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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital</title><author><name sortKey="Zeng, Jie" sort="Zeng, Jie" uniqKey="Zeng J" first="Jie" last="Zeng">Jie Zeng</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</nlm:aff></affiliation></author><author><name sortKey="Huang, Jianxin" sort="Huang, Jianxin" uniqKey="Huang J" first="Jianxin" last="Huang">Jianxin Huang</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</nlm:aff></affiliation></author><author><name sortKey="Pan, Lingai" sort="Pan, Lingai" uniqKey="Pan L" first="Lingai" last="Pan">Lingai Pan</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32162032</idno><idno type="pmc">7079823</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7079823</idno><idno type="RBID">PMC:7079823</idno><idno type="doi">10.1007/s00134-020-05993-9</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000132</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000132</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital</title><author><name sortKey="Zeng, Jie" sort="Zeng, Jie" uniqKey="Zeng J" first="Jie" last="Zeng">Jie Zeng</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</nlm:aff></affiliation></author><author><name sortKey="Huang, Jianxin" sort="Huang, Jianxin" uniqKey="Huang J" first="Jianxin" last="Huang">Jianxin Huang</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</nlm:aff></affiliation></author><author><name sortKey="Pan, Lingai" sort="Pan, Lingai" uniqKey="Pan L" first="Lingai" last="Pan">Lingai Pan</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</nlm:aff></affiliation></author></analytic><series><title level="j">Intensive Care Medicine</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Huang, Cl" uniqKey="Huang C">CL Huang</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, Xw" uniqKey="Li X">XW Li</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Intensive Care Med</journal-id><journal-id journal-id-type="iso-abbrev">Intensive Care Med</journal-id><journal-title-group><journal-title>Intensive Care Medicine</journal-title></journal-title-group><issn pub-type="ppub">0342-4642</issn><issn pub-type="epub">1432-1238</issn><publisher><publisher-name>Springer Berlin Heidelberg</publisher-name><publisher-loc>Berlin/Heidelberg</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32162032</article-id><article-id pub-id-type="pmc">7079823</article-id><article-id pub-id-type="publisher-id">5993</article-id><article-id pub-id-type="doi">10.1007/s00134-020-05993-9</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letter</subject></subj-group></article-categories><title-group><article-title>How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital</article-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Zeng</surname><given-names>Jie</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Huang</surname><given-names>Jianxin</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Pan</surname><given-names>Lingai</given-names></name><address><email>panlingai2004@163.com</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.54549.39</institution-id><institution-id institution-id-type="ISNI">0000 0004 0369 4060</institution-id><institution>Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,</institution><institution>University of Electronic Science and Technology of China,</institution></institution-wrap>Chengdu, 610072 Sichuan Province China</aff></contrib-group><pub-date pub-type="epub"><day>11</day><month>3</month><year>2020</year></pub-date><fpage>1</fpage><lpage>3</lpage><history><date date-type="accepted"><day>26</day><month>2</month><year>2020</year></date></history><permissions><copyright-statement>© Springer-Verlag GmbH Germany, part of Springer Nature 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions></article-meta></front><body><p id="Par1">Dear Editor,</p><p id="Par2">Acute myocardial infarction (AMI) is a cardiovascular emergency and requires an emergency diagnosis and treatment process. Unfortunately, the highly contagious COVID-19 pneumonia is obviously affecting the diagnosis and treatment of acute myocardial infarction (AMI) which includes ST-elevated myocardial infarction (STEMI) and non-ST-segment elevation acute myocardial infarction (NSTEMI). There are increasing confirmed cases around multiple countries every day. The transmission dynamics is not fully understood [<xref ref-type="bibr" rid="CR1">1</xref>]. It is necessary to adjust the routine diagnosis and treatment protocol of AMI to face the serious public health event.</p><sec id="Sec2"><title>General principles</title><p id="Par3">The emergency call should instruct patients to choose the nearest center that can complete primary percutaneous coronary intervention (PCI) treatment. Avoid public transportation.</p><p id="Par4">Adopt the principle of maximum protection. Patients with AMI accompanied by fever, especially respiratory symptoms, should first go to a fever outpatient clinic. Combined with epidemiological history and body temperature screening, if suspected of SARS-CoV-2 infection, they will be admitted to the hospital isolation ward for rapid nucleic acid test.