ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) infection has changed everyday clinical practice with a shortage of solid data about its implications on ST-elevation myocardial infarction (STEMI) patients. Aim: To evaluate the impact of COVID-19 on six-month clinical outcomes of patients with STEMI and determine the mortality predictors after STEMI during the COVID-19 pandemic. Methods: This prospective observational study was conducted on consecutive STEMI patients with confirmed COVID-19 infection who were presented to our hospital between April and October 2021. A total of 74 COVID-19 patients were included (group I) and were compared to 148 STEMI patients with matched baseline clinical parameters to the COVID-19 cases (group II). We compared the two cohorts' rates of major adverse cardiovascular events (MACEs;composite of death from any cause, recurrent MI, target-vessel revascularization, and stroke) at six months. Results: COVID-19 STEMI patients were more likely to present with angina equivalent symptoms, had higher Killip class at admission, and higher levels of high-sensitive cardiac Troponin T and serum C-reactive Protein. The six-month rates of MACEs were significantly higher in STEMI patients with COVID-19 compared to non- COVID-19 patients (41.9% vs. 16.9%, respectively;P<0.001) and were mainly due to higher in-hospital mortality (20.3% vs. 6.1%, respectively;P=0.001). The independent predictors of Six-month mortality in STEMI patients during the COVID-19 pandemic were the absence of ST resolution, low systolic blood and higher Killip class on admission, presence of severe MR and atrial fibrillation, and anterior wall STEMI. Conclusion: STEMI patients with superimposed COVID -19 infection had worse clinical outcomes with almost three times higher in-hospital mortality and six-month MACEs.