Association Between COVID-19 Diagnosis and In-Hospital Mortality in Patients Hospitalized With ST-Segment Elevation
Marwan Saad1, Kevin F Kennedy2, Hafiz Imran1
1Division of Cardiology, Warren Alpert Medical School of Brown University, Lifespan Cardiovascular Institute, Providence, Rhode Island.
JAMA
|October 29, 2021
Summary
Patients with ST-elevation myocardial infarction (STEMI) and COVID-19 had significantly higher in-hospital mortality rates compared to those without COVID-19. This highlights the critical impact of COVID-19 on STEMI patient outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Limited research exists on the intersection of ST-elevation myocardial infarction (STEMI) and COVID-19.
- Understanding outcomes for STEMI patients with concurrent COVID-19 is crucial.
Purpose of the Study:
- To compare the characteristics, treatment, and outcomes of STEMI patients with and without COVID-19 infection.
- To assess the impact of COVID-19 on in-hospital mortality in STEMI patients.
Main Methods:
- Retrospective cohort study of over 80,000 adult STEMI patients from 509 US centers (January 2019-December 2020).
- Propensity matching was used to compare patients with active COVID-19 infection during their STEMI encounter against those without COVID-19 from the previous year.
- Primary outcome was in-hospital mortality.
Main Results:
- Among out-of-hospital STEMI patients, COVID-19 was associated with a significant increase in in-hospital mortality (15.2% vs 11.2%).
- For in-hospital STEMI patients, COVID-19 significantly increased in-hospital mortality (78.5% vs 46.1%).
- Patients with in-hospital STEMI and COVID-19 were less likely to undergo coronary procedures.
Conclusions:
- Concomitant COVID-19 diagnosis in STEMI patients is significantly associated with higher in-hospital mortality.
- Further research is needed to elucidate the mechanisms driving this increased mortality.
- These findings underscore the heightened risk for STEMI patients with COVID-19.
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