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Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms.
Akhtar, Zubair; Chowdhury, Fahmida; Aleem, Mohammad Abdul; Ghosh, Probir Kumar; Rahman, Mahmudur; Rahman, Mustafizur; Hossain, Mohammad Enayet; Sumiya, Mariya Kibtiya; Islam, A K M Monwarul; Uddin, Mir Jamal; MacIntyre, C Raina; Cajander, Sara; Frobert, Ole.
  • Akhtar Z; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh zakhtar@icddrb.org.
  • Chowdhury F; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Aleem MA; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Ghosh PK; Biosecurity Research Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
  • Rahman M; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Rahman M; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Hossain ME; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Sumiya MK; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Islam AKMM; Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
  • Uddin MJ; Department of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, Bangladesh.
  • MacIntyre CR; Department of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, Bangladesh.
  • Cajander S; Biosecurity Research Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
  • Frobert O; Department of Infectious Diseases, Orebro University, Orebro, Sweden.
Open Heart ; 8(1)2021 04.
Article in English | MEDLINE | ID: covidwho-1166562
ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Non-ST Elevated Myocardial Infarction / ST Elevation Myocardial Infarction / Undiagnosed Diseases / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Year: 2021 Document Type: Article Affiliation country: Openhrt-2021-001617

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Non-ST Elevated Myocardial Infarction / ST Elevation Myocardial Infarction / Undiagnosed Diseases / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Year: 2021 Document Type: Article Affiliation country: Openhrt-2021-001617