Considerations for Management of Acute Coronary Syndromes During the SARS-CoV-2 (COVID-19) Pandemic

Accumulating evidence suggests that influenza and influenza-like illnesses can act as a trigger for acute myocardial infarction. Despite these unprecedented times providers should not overlook acute coronary syndrome (ACS) guidelines, but may choose to modify the recommended approach in situations with confirmed or suspected COVID-19 disease. In this document, we suggest recommendations as to how to triage patients diagnosed with ACSs and provide with algorithms of how to manage the patients and decide the appropriate treatment options in the era of COVID-19 pandemic. We also address the inpatient logistics and discharge to follow-up considerations for the function of already established ACS network during the pandemic. Accumulating evidence suggests that influenza and influenza-like illnesses can act as a trigger for acute myocardial infarction.1, 2, 3, 4 In this document, we suggest recommendations as to how to triage patients diagnosed with acute coronary syndromes (ACSs) and provide with algorithms of how to manage the patients and decide the appropriate treatment options in the era of COVID-19 pandemic. We also address the inpatient logistics and discharge to follow-up considerations for the function of already established ACS network during the pandemic. Definitions To minimize the misunderstanding in COVID-19 case definitions between healthcare workers we recommend adopting the World Health Organization guidelines on case definitions as following:• Confirmed case (COVID-19 +) – a patient with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms. • Suspected case (COVID-19 +/-) – a patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath), OR a patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath), AND ...[...].