Comparison of Characteristics and Outcomes of Patients With Acute Myocardial Infarction With Versus Without Coronarvirus-19

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted the US healthcare system. Cardiac involvement in COVID-19 is common and manifested by troponin and natriuretic peptide elevation and tends to have a worse prognosis. We analyzed patients who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) with either an ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) early in the pandemic (March 1, 2020 – June 30, 2020) using the International Classification of Diseases, Tenth Revision. Patients’ clinical course and outcomes, including in-hospital mortality, were compared on the basis of the results of COVID-19 status (positive or negative). The cohort included 1533 patients admitted with an acute myocardial infarction (AMI), of whom 86 had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, during the study period. COVID-19-positive patients were older and non-White and had more co-morbidities. Furthermore, inflammatory markers and N-terminal-proB-type-natriuretic peptide were higher in COVID-19-positive AMI patients. Only 20.0% (17) of COVID-19-positive patients underwent coronary angiography. In-hospital mortality was significantly higher in AMI patients with concomitant COVID-19-positive status (27.9%) than in patients without COVID-19 during the same period (3.7%; p<0.001). Patients with AMI and COVID-19 tended to be older, with more co-morbidities, when compared to those with an AMI and without COVID-19. In conclusion, myocardial infarction with concomitant COVID-19 was associated with increased in-hospital mortality. Efforts should be focused on the early recognition, evaluation, and treatment of these patients.

Myocardial Infarction in Patients with and Without Covid-19: Comparison of Characteristics, Clinical Course and Outcome

“…In-hospital death was more frequent in Covid-19 group. This situation was similar in other articles (5).…”

“…ndings con rm that Covid-19 is more common at older ages although younger ages are not safe from Covid-19. These ndings are consistent with another study(5), and the age range for MI may be changed if Covid-19 develops in patients.Two models of MI do not have a good prognosis due to poor arteries and multiple stenoses (in NSTEMI) and due to the lack of adequate collaterals (in SVD)(13)(14)(15). LAD was the most involved vessel in the Covid-19 patients with STEMI which may explain the more decrease in EF in them after MI.Injury to the patient's vital organs, including the kidney, is one of the causes of worsening prognosis in patients with ACS.…”

“…Unfortunately, Covid-19 is a highly contagious pneumonia that affects the diagnosis and treatment of patients with MI signi cantly (5). Studies in Europe and the United States have shown that the hospital valid hospital laboratory.…”

Cardiac PET and SPECT During the COVID-19 Pandemic

“…One meta-analysis reported that out of hospital cardiac arrests had increased by 120% in five countries (Australia, Italy, Spain, United States, and France) compared to before the pandemic 11 . In-hospital mortality rates for patients presenting with acute coronary syndrome were found to be significantly higher in patients who had COVID-19 (27.9%) compared to those who did not carry the virus (3.7%) as reported by Case et al 12 . Only 20% of patients with acute myocardial infarction and COVID-19 infection underwent coronary angiography in that study 12 .…”

“…In-hospital mortality rates for patients presenting with acute coronary syndrome were found to be significantly higher in patients who had COVID-19 (27.9%) compared to those who did not carry the virus (3.7%) as reported by Case et al 12 . Only 20% of patients with acute myocardial infarction and COVID-19 infection underwent coronary angiography in that study 12 . One observational cohort study discovered that during the initial months of the pandemic, deaths from ischemic heart disease and hypertensive disorders significantly increased compared to the months leading up to the pandemic, confirming fears that withholding indicated cardiovascular testing was impacting patient morbidity and mortality 13 .…”