Acute myocardial infarction in post COVID-19 patients

Moisés Andrés Lombana Salas, ,María Camila Miranda Jiménez,General Medical, University Of Sucre, Sincelejo, Sucre, Colombia ,Michelle Bedoya Coronel,Wendy Yulieth Herazo Madera,Enrique Arturo Lombana Salas

doi:10.17511/ijmrr.2021.i05.02

Moisés Andrés Lombana Salas, + Show 5 more

Open Access

https://doi.org/10.17511/ijmrr.2021.i05.02

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Abstract

The SARS-CoV-2 infection has caused mortality in different populations; in addition, morbidity withimmunological, hematological and/or cardiovascular compromises has been reported, with acutemyocardial infarction (AMI) standing out. A literature search was conducted in databases todetermine existing evidence regarding AMI in post-COVID-19 patients. It was found that initially AMIwas described in some patients during the disease; however, a recently published case seriesshowed that it could occur in recovered patients, secondary to systemic and procoagulantinflammation over time, suggesting further research in this area.

Highlights

COVID-19 has left multiple health sequelae around the world, generating the need for continuous care in survivors of severe acute respiratory syndrome (SARS)-CoV-2 infection who consult for different systemic conditions, among which stand out: Guillain-Barré syndrome, rheumatoid arthritis, pediatric multisystemic inflammatory syndromes such as Kawasaki disease, hematologic and cardiovascular system dysfunction [1]; the latter system is known to be predisposed to be affected by SARS-CoV-2 directly by virus damage itself or indirectly through inflammation, endothelial activation and microvascular thrombosis
We found a single case series published in May 2021, described by Shiun Woei Wong et al, which mentions the presentation of acute myocardial infarction (AMI) in 3 patients post COVID-19 with more than 80 days of recovery, all-male, with no previous cardiovascular history, standard features were elevated levels of von Willebrand factor antigen, factor VIII and D-dimer, ST-segment elevation and ultrasound findings of a fibrotic plaque with the minimal necrotic centre, with a hypercoagulable state determined by ultrasound analysis of the clot. [5]
The presentation of post-COVID-19 AMI is not frequently described in the medical literature, it is only known from the previously mentioned case series, and it is this report that shows the possibility of suffering AMI after recovery from COVID-19, based on the chance that systemic inflammatory and procoagulant activity is maintained over time.[4]

Summary

Introduction

COVID-19 has left multiple health sequelae around the world, generating the need for continuous care in survivors of SARS-CoV-2 infection who consult for different systemic conditions, among which stand out: Guillain-Barré syndrome, rheumatoid arthritis, pediatric multisystemic inflammatory syndromes such as Kawasaki disease, hematologic and cardiovascular system dysfunction [1]; the latter system is known to be predisposed to be affected by SARS-CoV-2 directly by virus damage itself or indirectly through inflammation, endothelial activation and microvascular thrombosis. Little has been written in the medical literature on post-COVID-19 acute myocardial infarction (AMI). This short review aims to describe the mechanisms that cause AMI in the context of COVID-19, based on the pathophysiological bases that have already been described and to analyze the possible causes that determine the appearance of cases of postCOVID-19 AMI based on what the literature suggests, using a recently published case series as a starting point

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