%0 Journal Article
%A Alquézar-Arbé, Aitor
%A Miró, Òscar
%A Castillo, Juan González Del
%A Jiménez, Sònia
%A Llorens, Pere
%A Martín, Alfonso
%A Martín-Sánchez, Francisco Javier
%A García-Lamberechts, Eric Jorge
%A Piñera, Pascual
%A Jacob, Javier
%A Porrino, Juan Miguel Marín
%A Jiménez, Blas
%A Río, Rigoberto Del
%A García, Carles Pérez
%A Aznar, José Vicente Brasó
%A Ponce, María Carmen
%A Fernández, Elena Díaz
%A Tost, Josep
%A Mojarro, Enrique Martín
%A García, Arturo Huerta
%A Quirós, Alejandro Martín
%A Noceda, José
%A Cano, María José Cano
%A Almela, Amparo Fernández de Simón
%A Bayarri, María José Fortuny
%A Tejera, Matilde González
%A Rodriguez, Alberto Domínguez
%A Burillo-Putze, Guillermo
%A Spanish Investigators on Emergency Situations TeAm (SIESTA) Network
%T Incidence, Clinical Characteristics, Risk Factors and Outcomes of Acute Coronary Syndrome in Patients With COVID-19: Results of the UMC-19-S1010.
%D 2021
%U http://hdl.handle.net/10668/22302
%X 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. We investigated the incidence, clinical characteristics, risk factors, and outcomes of ACS in patients with COVID-19 in the emergency department. 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. 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-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). 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.
%K COVID-19
%K SARS-Cov-2
%K acute coronary syndrome
%K clinical characteristics
%K incidence
%K outcome
%K risk factors
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