To test again or not? – the experience of an emergency cardiology clinic during the COVID-19 pandemic

Scope: We did a follow-up in a Cardiology clinic of an emergency hospital of the number of positive SARS-CoV2 cases, the motivation to retest patients with a negative initial test, as well as to identify the correlations between clinical and paraclinical parameters and the retesting decision.

Methods: We retrospectively identified all patients ad-mitted to the SUUB Cardiology Department between May 1, 2020 and July 1, 2020. We selected patients positive for SARS-CoV2 infection, as well as those who were tested at least twice by RT-PCR. We considered demographic parameters, the existence of a contact with a positive case, cardiovascular diagnosis, clinical presentation of the patient, symptoms suggestive of SARS-CoV2 infection, lung imaging, hemogram, renal and hepatic function, inflammatory markers, the existence of another concomitant infection and antibiotic administration. We followed-up the motivation of retesting, as well as the possible correlations between clinical and paraclinical parameters and the retesting decision.

Results: 341 patients were identified, 2 patients with first positive RT-PCR test for SARS-CoV2 infection, 110 being tested for the infection at least 2 times. Of these, 3 had a first inconclusive test and a second negative test, the rest having at least two negative RT-PCRs. The most common reasons for retesting were suggestive lung imaging and low-grade fever, followed by hemogram lymphopenia and associated symptoms of CO-VID 19. The most common cardiovascular diagnosis at admission was acute coronary syndrome, followed by acute heart failure. One third of the retested patients received antibiotic treatment for another type of infection. There were correlations between paraclinical parameters and the appearance of low-grade fever.

Conclusions: Acute cardiovascular pathology is associated on one hand with a significant inflammatory status, as well as with adrenergic hyperstimulation. At the same time, infections of any kind are a precipitating factor in heart disease. Moreover, most patients admitted to cardiology departments show changes in lung imaging. Thus, in the current epidemiological context of the Covid-19 pandemic, increased attention should be paid both to the prompt detection of patients with a high suspicion of SARS-CoV2 infection and to avoid the misuse of material resources, given that cardiovascular patients may have clinical and paraclinical features similar to those present in this infection.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)