Organizational and clinical aspects of acute coronary syndrome combined with a new coronavirus infection (SARS-COV-2)

I. I. Serebrennikov, P. Kopylov, R. Komarov, M. Mukanova, A. Ismailbaev, F. S. Gafurov
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Abstract

Objective. Assessment of organizational and clinical aspects of acute coronary syndrome combined with a new coronavirus infection (SARS- CoV-2).Materials and methods. This is a retrospective study where 60 patients were divided into the following groups: group 1 patients with acute coronary syndrome (ACS) and a new coronavirus infection hospitalized in the «red» zone after infection was detected at the prehospital stage (n=29); group 2 - uninfected coronavirus infection patients with ACS (n=31). The primary points were mortality in the hospital and the average time (up to 2 months) after ACS, the incidence of acute heart failure, the incidence of ACS with ST segment elevation, the frequency of acute coronary artery occlusions.Results. The analysis of hospital mortality revealed its higher level in the ACS group and COVID-19 (group 1) (p=0.009). Mortality within 2 months was also higher in group 1 (p=0.017). The groups did not differ in the number of patients with ACS and ST segment elevation and acute coronary artery occlusions. Analysis of the incidence of OSN at admission revealed a statistically significant difference (p=0.05) in group 2 (n=12, 38.7%) compared with group 1 (n=5, 17.2%).Conclusions. Patients with ACS and COVID-19 are characterized by a higher initial severity, a tendency to develop ACS with ST segment elevation, high rates of hospital and 60-day mortality. Separating the flows of infected and uninfected patients makes it possible to improve the epidemiological situation in non-infectious hospitals, however, it leads to a delay in hospitalization of patients with ACS and COVID-19, which potentially increases the risk of fatal complications in this cohort.
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急性冠状动脉综合征合并新型冠状病毒感染(SARS-COV-2)的组织和临床研究
目标。急性冠脉综合征合并新型冠状病毒感染(SARS- CoV-2)的组织和临床方面的评估材料和方法。这是一项回顾性研究,60例患者被分为以下组:1组急性冠状动脉综合征(ACS)患者和院前阶段发现感染后住院的“红色”区新型冠状病毒感染患者(n=29);2组:未感染冠状病毒的ACS患者(31例)。主要观察住院死亡率及ACS发生的平均时间(最长2个月)、急性心力衰竭发生率、ACS合并ST段抬高发生率、急性冠状动脉闭塞发生率。住院死亡率分析显示,ACS组和COVID-19(1组)的住院死亡率较高(p=0.009)。1组患者2个月内死亡率也高于对照组(p=0.017)。两组在ACS、ST段抬高和急性冠状动脉闭塞的患者数量上没有差异。入院时OSN的发生率分析显示,2组(n=12, 38.7%)与1组(n=5, 17.2%)比较,差异有统计学意义(p=0.05)。ACS合并COVID-19患者的特点是初始严重程度较高,易发展为伴有ST段抬高的ACS,住院率高,60天死亡率高。将感染和未感染患者分开,可以改善非感染医院的流行病学情况,但会导致ACS和COVID-19患者住院时间延迟,这可能会增加该队列中致命性并发症的风险。
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