Takostubo syndrome during the COVID-19 pandemic: a single center experience

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Abstract Background Takotsubo syndrome (TTS) is a major psychosomatic cardiovascular disease. It has been suggested that in the current pandemic of coronavirus disease 2019 (COVID-19), the psychological, mental and physical consequences of the restrictive measures taken to combat the pandemic, is likely to make individuals more vulnerable to TTS. Purpose In our study, we investigated whether TTS incidence has increased during the COVID-19 era in a major tertiary hospital in Athens. Methods The study population included 316 consecutive patients admitted to the Coronary Care Unit (CCU) of our hospital throughout the 16 months (March 2020-June 2021) pandemic COVID-19 with the initial diagnosis of acute coronary syndrome (ACS). For comparison 342 patients with ACS admitted to CCU during the 16 months period preceding the COVID-19 pandemic (November 2018-February 2020) were analyzed. All ACS patients underwent coronary angiography within 48 hours of admission. A prerequisite for admission to CCU of all ACS patients during the pandemic period was a negative reverse transcription-polymerase chain reaction test for COVID-19. Results The vast majority (95%) of TTS patients were women and the mean age was 71.1±15.4 years. There was a significant increase in the incidence of TTS during the 16 months COVID-19 period (6.3%, i.e., 20 TSS among 316 ACS patients) compared with the corresponding incidence of TTS 16 months prior the pandemic (2.6%, i.e., 9 TTS among 342 ACS patients) [Figure 1]. The incidence rate ratio comparing the TTS cases of COVID-19 pandemic period to the pre-pandemic period was 2.22 (95% CI: 0.97–5.54, p=0.021). Conclusions COVID-19 pandemic was associated with a significant increase in the incidence of TTSprobably due to the additional psychological burden imposed by the pandemic. Funding Acknowledgement Type of funding sources: None.

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