In-hospital clinical outcomes of COVID-19 patients with myocardial infarction

Abstract

Introduction: Hospital outcomes for myocardial infarction are among the clinical conditions influenced by the spread of COVID-19. Patients with COVID-19 frequently experience cardiovascular complications, with challenges encountered in acute management. We assessed clinical presentation, incidence, clinical outcomes and angiographic findings of myocardial infarction in COVID-19 patients.Methods: This study is a observational retrospective multicenter, medical diagram study was conducted on successive patients hospitalized with diagnosis of Covid-19 and myocardial infarction ,in two large referral hospitals with catheterization equipment and laboratories.COVID-19 infection was confirmed with reverse transcription–polymerase chain reaction assays of a nasopharyngeal sample or pattern of pulmonary parenchymal involvement in lung HRCT (approved by an expert respiratory or infection disease specialist). Data collected included patient demographics, comorbidities, electrocardiogram(ECG) and echocardiography results ,inpatient medication, treatment (fibrinolytic therapy, percutaneous coronary intervention (PCI) ,coronary artery bypass graft (CABG), vasopressor use, invasive mechanical ventilation),laboratory test results (leucocyte count, C-reactive protein , D dimer, BUN, Cr, and ferritin)and outcome(duration of hospitalization, revascularization success, in-hospital reinfarction and mortality).Results: The most common comorbidities were hypertension (29, 58%), diabetes mellitus (21, 42%), dyslipidemia (14, 28%) and smoking (5, 10%). Fourteen patients (44.4%) were treated with PCI and 8 (19.5%) patients with fibrinolytic therapy as the initial reperfusion strategy. Revascularization was successful in 62% of patients. The median CRP level of patients died was 96, which was significantly more than the level (46) in discharged cases (p<0.001). Creatinine levels were also significantly higher in patients who died compared to those who were discharged (p=0.008).Conclusion: The results of this study demonstrate upper mortality rate in patients with diabetes, kidney injury and high-level CRP, denoting the baseline clinical and laboratory data could be defined as prognostic markers in COVID-19 patients, especially while managing myocardial infarction with concurrent COVID-19 infection.

Keywords

• myocardial infarction
• covid-19 infection
• mortality
• creatinine
• c-reactive protein