Aims 

Patients with acute coronary syndrome (ACS) often arrive in the catheterization (cath) lab directly from the field or an emergency department without an accurate triage for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Although in the pandemic period the treatment in the cath laboratory of high-risk ACS should not be delayed because the operators wear special protection systems, the subsequent risk of contagion in a non-Covid coronary care unit could be high in the case of patients positive for SARS-CoV-2.

Methods 

We tested the possibility of a fast-track protocol in 51 consecutive patients (mean age 65 ± 12 years) transferred from spokes centres or from the field to our HUB centre and admitted to our coronary care unit (CCU). Once the patient had arrived in the cath lab, the nasopharyngeal swab was performed. The real-time PCR to extract RNA for SARS-CoV-2 detection was performed with an automated rapid molecular Xpert Xpress test. Meanwhile, coronary angiography or percutaneous coronary intervention was performed if necessary.

Results 

In this fast-track protocol, the time to perform nasopharyngeal swab was 11 ± 11 min; time spent to transport nasopharyngeal swab to the laboratory was 29 ± 20 min; time to detect viral nucleic acid was 68 ± 16 min. The overall time from the execution of nasopharyngeal swab to the result was 109 ± 26 min. The results were immediately put into the hospital computer system and made readily available. Depending on the test result, patients were then transferred to the regular CCU or Covid area.

Conclusion 

This study demonstrates that 0–1.5 h fast-track triage for coronavirus disease 2019 (COVID 19) is feasible in patients with ACS. The execution of nasopharyngeal swab in the cath lab and its analysis with a rapid molecular test allows rapid stratification of SARS-CoV-2 infection.

中文翻译：

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急性冠状动脉综合征的快速追踪入/出SARS-CoV-2感染及快速0 / 1.5 h分子检测

目的 

患有急性冠状动脉综合征（ACS）的患者通常直接从野外或急诊室到达导管实验室，而没有对严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）感染进行准确的分类。

尽管在大流行期间，不应因为操作员佩戴特殊的保护系统而推迟在高风险ACS的导管实验室中进行治疗，但如果患者为阳性，则随后在非Covid冠状动脉护理部门中传染的风险可能很高。用于SARS-CoV-2。

方法 

我们测试了从轮辐中心或从现场转移到我们的HUB中心并入我们的冠心病监护病房（CCU）的51名连续患者（平均年龄65±12岁）实施快速跟踪方案的可能性。患者到达导管实验室后，将进行鼻咽拭子检查。使用自动快速分子Xpert Xpress测试进行实时PCR提取RNA，用于SARS-CoV-2检测。同时，必要时进行冠状动脉造影或经皮冠状动脉介入治疗。

结果 

在此快速通道协议中，执行鼻咽拭子的时间为11±11分钟；将鼻咽拭子运送到实验室所花费的时间为29±20分钟；检测病毒核酸的时间为68±16分钟。从执行鼻咽拭子到得到结果的总时间为109±26分钟。结果立即被输入医院的计算机系统中并随时可用。然后，根据测试结果，将患者转移到常规CCU或Covid区域。

结论 

这项研究表明，对于ACS患者，2019年冠状病毒病0-1.5小时快速分流（COVID 19）是可行的。在导管实验室中执行鼻咽拭子，并通过快速分子检测进行分析，可以对SARS-CoV-2感染进行快速分层。