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Stroke ve STEMI Tanılı Genç ve Orta Yaşlı Hastaların COVID-19 ile İlişkisinin Araştırılması

Year 2025, Volume: 10 Issue: 2, 28 - 32, 31.08.2025

Abstract

Amaç: Bu çalışmada, rutin klinik pratikte giderek artan sayıda inme ve ST-segment yükselmeli miyokard enfarktüsü
(STEMI) vakasıyla karşılaştığımız genç bireylerde COVID-19 pandemisi ile inme ve ST-segment yükselmeli miyokard
enfarktüsü görülme sıklığındaki artış arasındaki olası ilişkiyi aydınlatmayı amaçladık.
Gereç ve Yöntemler: Bu çalışma, 01.01.2024 ile 31.12.2024 tarihleri arasında kliniğimize başvuran ve 50 yaş ve altında
olan, ST segment elevasyonlu miyokard enfarktüsü veya inme tanısı almış hastalar üzerinde gerçekleştirilmiştir.
Hastaların özgeçmişlerinde COVID-19 geçirmiş olma durumları retrospektif olarak değerlendirilmiştir. Dahil
edilen hastalardan, Polimeraz Zincir Reaksiyon (PCR) testi pozitif olanlar ya da klinik ve radyolojik bulgularla
COVID-19 tanısı alarak tedavi görmüş olanlar “özgeçmişinde COVID-19 pozitif” (Grup I) olarak kabul edilmiştir.
Bu iki kriterden herhangi birini karşılamayan hastalar ise “özgeçmişinde COVID-19 negatif” (Grup II) olarak
sınıflandırılmıştır.
Bulgular: Çalışmaya, 50 yaş ve altı olup iskemik inme veya ST segment elevasyonlu miyokard enfarktüsü (STEMI)
tanısı alan toplam 196 hasta dahil edildi. Hastalar, COVID-19 geçirme öyküsüne göre iki gruba ayrıldı: Grup I
(COVID-19 pozitif) ve Grup II (COVID-19 negatif). Tanı dağılımı değerlendirildiğinde, gruplar arasında iskemik
inme ve STEMI sıklığı açısından istatistiksel olarak anlamlı bir fark saptandı (p=0,026). Özellikle, iskemik inme
tanısı alan hastalarda PCR ile doğrulanmış COVID-19 öyküsünün daha yüksek oranda bulunduğu gözlendi.
Sonuç: Bu çalışmayla COVID-19 pandemisinin sadece akut zararlarına değil sonrasında inme olasılığını arttırma
durumu da göz önüne alınarak uzun dönemdeki etkilerine dikkat edilmesi gerektiği sonucuna varıldı.

References

  • 1. Alpaslan M, Baykan N, Oktay M, Salt Ö, Koyuncu S, Bol O, et al. Evaluation of patients diagnosed with thromboembolism in the emergency department before and during the COVID-19 pandemic. Med Res Arch. 2024;12(10).
  • 2. Mehta S, Kakouros N, Mir T, Loree S, Qureshi W. Prevalence and Outcomes of Patients With Acute Ischemic Stroke With Concomitant ST-Segment–Elevation Myocardial Infarction (Results From National Inpatient Sample 2016–2019). Stroke. 2024;55(5):1245-1253.
  • 3. Partow-Navid R, Prasitlumkum N, Mukherjee A, Varadarajan P, Pai RG. Management of ST elevation myocardial infarction (STEMI) in different settings. Int J Angiol. 2021;30(1):67-75.
  • 4. Zasada W, Bobrowska B, Plens K, Dziewierz A, Siudak Z, Surdacki A, et al. Acute myocardial infarction in young patients. Pol Heart J. 2021;79(10):1093-1098.
  • 5. Cole JW, Stack CA. The clinical approach to stroke in young adults. Exon Publications. 2021:53-78.
  • 6. Pohl M, Hesszenberger D, Kapus K, Meszaros J, Feher A, Varadi A, et al. Ischemic stroke mimics: a comprehensive review. J Clin Neurosci. 2021;93:174-182.
  • 7. World Health Organization. WHO COVID-19 dashboard. [Internet]. Geneva: WHO; 2025 Mar 10. [cited 2025 Mar 22]. Available from: https://covid19.who.int/
  • 8. Malempati M, Patel M, Patel J. Ischemic stroke and COVID-19 infection—a review of clinical case reports. Egypt J Intern Med. 2024;36(1):50.
  • 9. Ghasemzadeh N, Kim N, Amlani S, Madan M, Shavadia JS, Chong A, et al. A review of ST-elevation myocardial infarction in patients with COVID-19. Cardiol Clin. 2022;40(3):321-328.
  • 10. Yamakawa M, Kuno T, Mikami T, Takagi H, Gronseth G. Clinical characteristics of stroke with COVID-19: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2020;29(12):105288.
  • 11. Fifi JT, Mocco J. COVID-19 related stroke in young individuals. Lancet Neurol. 2020;19(9):713–715.
  • 12. Gupta MD, Batra V, Muduli S, Mp G, Kunal S, Bansal A, et al. Epidemiological profile and clinical outcomes of very young (< 35 years) and young (35–50 years) patients with STEMI: Insights from the NORIN STEMI registry. Indian Heart J. 2024;76(2):128- 132.
  • 13. Shrestha AB, Mehta A, Pokharel P, Mishra A, Adhikari L, Shrestha S, et al. Long COVID syndrome and cardiovascular manifestations: A systematic review and meta-analysis. Diagnostics (Basel). 2023;13(3):491.
  • 14. Capaccione KM, Leb JS, D’souza B, Utukuri P, Salvatore MM. Acute myocardial infarction secondary to COVID-19 infection: A case report and review of the literature. Clin Imaging. 2021;72:178- 182.

