Incidence, Clinical Characteristics, Risk Factors and Outcomes of Acute Coronary Syndrome in Patients With COVID-19: Results of the UMC-19-S10(10)
Por:
Alquézar-Arbé A., Miró Ò., Castillo J.G.D., Jiménez S., Llorens P., Martín A., Martín-Sánchez F.J., García-Lamberechts E.J., Piñera P., Jacob J., Porrino J.M.M., Jiménez B., Río R.D., García C.P., Aznar J.V.B., Ponce M.C., Fernández E.D., Tost J., Mojarro E.M., García A.H., Quirós A.M., Noceda J., Cano M.J.C., Almela A.F.D.S., Bayarri M.J.F., Tejera M.G., Rodriguez A.D., Burillo-Putze G.
Publicada:
1 abr 2022
Ahead of Print:
1 ene 2022
Resumen:
Background: There 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. Objective: We investigated the incidence, clinical characteristics, risk factors, and outcomes of ACS in patients with COVID-19 in the emergency department. Methods: We 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. Results: We 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-COVID19 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 1.8422.1], 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 0.210.80), while the aOR for in-hospital mortality was 5.94 (95% CI 2.84-12.4). Conclusions: The 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. (C) 2021 Elsevier Inc. All rights reserved.
Filiaciones:
Alquézar-Arbé A.:
Emergency Department, Hospital de la Santa Creu i Sant PauBarcelona, Spain
Miró Ò.:
Emergency Department, Hospital Clínic, IDIBAPS, University of BarcelonaBarcelona, Spain
Castillo J.G.D.:
Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
Jiménez S.:
Emergency Department, Hospital Clínic, IDIBAPS, University of BarcelonaBarcelona, Spain
Llorens P.:
Emergency Department, Hospital General de Alicante, University Miguel Hernández, Alicante, Spain
Martín A.:
Emergency Department, Hospital Universitario de Móstoles, Madrid, Spain
Martín-Sánchez F.J.:
Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
García-Lamberechts E.J.:
Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
Piñera P.:
Emergency Department, Hospital Reina SofíaMurcia, Spain
Jacob J.:
Emergency Department, Hospital Universitari de BellvitgeBarcelona, Spain
Porrino J.M.M.:
Emergency Department, Hospital Marina Baixa de Villajoyosa de Alicante, Alicante, Spain
Jiménez B.:
Emergency Department, Hospital Universitario Vinalopó de Elche, Alicante, Spain
Río R.D.:
Emergency Department, Hospital Universitario de Torrevieja, Alicante, Spain
García C.P.:
Emergency Department, Hospital Lluis Alcanys de Xativa, Valencia, Spain
Aznar J.V.B.:
Emergency Department, Hospital Universitario de La Ribera, Valencia, Spain
Ponce M.C.:
Emergency Department, Hospital de la Vega Baja Orihuela, Alicante, Spain
Fernández E.D.:
Emergency Department, Hospital Universitario Sant Joan, Alicante, Spain
Tost J.:
Emergency Department, Hospital de TerrassaBarcelona, Spain
Mojarro E.M.:
Emergency Department, Hospital de Sant Pau i Santa TeclaTarragona, Spain
García A.H.:
Emergency Department, Clinica Sagrada FamiliaBarcelona, Spain
Quirós A.M.:
Emergency Department, Hospital Universitario La Paz, Madrid, Spain
Noceda J.:
Emergency Department, Hospital Clínico Universitario de Valencia, Spain
Cano M.J.C.:
Emergency Department, Hospital Arnau de Vilanova de Valencia, Valencia, Spain
Almela A.F.D.S.:
Emergency Department, Hospital Virgen del RocioSevilla, Spain
Bayarri M.J.F.:
Emergency Department, Hospital Francesc de Borja de Gandia, Valencia, Spain
Tejera M.G.:
Emergency Department, Hospital General Universitario de Elche, Alicante, Spain
Rodriguez A.D.:
Cardiology Department, Hospital Universitario de Canarias, Tenerife, Spain
Burillo-Putze G.:
Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain
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