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Inicio Medicina Clínica (English Edition) SARS-CoV-2 infection: A predisposing factor for acute coronary syndrome
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DOI: 10.1016/j.medcle.2021.01.012
SARS-CoV-2 infection: A predisposing factor for acute coronary syndrome
Infección por SARS-CoV-2: un factor predisponente para síndrome coronario agudo
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Cristina de Cortina Camareroa,
Corresponding author
ccortinac@gmail.com

Corresponding author.
, Eloy Gómez Mariscala, Victoria Espejo Baresb, Alberto Núñez Garciab, Roberto Muñoz Aguileraa, Javier Botas Rodriguezb
a Servicio de Cardiología, Hospital Universitario Infanta Leonor, Madrid, Spain
b Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
Received 08 November 2020. Accepted 19 January 2021
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Table 1. Baseline and progression characteristics of the ACS COVID and ACS 2019 groups.
Table 2. Characteristics of COVID-19 in ACS-COVID patients.
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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.

Keywords:
Acute coronary syndrome
Coronavirus
Myocardial ischemia
Thrombosis
Resumen
Introducción

Se han reportado series de casos de SCA en pacientes COVID Nuestro objetivo fue describir su incidencia, características, y pronóstico a 3 meses. Para contextualizar esta incidencia se comparó con la incidencia de SCA intrahospitalarios durante el mismo periodo del 2019.

Métodos

Estudio observacional de cohortes multicéntrico, de 3.108 pacientes COVID-19 ingresados en dos hospitales madrileños, entre el 1 de marzo y 15 de mayo de 2020. Diez pacientes sufrieron un SCA durante la fase hospitalaria realizándose un seguimiento clínico de 3 meses. Se estudiaron asimismo los pacientes con SCA intrahospitalarios durante el mismo periodo del 2019.

Resultados

La incidencia de SCA en COVID-19 fue 3,31‰, significativamente superior a la del periodo 2019, de 1,01‰ (p=0,013). Los pacientes COVID-19 con SCA, tenían una infección grave, mayoritariamente SCACEST (80%) y enfermedad multivaso (67%). La tasa de mortalidad (30%) y reingresos hospitalarios a 3 meses (20%) fueron muy elevadas.

Conclusiones

El SCA es una complicación más frecuente de lo habitual en COVID-19 grave pero poco común y con mal pronóstico inmediato y a 3 meses.

Palabras clave:
Síndrome coronario agudo
Coronavirus
Isquemia miocárdica
Trombosis

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