IMPACT OF THE COVID-19 PANDEMIC ON CLINICAL OUTCOMES OF ACS: RETROSPECTIVE ANALYSIS FROM AN ITALIAN CARDIOLOGY NETWORK

Several authors worldwide have reported a significant decrease in hospital admissions for acute coronary syndromes (ACSs) during the most recent months of the COVID-19 outbreak. The causes of this pattern and its impact on patients and hospital management have been studied. We conducted a monocentric, observational, retrospective study aimed at evaluating consecutive patients discharged from our local network with a diagnosis of ACS from the 20th of February 2020 to the 30th of April 2020. 201 patients with ACS were included in the analysis. The number of patients with NSTE (Non-ST elevation)-ACS dropped from 84 (65%) in 2019 to 21 (44.4%) in 2020 (62% reduction, p < 0.01), while more patients with a diagnosis of STEMI were admitted in 2020. 38 composite events were observed in 2020, while only 34 patients were free from events. Conversely, in the 2019 ACS group, 37 events were recorded, while 92 patients did not develop any events (RR 1.82; 1.29- 2.6 95% CI; p< 0.01). Delay in diagnosis and treatment of patients with ACS has a significant impact on public health costs and sustainability of care, since it is associated with a significant increase in short-term complications and deaths. Public health messaging and proper healthcare services organization should play a crucial role in adjusting the system to the new needs of public health.