How to keep the cath-lab of a COVID-free hub center during the pandemic in a hub and spoke cardiology network: a single center's experience

Minerva Cardiol Angiol. 2022 Aug;70(4):468-475. doi: 10.23736/S2724-5683.20.05477-8. Epub 2021 Mar 11.

Abstract

Background: Northern Italy has been one of the most affected area in the world by the novel severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The healthcare system has been overwhelmed by the huge number of patients in need of mechanical ventilation or intensive care, resulting in a delay of treatment of patients with acute coronary syndrome (ACS), due to a crash in STEMI networks and closure of a certain number of hub centers, and to a delay in patients' seeking for medical evaluation for chest pain or angina-equivalent symptoms.

Methods: In the Trentino region, a mountainous area with about 500,000 inhabitants, very close to Lombardy that was the epicenter of the pandemic in Italy, to avoid these dramatic consequences, we developed a new protocol tailored to our specificity to keep our institution, and above all the cath-lab, clean from the SARS-CoV-2 infection, to ensure full operativity for cardiologic emergencies.

Results: Applying this protocol during the two months of the peak of the infection in Italy no one of the staff members of the cath-lab, the ICCU or the cardiology ward tested positive to nasal swab for SARS-CoV-2 and the same result was obtained for all the patients admitted to our units.

Conclusions: Our real-world experience shows that during the COVID-19 pandemic, quick activation of an appropriate protocol defining specific pathways for patients with a medical urgency is effective in minimizing healthcare personnel exposure and to preserve full operativity of the hub centers. This issue will be of a crucial importance, now that we are facing the second wave of the pandemic.

MeSH terms

  • COVID-19* / epidemiology
  • Cardiology*
  • Humans
  • Pandemics / prevention & control
  • SARS-CoV-2
  • ST Elevation Myocardial Infarction* / diagnosis
  • ST Elevation Myocardial Infarction* / epidemiology
  • ST Elevation Myocardial Infarction* / therapy