Impatto della pandemia COVID-19 sui ricoveri per sindrome coronarica acuta: revisione della letteratura ed esperienza monocentrica
Sabine Vecchio, Luca Fileti, Alessandra Reggi, Carlotta Moschini, Stefano Lorenzetti, Andrea Rubboli
Abstract
During the early phase of the lockdown following the COVID-19 pandemic, an alarm on the impact on cardiology admissions for cardiac causes, particularly in the field of acute coronary syndromes (ACS), has emerged. In order to evaluate this trend, we analyzed the literature data published since the beginning of the COVID-19 pandemic to date, in addition to our intensive cardiac care unit (ICCU) experience. This analysis showed (i) a reduction of the overall ICCU admissions up to 50%; (ii) a 40-50% reduction of ACS admissions, greater for non-ST-elevation myocardial infarction (NSTEMI) than for ST-elevation myocardial infarction (STEMI); (iii) a reduction greater than 50% of coronary angiography and percutaneous coronary angioplasty; (iv) a higher time delay of STEMI; and (v) a higher number of ICCU admissions for non-primarily cardiac problems. In conclusion, the lockdown imposed due to the spread of COVID-19 infection has led to a change in the number and type of cardiology admissions. It seems therefore necessary that patients, especially for time-dependent diseases such as ACS, continue to refer to hospital care; that contemporary standard of care for acute cardiac disease should be guaranteed, and that intensivist cardiologists acquire specific skills for the treatment of patients with clinical conditions normally treated by other specialists.