• J Emerg Med · Apr 2022

    Incidence, Clinical Characteristics, Risk Factors and Outcomes of Acute Coronary Syndrome in Patients With COVID-19: Results of the UMC-19-S1010.

    • Aitor Alquézar-Arbé, Òscar Miró, CastilloJuan González DelJGDEmergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain., Sònia Jiménez, Pere Llorens, Alfonso Martín, Francisco Javier Martín-Sánchez, Eric Jorge García-Lamberechts, Pascual Piñera, Javier Jacob, Juan Miguel Marín Porrino, Blas Jiménez, Rigoberto Del Río, GarcíaCarles PérezCPEmergency Department, Hospital Lluis Alcanys de Xativa, Valencia, Spain., José Vicente Brasó Aznar, María Carmen Ponce, FernándezElena DíazEDEmergency Department, Hospital Universitario Sant Joan, Alicante, Spain., Josep Tost, MojarroEnrique MartínEMEmergency Department, Hospital de Sant Pau i Santa Tecla, Tarragona, Spain., GarcíaArturo HuertaAHEmergency Department, Clinica Sagrada Familia, Barcelona, Spain., QuirósAlejandro MartínAMEmergency Department, Hospital Universitario La Paz, Madrid, Spain., José Noceda, María José Cano Cano, AlmelaAmparo Fernández de SimónAFSEmergency Department, Hospital Virgen del Rocio, Sevilla, Spain., María José Fortuny Bayarri, TejeraMatilde GonzálezMGEmergency Department, Hospital General Universitario de Elche, Alicante, Spain., Alberto Domínguez Rodriguez, Guillermo Burillo-Putze, and Spanish Investigators on Emergency Situations TeAm (SIESTA) Network.
    • Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
    • J Emerg Med. 2022 Apr 1; 62 (4): 443454443-454.

    BackgroundThere is a lack of knowledge about the real incidence of acute coronary syndrome (ACS) in patients with COVID-19, their clinical characteristics, and their prognoses.ObjectiveWe investigated the incidence, clinical characteristics, risk factors, and outcomes of ACS in patients with COVID-19 in the emergency department.MethodsWe retrospectively reviewed all COVID-19 patients diagnosed with ACS in 62 Spanish emergency departments between March and April 2020 (the first wave of COVID-19). We formed 2 control groups: COVID-19 patients without ACS (control A) and non-COVID-19 patients with ACS (control B). Unadjusted comparisons between cases and control subjects were performed regarding 58 characteristics and outcomes.ResultsWe identified 110 patients with ACS in 74,814 patients with COVID-19 attending the ED (1.48% [95% confidence interval {CI} 1.21-1.78%]). This incidence was lower than that observed in non-COVID-19 patients (3.64% [95% CI 3.54-3.74%]; odds ratio [OR] 0.40 [95% CI 0.33-0.49]). The clinical characteristics of patients with COVID-19 associated with a higher risk of presenting ACS were: previous coronary artery disease, age ≥60 years, hypertension, chest pain, raised troponin, and hypoxemia. The need for hospitalization and admission to intensive care and in-hospital mortality were higher in cases than in control group A (adjusted OR [aOR] 6.36 [95% CI 1.84-22.1], aOR 4.63 [95% CI 1.88-11.4], and aOR 2.46 [95% CI 1.15-5.25]). When comparing cases with control group B, the aOR of admission to intensive care was 0.41 (95% CI 0.21-0.80), while the aOR for in-hospital mortality was 5.94 (95% CI 2.84-12.4).ConclusionsThe incidence of ACS in patients with COVID-19 attending the emergency department was low, around 1.48%, but could be increased in some circumstances. Patients with COVID-19 with ACS had a worse prognosis than control subjects with higher in-hospital mortality.Copyright © 2021 Elsevier Ltd. All rights reserved.

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