Assessment Of COVID-19 Positive Patients With ST-Segment Elevation Myocardial Infarction During The COVID-19 Pandemic

Abstract

Objective: The global impact of the coronavirus disease 2019 (COVID-19) pandemic has been shown to adversely affect the cardiovascular system. Investigating the clinical course of patients with ST-segment elevation myocardial infarction (STEMI) associated with COVID-19 infection is crucial to elucidate the mechanisms linking COVID-19 and STEMI. Assessing these patients from both cardiovascular and infection control perspectives is essential for improving clinical outcomes and reducing the burden on healthcare systems. This study aims to provide a comprehensive evaluation of the clinical course of COVID-19-positive STEMI patients. Methods: This single-center, cross-sectional study analyzed 80 STEMI patients who underwent coronary angiography, comprising 38 COVID-19-positive individuals and 42 COVID-19-negative individuals. We assessed admission times, biochemical parameters, door-to-balloon times, angiographic data, length of hospital stay, and in-hospital mortality. Results: The mean age in the COVID-19-positive group was 56.6±10.8 years, whereas that in the COVID-19-negative group was 53.6±10.8 years (P = .238). No significant differences in demographic characteristics were observed between the groups. However, C-reactive protein (CRP), white blood cell (WBC), and baseline troponin levels were significantly greater in the COVID-19-positive group (P < .001, P = .005, and P = .037, respectively). Echocardiographic evaluation revealed a lower ejection fraction (EF) in COVID-19-positive patients than in COVID-19-negative patients (P = .023). Angiographic evaluation revealed a greater thrombus burden and longer pain-to-balloon time in the COVID-19-positive group (P = .001 and P < .001, respectively). The length of hospital stay was also longer in the COVID-19-positive group (P < .001). Conclusion: The findings of increased thrombus burden, prolonged pain-to-balloon time, and extended hospital stays among COVID-19-positive patients underscore the adverse cardiovascular effects of COVID-19. Delayed hospital presentation of patients with cardiovascular symptoms during the pandemic poses a challenge for timely diagnosis and management of critical cardiovascular conditions.

Keywords

• COVID-19
• STEMI
• Thrombus burden

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