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Acute Coronary Syndromes and Covid-19: Exploring the Uncertainties

1
Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy
2
University of Milan, 20122 Milan, Italy
3
Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
4
Mediterranea Cardiocentro, 80122 Naples, Italy
5
Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, 10126 Turin, Italy
6
Cardiovascular Diseases Unit, Department of Medical Sciences, AOUS Le Scotte Hospital, University of Siena, 53100 Siena, Italy
7
Department of Infectious Diseases, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy
8
Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
9
Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University of Rome, 00161 Rome, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this manuscript.
J. Clin. Med. 2020, 9(6), 1683; https://doi.org/10.3390/jcm9061683
Received: 6 May 2020 / Revised: 20 May 2020 / Accepted: 25 May 2020 / Published: 2 June 2020
(This article belongs to the Section Cardiology)
Since an association between myocardial infarction (MI) and respiratory infections has been described for influenza viruses and other respiratory viral agents, understanding possible physiopathological links between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and acute coronary syndromes (ACS) is of the greatest importance. The initial data suggest an underestimation of ACS cases all over the world, but acute MI still represents a major cause of morbidity and mortality worldwide and should not be overshadowed during the coronavirus disease (Covid-19) pandemic. No common consensus regarding the most adequate healthcare management policy for ACS is currently available. Indeed, important differences have been reported between the measures employed to treat ACS in China during the first disease outbreak and what currently represents clinical practice across Europe and the USA. This review aims to discuss the pathophysiological links between MI, respiratory infections, and Covid-19; epidemiological data related to ACS at the time of the Covid-19 pandemic; and learnings that have emerged so far from several catheterization labs and coronary care units all over the world, in order to shed some light on the current strategies for optimal management of ACS patients with confirmed or suspected SARS-CoV-2 infection. View Full-Text
Keywords: acute coronary syndromes; myocardial infarction; STEMI; Covid-19; infectious disease; respiratory infections; pathophysiology; percutaneous coronary intervention; thrombolysis; drug treatment acute coronary syndromes; myocardial infarction; STEMI; Covid-19; infectious disease; respiratory infections; pathophysiology; percutaneous coronary intervention; thrombolysis; drug treatment
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MDPI and ACS Style

Schiavone, M.; Gobbi, C.; Biondi-Zoccai, G.; D’Ascenzo, F.; Palazzuoli, A.; Gasperetti, A.; Mitacchione, G.; Viecca, M.; Galli, M.; Fedele, F.; Mancone, M.; Forleo, G.B. Acute Coronary Syndromes and Covid-19: Exploring the Uncertainties. J. Clin. Med. 2020, 9, 1683.

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