</p><p id="Par5">The nucleic acid test can significantly delay the time of STEMI emergency reperfusion. Patients suspected or diagnosed with SARS-CoV-2 infection should be isolated and begin thrombolytic therapy immediately, if within reperfusion time. High-risk patients with contraindications for thrombolysis need to assess the risk of infection and the benefit of PCI. Perform PCI only for culprit vessel.</p></sec><sec id="Sec3"><title>Protocol for STEMI</title><p id="Par6">Perform the following management: [Fig. <xref rid="Fig1" ref-type="fig">1</xref>a: Partial reference to “Diagnosis and treatment process of acute myocardial infarction in the prevention and control of coronavirus Chinese expert advice (first edition)”].<list list-type="order"><list-item><p id="Par7"><italic>Stable patients when the onset time is within 12 h</italic>.</p><p>In case of patients within the reperfusion time window and no contraindication to thrombolysis, thrombolytic therapy is performed in an isolation ward. After successful thrombolysis, treatment is continued in the isolation ward. After the patient has recovered from COVID-19 pneumonia and test of nucleic acid is twice negative, elective PCI should be considered. Patients within the reperfusion time window with contraindications for thrombolysis or failure of thrombolysis need to comprehensively evaluate the risks of PCI and infection control.</p><p><italic>Stable patients when the onset time is more than 12 h</italic>: comprehensively evaluate the risks of PCI and infection control.</p></list-item><list-item><p id="Par9"><italic>Unstable patients with severe pneumonia</italic>.</p><p>Transfer to isolation ward for conservative treatment.</p><p id="Par10"><italic>Unstable patients with mild to moderate pneumonia</italic>: assess whether the onset time of STEMI is longer than 12 h. The subsequent steps are the same as those for STEMI patients with stable vital signs.</p></list-item><list-item><p id="Par11">Perform echocardiography and ECG 24–48 h after the reperfusion therapy. If the patient is stable, rapid rehabilitation should be performed to shorten the hospitalization time as much as possible. Follow-up should be performed through the internet outpatient clinic of Sichuan Provincial People’s Hospital.</p></list-item></list><fig id="Fig1"><label>Fig. 1</label><caption><p>Protocol of <bold>a</bold> STEMI, <bold>b</bold> NSTEMI</p></caption><graphic xlink:href="134_2020_5993_Fig1_HTML" id="MO1"></graphic></fig></p></sec><sec id="Sec4"><title>Protocol for NSTEMI</title><p id="Par12">The door-to-balloon time in NSTMI patients is less strict than that in STEMI patients. Therefore, we should exclude the SARS-CoV-2 infection first (Fig. <xref rid="Fig1" ref-type="fig">1</xref>b). The confirmed case should be transferred to the isolation ward until patient recovery and then it was assessed whether further invasive interventions are needed. Very few NSTEMI patients may present hemodynamic instability and fatal arrhythmia who cannot wait for the results of nucleic acid tests, and then, the isolated intervention surgery should be the first choice.</p></sec></body><back><fn-group><fn><p><bold>Publisher's Note</bold></p><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></fn><fn><p>Jie Zeng and Jianxin Huang contributed equally to this work and should be considered co-first authors.</p></fn></fn-group><ack><title>Acknowledgements</title><p>We would like to thank all our hospital members for their efforts: Gang Li, Tao He, Jianhong Tao from the Department of Cardiology, Sichuan Provincial People’s Hospital; Xiaobo Huang, Xiaoqin Zhang, Yihui Zhang, Yiping Wang from the Department of Critical Care Medicine, Sichuan Provincial People’s Hospital; head nurse Rong Lu, Qin Yang from the Department of Critical Care Medicine, Sichuan Provincial People’s Hospital; Mengchang Yang from the Department of Anesthesiology, Sichuan Provincial People’s Hospital.</p></ack><notes notes-type="funding-information"><title>Funding</title><p>None.</p></notes><notes notes-type="ethics"><title>Compliance with ethical standards</title><notes notes-type="COI-statement"><title>Conflicts of interest</title><p id="Par8">The authors declare that they have no conflicts of interest in relation to this study.</p></notes></notes><ref-list id="Bib1"><title>Reference</title><ref id="CR1"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Huang</surname><given-names>CL</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>XW</given-names></name></person-group><article-title>Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China</article-title><source>Lancet</source><year>2020</year><pub-id pub-id-type="doi">10.1016/S0140-6736(20)30183-5</pub-id><pub-id pub-id-type="pmid">32151324</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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