Patient and Provider Risk in Managing ST-Elevation Myocardial Infarction During the COVID-19 Pandemic: A Decision Analysis

Assessing the Frequency of COVID-19 in Patients Undergoing Primary Percutaneous Coronary Intervention (PCI)

BACKGROUND

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health crisis with significant morbidity and mortality.

OBJECTIVE

The aim of this study was to investigate the incidence of COVID-19 in patients undergoing primary percutaneous coronary intervention (PCI) for myocardial infarction and identify associated demographic and clinical characteristics.

METHODS

In this study, a retrospective and descriptive cross-sectional design was used to examine all patients (a total of 85) who experienced acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI). The study measured various parameters, such as COVID-19 status, age, sex, ethnicity, diabetes, and hypertension. Data analysis was conducted using SPSS version 25 software.

RESULTS

Out of the 85 patients who underwent primary percutaneous coronary intervention (PCI) for myocardial infarction (MI), 14 patients (16.5%) were found to have COVID-19. COVID-19 diagnosis was confirmed through RT-PCR testing for 2 patients, while the remaining 12 patients were diagnosed using lung CT scans. Among the COVID-19 patients, 21.4% (n = 3) had background diabetes, and 7.1% (n = 1) had background hypertension. MI recurrence was observed in 14.3% of COVID-19 patients (2 cases). Unfortunately, 1 COVID-19 patient, a 70- year-old Persian woman with diabetes and hypertension, passed away. No significant differences were found in terms of age, sex, ethnicity, underlying diabetes, or underlying hypertension between the COVID-19 and non-COVID-19 groups.

CONCLUSION

The high occurrence of COVID-19 among myocardial infarction (MI) patients undergoing primary percutaneous coronary intervention (PCI) is worth noting. Further investigation is recommended to explore the impact of demographic and contextual factors on the severity and outcomes of primary PCI in MI patients with COVID-19, as well as the underlying mechanisms involved.

Management of Acute Coronary Syndrome in the COVID Era

Management of acute coronary syndrome (ACS) has emerged as a challenge during the COVID-19 era. There has been a significant increase in the morbidity and mortality associated with ACS both as a direct and an indirect consequence of the pandemic. In this review, we provide an overview of the impact of COVID-19 on patients presenting with ACS and current practices for managing patients presenting with chest pain during the pandemic and for ensuring safety of healthcare professionals. We also discuss treatment strategies and post-ACS care along with current and future perspectives for management of ACS during future waves of COVID-19 infection or similar pandemics.