An In-hospital Pathway for Acute Coronary Syndrome Patients During the COVID-19 Outbreak: Initial Experience under Real-world Suboptimal Conditions

Cosentino, Nicola; Assanelli, Emilio; Merlino, Luca; Mazza, Mario; Bartorelli, Antonio L.; Marenzi, Giancarlo

Unstructured Abstract In Lombardy (Italy), due to the COVID-19 outbreak, there is an urgent need to manage cardiovascular emergencies, including acute coronary syndrome (ACS), with appropriate standards of care and dedicated preventive measures and pathways against the risk of SARS-CoV-2 infection. For this reason, the Government of Lombardy decided to centralize the treatment of ACS patients in a limited number of centers, including our University Cardiology Institute that in the last four weeks became a cardiovascular emergency referral center in a regional hub and spoke system. Thus, we rapidly developed a customized pathway in order to allocate patients to the appropriate hospital ward, and treat them according to the ACS severity and the risk of suspected SARS-CoV-2 infection. We present here a protocol dedicated to ACS patients adopted in our center since March 13th 2020 and our initial experience in the management of ACS patients during the first four weeks of its use. Certainly, the protocol has room for further improvement as everyone's experience grows, but we hope that it could be a starting point, adaptable to different realities and local resources.