Acute myocardial infarction in COVID-19 patients. A review of cases in the literature
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Department of Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Jamshoro, Pakistan
Department of Internal Medicine, Guru Gobind Singh Medical College and Hospital, Punjab, India
Department of Pediatrics, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Submission date: 2021-07-28
Final revision date: 2021-08-31
Acceptance date: 2021-08-31
Publication date: 2021-09-20
Arch Med Sci Atheroscler Dis 2021;6(1):169-175
COVID-19 is an ongoing pandemic that has lasted more than a year. Patients with multiple comorbidities such as diabetes, hypertension, and smoking have been shown to be at increased risk of a more severe course and lethal outcome. Since the disease can also lead to a hypercoagulable state, several cases of acute myocardial infarction (AMI) have also been recorded.

Material and methods:
We searched PubMed/Medline for case reports of AMI occurring in COVID-19 positive patients using “acute myocardial infarction”, “COVID-19”, and “SARS-CoV-2” as keywords.

Thirty-three articles covering 37 patients were identified, among which 30 (81.1%) were male, and 7 (18.9%) were females. The mean age of these 37 patients was 52.8 ±15.6 years. Most cases were from the United States (17 cases, 45.9%). Several comorbidities such as hypertension (16 cases, 43.2%), diabetes (14 cases, 37.8%), smoking (8 cases, 21.6%), obesity (3 cases, 8.1%), morbid obesity (1 case, 2.7%), and elevated lipid levels (4 cases, 10.8%) were also identified. The most common symptom of AMI was chest tightness (22 cases, 59.5%), while the most common symptoms for COVID-19 were dyspnoea (25 cases, 67.6%) and fever (22 cases, 59.5%). The mortality rate was 35.1%.

Given the high mortality rate, physicians are encouraged to properly check for signs of cardiac dysfunction and possible AMI while treating COVID-19 positive patients with several comorbidities or previous history of AMI.

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