Abstract
Introduction: Corona Virus Disease 2019 (COVID-19) Infection is associated with acute cardiac injury. We examined the risk of in-hospital mortality in patients with concomitant COVID-19 infection and acute myocardial infarction (AMI) as compared to patients with AMI without COVID-19 infection. Hypothesis: COVID-19 is associated with increased in-hospital mortality in patients hospitalized for AMI. Methods: We conducted a systematic review and meta-analysis of published articles from January 2019 to May 2021. Literature search was performed on PubMed, Cochrane database, Embase, and Web of Science. We included studies done in patients with index hospitalization for AMI. Patients with positive COVID-19 Polymerase Chain Reaction were considered to have COVID-19 infection. We used random-effects model using the risk ratio (RR) and 95% confidence interval (CI). We used I squared test to assess for heterogeneity. Results: After assessing 20 articles for full text screen for eligibility, four cohort studies met our inclusion criteria. There were a total of 1918 participants in both COVID and non-COVID groups, who were hospitalized for AMI between February 1, 2020 to June 30, 2020. 168 participants (8.76%) had concomitant COVID-19. Confounders were adjusted in only one article. Most of the confounders like age, sex, race and BMI were similar in both groups but co-morbidities were higher in COVID group in all four studies. 42 patients (61%) with COVID-19 and 69 patients (0.96%) with no COVID-19 died in hospital. Pooled data from the four studies showed patients with AMI and COVID-19 infection had more than six times increased risk of in-hospital mortality compared with patients who had AMI but no COVID-19 infection (RR 6.17, 95% CI: 4.11-9.26; I 2 =9%, P<0.00001). Conclusions: Our study shows that COVID-19 infection is associated with increased in-hospital mortality in patients hospitalized for AMI. Our limitations include higher comorbidities in COVID group, unable to capture all COVID patients, and high risk of bias with cohort studies. Whether patients with concomitant COVID-19 infection and AMI will benefit from unique management approaches should be further examined.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
