In the face of the quickly evolving coronavirus disease 2019 (COVID-19) pandemic, many health-care systems around the globe have modified their routine management of patients presenting with acute cardiovascular emergencies including patients with ACS.A unifying theme in the new management strategies is the adoption of new restrictive measures to meet the challenges of increased risk of infection of health-care workers; limited numbers of beds, shortage of personal protective equipment (PPE), inadequate number of protected catheterization rooms; and the clinical overlap between ACS and COVID-19 infection in some of patients.~In developing countries, with an already strained health system due to economic problems, the situation is more challenging and needs the formulation of efficient protocols that can accommodate several medical and socioeconomic challenges.~Egypt, with an estimated population of 100 million, is facing exceptional challenges during the COVID-19 crisis. Because large scale use of polymerase chain reaction (PCR) test for SARS-CoV-2 in a large population is a problem, the prevalence of COVID-19 infection in Egypt is unknown. Furthermore, the supply of PPE falls far short of demands with lack of professionally protected cardiac catheterization rooms. With progression of the pandemic in such a large population, care of COVID-19 patients is expected to rapidly overwhelm the supplies, beds, and staff available in Egyptian hospitals.~The Cardiology Department in Assiut university hospital has revised the management protocols for ACS patients and implemented new management protocols both for patients with ST-segment elevation myocardial infarction (STEMI) and Non-ST-segment elevation acute coronary syndromes (NSTE-ACS).
To register pathological events occurring to all acute coronary syndrome patients coming to Assiut university heart hospital through one year during COVID- 19 pandemic