• Alaide Chieffo, Giulio G Stefanini, Susanna Price, Emanuele Barbato, Giuseppe Tarantini, Nicole Karam, Raul Moreno, Gill Louise Buchanan, Martine Gilard, Sigrun Halvorsen, Kurt Huber, Stefan James, Franz-Josef Neumann, Helge Möllmann, Marco Roffi, Guido Tavazzi, Josepa Mauri Ferré, Stephan Windecker, Dariusz Dudek, and Andreas Baumbach.
• Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy.
• Eur. Heart J. 2020 May 14; 41 (19): 1839-1851.

AbstractThe coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.This article has been co-published with permission in the European Heart Journal and EuroIntervention. All rights reserved. © 2020 European Society of Cardiology. These articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.

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