-hospital all-cause mortality was significantly higher during the case period compared to the control periods (6.4% vs. 3.5% vs. 4.4% respectively; p 0.026), but similar after excluding patients with COVID-19 (4.5% vs. 3.5% vs. 4.4%; p 0.73). Cardiovascular mortality was similar between the study groups. After multivariable adjustment, admission for ACS during the COVID-19 outbreak had no impact on in-hospital mortality. In the case period, patients with concomitant ACS and Covid-19 experienced significantly higher in-hospital mortality (25% vs. 5%, p < 0.001) compared to patients without. Moreover, higher rates of cardiovascular death, cardiogenic shock and sustained ventricular tachycardia were found in Covid-19 patients. Conclusion: ACS patients presenting during the Covid-19 pandemic experienced increased all-cause mortality, driven by Covid-19 positive status due to higher rates of cardiogenic shock and sustained ventricular tachycardia. No differences in cardiovascular mortality compared to non-pandemic scenarios were reported.
AB - Introduction: The impact of Covid-19 on the survival of patients presenting with acute coronary syndrome (ACS) remains to be defined. Methods: Consecutive patients presenting with ACS at 18 Centers in Northern-Italy during the Covid-19 outbreak were included. In-hospital all-cause death was the primary outcome. In-hospital cardiovascular death along with mechanical and electrical complications were the secondary ones. A case period (February 20, 2020-May 3, 2020) was compared vs. same-year (January 1–February 19, 2020) and previous-year control periods (February 20–May 3, 2019). ACS patients with Covid-19 were further compared with those without. Results: Among 779 ACS patients admitted during the case period, 67 (8.6%) tested positive for Covid-19. In-hospital all-cause mortality was significantly higher during the case period compared to the control periods (6.4% vs. 3.5% vs. 4.4% respectively; p 0.026), but similar after excluding patients with COVID-19 (4.5% vs. 3.5% vs. 4.4%; p 0.73). Cardiovascular mortality was similar between the study groups. After multivariable adjustment, admission for ACS during the COVID-19 outbreak had no impact on in-hospital mortality. In the case period, patients with concomitant ACS and Covid-19 experienced significantly higher in-hospital mortality (25% vs. 5%, p < 0.001) compared to patients without. Moreover, higher rates of cardiovascular death, cardiogenic shock and sustained ventricular tachycardia were found in Covid-19 patients. Conclusion: ACS patients presenting during the Covid-19 pandemic experienced increased all-cause mortality, driven by Covid-19 positive status due to higher rates of cardiogenic shock and sustained ventricular tachycardia. No differences in cardiovascular mortality compared to non-pandemic scenarios were reported.
KW - Acute coronary syndromes
KW - Cardiovascular outcomes
KW - COVID-19
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U2 - 10.1016/j.ijcard.2021.03.063
DO - 10.1016/j.ijcard.2021.03.063
M3 - Article
AN - SCOPUS:85103720469
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -