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Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh; Biosecurity Research Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
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2021 (English)In: Open heart, E-ISSN 2053-3624, Vol. 8, no 1, article id e001617Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: We aimed to determine the prevalence and outcome of occult infection with SARS-CoV-2 and influenza in patients presenting with myocardial infarction (MI) without COVID-19 symptoms.

METHODS: We conducted an observational study from 28 June to 11 August 2020, enrolling patients admitted to the National Institute of Cardiovascular Disease Hospital, Dhaka, Bangladesh, with ST-segment elevation MI (STEMI) or non-ST-segment elevation MI who did not meet WHO criteria for suspected COVID-19. Samples were collected by nasopharyngeal swab to test for SARS-CoV-2 and influenza virus by real-time reverse transcriptase PCR. We followed up patients at 3 months (13 weeks) postadmission to record adverse cardiovascular outcomes: all-cause death, new MI, heart failure and new percutaneous coronary intervention or stent thrombosis. Survival analysis was performed using the Kaplan-Meier method.

RESULTS: We enrolled 280 patients with MI, 79% male, mean age 54.5±11.8 years, 140 of whom were diagnosed with STEMI. We found 36 (13%) to be infected with SARS-CoV-2 and 1 with influenza. There was no significant difference between mortality rate observed among SARS-CoV-2 infected patients compared with non-infected (5 (14%) vs 26 (11%); p=0.564). A numerically shorter median time to a recurrent cardiovascular event was recorded among SARS-CoV-2 infected compared with non-infected patients (21 days, IQR: 8-46 vs 27 days, IQR: 7-44; p=0.378).

CONCLUSION: We found a substantial rate of occult SARS-CoV-2 infection in the studied cohort, suggesting SARS-CoV-2 may precipitate MI. Asymptomatic patients with COVID-19 admitted with MI may contribute to disease transmission and warrants widespread testing of hospital admissions.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021. Vol. 8, no 1, article id e001617
Keywords [en]
COVID-19, NSTEMI, STEMI
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-90984DOI: 10.1136/openhrt-2021-001617ISI: 000637320900001PubMedID: 33811137Scopus ID: 2-s2.0-85103757614OAI: oai:DiVA.org:oru-90984DiVA, id: diva2:1544064
Note

Funding Agency:

Örebro University, Sweden - Sanofi Pasteur  

Available from: 2021-04-14 Created: 2021-04-14 Last updated: 2024-01-16Bibliographically approved

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Cajander, SaraFröbert, Ole

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