Abstract 17143: Acute Coronary Syndromes Associated With SARS-CoV-2 Infection Admissions in a Medium Size Community Hospital
Background: The presence of cardiovascular complications were reported in small studies of critical care patients admitted with SARS-CoV-2infection There is a dearth of data regarding presence of acute coronary syndromes (ACS) in patients admitted with symptomatic SARS-CoV-2 infection, the cause of the myocardial injury and particularities of management. Objectives: The aim of the study is to describe the presence and type ACS in patients admitted with symptomatic SARS-CoV-2 infection. Secondary outcomes were contributing factors, presenting symptoms and medical management. Methods: A descriptive, retrospective study of patients with a positive COVID-19 test and symptomatic infection admitted from 10 March 2020 to 10 April 2020 in our hospital. Results: There were a total of 127 patients admitted with symptomatic SARS-CoV-2 infection. The most common ACS was Type II Myocardial Infarction (MI). 16 patients were diagnosed with type II MI, 3 patients with Non ST elevation myocardial infarction (NSTEMI) and no patient was diagnosed with unstable angina and ST elevation myocardial infarction (STEMI). The most common cause of Type II MI was hypoxia followed by congestive heart failure and new onset atrial fibrillation. One patient has chest pain as presenting symptom. Except for Aspirin loading and use of beta blocker no other antischemic, statin or ACE/ARB medication was used for management of type II MI. All patients with Type II MI were managed by primary care teams. 3 patients developed NSTEMI and were managed by primary care teams with Cardiology consults. Anti-coagulation was considered for all patients. All patients received Aspirin loading, high intensity statin and beta blockers. Conclusions: Majority of patients with ACS had symptoms related to SARS-CoV-2 infection and chest pain was absent in 95% of cases. The most common ACS was type II MI- myocardial ischemia in context of hypoxia and the treatment was focused in treating the underlying cause rather than initiation of classical guideline directed therapy or invasive management. There were no cases of unstable angina and STEMI, results consistent with previous studies underlying the low incidence of STEMI cases during this pandemic.