Acute myocardial infarction after laboratory confirmed SARS-CoV-2 infection

Ena, J.; Bou-Collado, M.; Reyes-Jara, M. D.; Afonso-Carrillo, R.; Mulet, R.; Valls, V.

Background and Aims: Acute respiratory infections can trigger acute myocardial infarction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes an endotheliopathy that leads to some patients to thrombotic microangiopathy and microcirculatory impairment. We evaluated the association between laboratory-confirmed SARS-CoV-2 disease and the incidence of myocardial infarction. Also, we assessed the management of acute myocardial infarction during the COVID-19 pandemic. Methods: We compared the incidence of acute myocardial infarction (CIE 10: I21) between March 1st and May 31st in the years 2019 and 2020 in a 280-bed University Affiliated Hospital in Eastern Spain. To evaluate the association between laboratory-confirmed SARS-CoV-2 infection and hospitalization for acute myocardial infarction we defined the “risk interval” as the first seven days after respiratory specimen collection. We compared patients and procedural characteristics before or after COVID-19. Results: In 2019, we recorded 50 patients with acute myocardial infarction among 3261 adult hospitalizations (incidence rate of 1.53 per 100 admissions;95% CI: 1.15-2.00). In 2020, we recorded 35 patients with acute myocardial infarction among 2268 adult hospitalizations (incidence rate of 1.54 per 100 admissions;95% CI 1.09-2.12) (P= 0.97). Only 1 (0.4%) out of 245 patients with confirmed SARS-CoV-2 infection had an acute myocardial infarction. We found an increase in time from symptoms onset to reperfusion time in the COVID-19 period. Conclusions: We did not find a significant association between SARS-CoV-2 infection and acute myocardial infarction. Nevertheless, procedural characteristics were affected during the COVID-19 period.