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Minerva Cardiology and Angiology 2021 Mar 11

DOI: 10.23736/S2724-5683.20.05477-8


language: English

How to keep the cath-lab of a hub center “covid free” during the pandemic in a hub & spoke cardiology network: a single center experience and literature review

Marco BORGHESI , Filippo ZILIO, Giuseppe BRAITO, Michele DALLAGO, Simone MURAGLIA, Daniel TODARO, Roberto BONMASSARI

Interventional Cardiology, Department of Cardiology, Santa Chiara Hospital, Trento, Italy


BACKGROUND: north of Italy has been one of the most affected area in the world by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). 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.

KEY WORDS: SARS Cov-2; Healthcare protection; Infections; Prevention; Acute myocardial infarction; Emergency medical system

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