Comparing Clinical Parameters and Outcomes of ST-elevation Myocardial Infarction (STEMI) Patients With and Without COVID-19 Infection

Abstract

Objectives: During the novel coronavirus disease 2019 (COVID-19) pandemic, the incidence of cardiovascular diseases increased. In this context, diagnosing ST-elevation myocardial infarction (STEMI) in COVID-19 cases has become complex and challenging. Objectives: This study explored the characteristics and compared clinical outcomes between COVID-19 and non-COVID-19 patients with STEMI. Methods: This prospective observational study was conducted on adult patients admitted with the diagnosis of STEMI in the first 6 months of the pandemic. Patients were evaluated for COVID-19 diagnosis and divided into two groups: COVID-19-positive and COVID-19-negative. Then, they were monitored during hospitalization and 6 months after discharge. Results: Of 131 patients admitted with STEMI, 22.13% had COVID-19 infection. Most patients were men, and the COVID-19-positive patients were older than non-infected patients (63.97±12.54 vs 58.19±10.97 years; P=0.039). The COVID-19-infected patients had a higher prevalence of diabetes (P=0.003) and heart failure (P=0.008). They had higher levels of erythrocyte sedimentation rate (ESR) (P=0.003) and neutrophil count (P=0.018), whereas lymphocyte count declined considerably in these patients (P=0.012). In addition, hospital length of stay was higher in the infected patients (6.64±4.30 vs 4.93±3.59 days; P=0.023). During the study period, the overall mortality rate in our setting was 8.82% and 17.24% in COVID-19-negative and -positive patients, respectively. However, this difference was not statistically significant (P=0.195). Discussion: Although the current study employed a small sample, the findings suggest notable differences between the STEMI patients with and without COVID-19 infection regarding some parameters, especially underlying comorbidities. However, the difference in mortality was not significant.