Investigation of the Relationship Between Stroke and STEMI in Young and Middle-Aged Patients and COVID-19

Year 2025, Volume: 10 Issue: 2, 28 - 32, 31.08.2025

Abstract

Aim: In this study, we aimed to elucidate the potential relationship between the COVID-19 pandemic and the
increasing occurrence of stroke and ST-segment elevation myocardial infarction (STEMI) in younger individuals, as
we have been encountering a growing number of such cases in routine clinical practice.
Materials and Methods: This study was conducted on patients aged 50 years or younger who presented to our clinic
between January 1, 2024, and December 31, 2024, and were diagnosed with STEMI or stroke. The history of prior
COVID-19 infection was evaluated retrospectively. Patients who had a positive Polymerase Chain Reaction (PCR)
test or had been clinically and radiologically diagnosed with COVID-19 and received treatment were classified
as having a history of COVID-19 positivity (Group I). Patients who did not meet either of these two criteria were
classified as having no history of COVID-19 (Group II).
Results: A total of 196 patients aged 50 years or younger who were diagnosed with either infarction STEMI or
ischemic stroke were included in the study. Patients were classified into two groups based on their history of
COVID-19 infection: Group I (COVID-19 positive) and Group II (COVID-19 negative). The distribution of diagnoses
between the two groups revealed a statistically significant difference between the rates of ischemic stroke and
STEMI (p=0.026). Specifically, a higher proportion of patients diagnosed with ischemic stroke were found to have a
history of PCR-confirmed COVID-19 infection.
Conclusion: This study highlights the importance of considering not only the acute effects of the COVID-19
pandemic but also its potential to increase the risk of stroke in the long term, emphasizing the need for attention to
its prolonged impact.

References

  • 1. Alpaslan M, Baykan N, Oktay M, Salt Ö, Koyuncu S, Bol O, et al. Evaluation of patients diagnosed with thromboembolism in the emergency department before and during the COVID-19 pandemic. Med Res Arch. 2024;12(10).
  • 2. Mehta S, Kakouros N, Mir T, Loree S, Qureshi W. Prevalence and Outcomes of Patients With Acute Ischemic Stroke With Concomitant ST-Segment–Elevation Myocardial Infarction (Results From National Inpatient Sample 2016–2019). Stroke. 2024;55(5):1245-1253.
  • 3. Partow-Navid R, Prasitlumkum N, Mukherjee A, Varadarajan P, Pai RG. Management of ST elevation myocardial infarction (STEMI) in different settings. Int J Angiol. 2021;30(1):67-75.
  • 4. Zasada W, Bobrowska B, Plens K, Dziewierz A, Siudak Z, Surdacki A, et al. Acute myocardial infarction in young patients. Pol Heart J. 2021;79(10):1093-1098.
  • 5. Cole JW, Stack CA. The clinical approach to stroke in young adults. Exon Publications. 2021:53-78.
  • 6. Pohl M, Hesszenberger D, Kapus K, Meszaros J, Feher A, Varadi A, et al. Ischemic stroke mimics: a comprehensive review. J Clin Neurosci. 2021;93:174-182.
  • 7. World Health Organization. WHO COVID-19 dashboard. [Internet]. Geneva: WHO; 2025 Mar 10. [cited 2025 Mar 22]. Available from: https://covid19.who.int/
  • 8. Malempati M, Patel M, Patel J. Ischemic stroke and COVID-19 infection—a review of clinical case reports. Egypt J Intern Med. 2024;36(1):50.
  • 9. Ghasemzadeh N, Kim N, Amlani S, Madan M, Shavadia JS, Chong A, et al. A review of ST-elevation myocardial infarction in patients with COVID-19. Cardiol Clin. 2022;40(3):321-328.
  • 10. Yamakawa M, Kuno T, Mikami T, Takagi H, Gronseth G. Clinical characteristics of stroke with COVID-19: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2020;29(12):105288.
  • 11. Fifi JT, Mocco J. COVID-19 related stroke in young individuals. Lancet Neurol. 2020;19(9):713–715.
  • 12. Gupta MD, Batra V, Muduli S, Mp G, Kunal S, Bansal A, et al. Epidemiological profile and clinical outcomes of very young (< 35 years) and young (35–50 years) patients with STEMI: Insights from the NORIN STEMI registry. Indian Heart J. 2024;76(2):128- 132.
  • 13. Shrestha AB, Mehta A, Pokharel P, Mishra A, Adhikari L, Shrestha S, et al. Long COVID syndrome and cardiovascular manifestations: A systematic review and meta-analysis. Diagnostics (Basel). 2023;13(3):491.
  • 14. Capaccione KM, Leb JS, D’souza B, Utukuri P, Salvatore MM. Acute myocardial infarction secondary to COVID-19 infection: A case report and review of the literature. Clin Imaging. 2021;72:178- 182.
There are 14 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Makale
Authors

Gözde Yılmaz Dursun 0009-0003-0032-4398

Necmi Baykan 0000-0002-6845-9550

Haticenur Yıldırım 0009-0003-9990-6928

Rukiye Aytekin Akdağ 0009-0007-7139-1562

İbrahim Toker 0000-0002-5346-2116

Publication Date August 31, 2025
Submission Date March 26, 2025
Acceptance Date August 6, 2025
Published in Issue Year 2025 Volume: 10 Issue: 2

Cite

Vancouver Yılmaz Dursun G, Baykan N, Yıldırım H, Aytekin Akdağ R, Toker İ. Investigation of the Relationship Between Stroke and STEMI in Young and Middle-Aged Patients and COVID-19. JAMER. 2025;10(2):28-32.