Covid-19 and Acute Coronary Syndrome (ACS): A Review of its Pathophysiology, Prevalence and Management during the Pandemic

Coronavirus disease-2019 (COVID-19) is a global medical burden. Severe acute respiratory coronavirus 2 (SARS-CoV-2) can cause significant mortality and morbidity by implicating pulmonary infection and respiratory failure. It has a corresponding inflammatory impact on various organ systems as well. A considerable drop in the number of patients attending the emergency department, undergoing elective procedures and surgeries has been reported in several studies from different countries affected by the pandemic. In the setting of the ongoing pandemic, cardiologic emergency of the acute coronary syndrome (ACS) has raised several critical clinical issues regarding its incidence, lower hospital admission rates, management, and therapeutic uncertainties. It is primarily due to the risk of association between respiratory infections and Covid-19 induced myocardial injury, hesitation by the patients to visit the high-risk hospital environment, and missed diagnoses. Consequently, short and long-term ACS complications are expected in the near future. Our study sought to investigate the correlation between diagnosis and management of ACS and pathophysiological links with SARS-CoV-2 infection, the decline in ACS cases across the world in the time of the pandemic, with a focus on the prediction of upcoming complications and also modifying the social and clinical approach towards ACS among the health care personnel to prevent the serious complications in acute cardiology care.