الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Corona viruses have been reported as causes for mild and moderate respiratory infections over 50 years ,In 2019, the epidemic COVID-19 has spread from Wuhan ,China throughout the world which required special procedures and precautions to overcome the epidemic with avoiding interventions that may be costly ineffective or unduly restrictive. This of course affected management protocol s for ACS patients all over the world including Egypt so as not to harm these patients or HCWs. All ACS patients admitted to Assiut university heart hospital within 15 months during COVID-19 pandemic were recruited in this study, all patients were subjected to full history taking, ECG ,echocardiography, all routine investigations and follow up for in-hospital major complications ,1 month and 12 months MACE . they were screened for COVID-19 symptoms, CT chest and PCR test were done for some of them. We found that ACS was more prevalent among rural, old aged, male hypertensive patients .2/3 of our population were STEMI ,74.7 % of them underwent PPCI in contrast to NST-ACS patients who were managed conservatively in most cases . STEMI patient had worse in-hospital and long term outcomes. AS for COVID status,30.6 % of patients were suspected by fever ,RD or both but only 4.8% confirmed by PCR test . Confirmed COVID -ACS patients had worse in-hospital mortality, cardiogenic shock ,HF and mechanical ventilation in comparison to non-COVID patients . Numbers of ACS admissions and PCI done during the pandemic all decreased in comparison to before and after it. Multivariate logistic regression model conducted to study population showed that COVID-19 infection with associated with more MACE on short and long term follow up along with uncontrolled diabetes, hypertension, COPD, CKD , lower EF and smoking. Prevalence of confirmed COVID-19 was 23.6 % among doctors and 21.2 % among HCWs. Confirmed COVID-19 patients in our study was 4.3 % ,they had more in-hospital mortality, cardiogenic shock, HF and need for mechanical ventilation, and more MACE on short and long term follow up in comparison to non-COVID ACS patients Unavailability of CT chest and COVID-19 PCR test for all patients of the study as it was an observational not interventional study. Some follow-up data were missed due to large sample size and loss of communication data. Meta-analysis for this study with other Egyptian studies for more comprehensive view for dealing with similar epidemic situations.