COVID-19 and its impact on the management of patients with acute coronary syndrome during the first COVID wave - A questionnaire-based survey among interventional cardiologists from Southern India

Background: The COVID-19 pandemic has transformed the medical society in many ways. With significant drain on the resources and altered healthcare priorities, there is a greater need for redeployment of the resources from noncommunicable diseases to COVID-19-related healthcare services. To understand the impact of the COVID-19 pandemic on the management of acute coronary syndrome (ACS) in Tamil Nadu, a survey was administered across cardiologists in Tamil Nadu. Methods: A survey was done using an electronic questionnaire administered regarding the change of patterns of acute coronary syndromes during the COVID through Google Forms with responses collected in excel format. Results: Among 256 cardiologists contacted, 101 responded to the survey. Among cardiologists who responded, all were interventional cardiologists- with most of them performing primary percutaneous coronary intervention (PCI) (95%) regularly during pre-COVID times. Most of them have noticed a significant reduction in the number of patients with ACS seeking health care (94%) and another 61% of respondents felt that there was a reduction in the number of patients with acute coronary syndrome. There was a significant delay in ST-segment elevation myocardial infarction presentation to the hospital (88%) and significant reduction in the number of primary PCI (47%). Only 19% of respondents did primary PCI for COVID-positive patients. Conclusions: COVID pandemic has emerged as a big challenge to the global health care system. Optimal acute coronary care could not be delivered in a timely manner due to multiple social, patient, and physician-related factors. The emerging techniques in rapid diagnosis of COVID-19 and protective measures of COVID infection are expected to improve the situation. Trial Registration: Clinical Trials Registry - India (CTRI), CTRI/2020/09/027517, Registered September 1, 2020 http://CTRI. nic. In/Clinicaltrials/pmaindet2. php? trialid = 47025 and EncHid = and user Name =.