tetano
Editor, Senior Moderator
J Community Hosp Intern Med Perspect
. 2022 Sep 9;12(4):17-24.
doi: 10.55729/2000-9666.1103. eCollection 2022.
COVID-19 Positive Status is Associated with Increased In-hospital Mortality in Patients with Acute Myocardial Infarction: A Systematic Review and Meta-analysis
Nischit Baral[SUP] 1 [/SUP], Waiel Abusnina[SUP] 2 [/SUP], Shravya Balmuri[SUP] 1 [/SUP], Amith Seri[SUP] 1 [/SUP], Soumya Kambalapalli[SUP] 1 [/SUP], Prem R Parajuli[SUP] 3 [/SUP], Basel Abdelazeem[SUP] 1 [/SUP], Krishna P Bashyal[SUP] 1 [/SUP], Niranjan Ojha[SUP] 4 [/SUP], Bidhya Timilsina[SUP] 5 [/SUP], Timir K Paul[SUP] 6 [/SUP]
Affiliations
Abstract
Patients hospitalized for acute myocardial infarction (AMI) may have concomitant positive coronavirus disease 2019 (COVID-19). We aimed to compare the risk of in-hospital mortality in patients primarily hospitalized for AMI with or without concomitant COVID-19 positive status. Using the random-effects model, we conducted a systematic review and meta-analysis of published articles from December 1, 2019, to April 1, 2022. There were eight studies with 10,128 patients, including 612 patients with COVID and 9516 patients without COVID. A total of 261 patients (42.64%) with COVID-19 positive and 612 patients (6.43%) with negative COVID-19 status died in the hospital. Pooled data showed that patients with a primary diagnosis of AMI with COVID-19 infection had more than five times increased risk of in-hospital mortality compared to patients without COVID-19 (OR: 5.06, 95% CI: 3.61, 7.09; I[SUP]2[/SUP] = 35%, P < 0.001). However, pooled data from five studies with adjustment of baseline differences in patient demographics and characteristics, comorbidities, and in-hospital pharmacology revealed more than three times increased risk of in-hospital mortality compared to patients who had primary AMI without COVID-19 infection (aOR: 3.47, 95% CI: 2.21, 5.45; I[SUP]2[/SUP] = 0%, P < 0.001). In subgroup analysis, ST-elevation myocardial infarction (STEMI) had lower in-hospital mortality (OR 4.23, 95% CI: 3.31, 5.40; I[SUP]2[/SUP] = 0%, P < 0.001) compared to non-ST-segment elevation myocardial infarction (NSTEMI) (OR 9.97, 95% CI: 5.71, 17.41; I[SUP]2[/SUP] = 0%, P < 0.001) (p-value = 0.006). Our study shows that COVID-19 infection is associated with increased in-hospital mortality in patients with index hospitalization for AMI.
Keywords: Acute myocardial infarction; COVID-19; In-hospital mortality; Meta-analysis; Systematic review.
. 2022 Sep 9;12(4):17-24.
doi: 10.55729/2000-9666.1103. eCollection 2022.
COVID-19 Positive Status is Associated with Increased In-hospital Mortality in Patients with Acute Myocardial Infarction: A Systematic Review and Meta-analysis
Nischit Baral[SUP] 1 [/SUP], Waiel Abusnina[SUP] 2 [/SUP], Shravya Balmuri[SUP] 1 [/SUP], Amith Seri[SUP] 1 [/SUP], Soumya Kambalapalli[SUP] 1 [/SUP], Prem R Parajuli[SUP] 3 [/SUP], Basel Abdelazeem[SUP] 1 [/SUP], Krishna P Bashyal[SUP] 1 [/SUP], Niranjan Ojha[SUP] 4 [/SUP], Bidhya Timilsina[SUP] 5 [/SUP], Timir K Paul[SUP] 6 [/SUP]
Affiliations
- PMID: 36348971
- PMCID: PMC9586181
- DOI: 10.55729/2000-9666.1103
Abstract
Patients hospitalized for acute myocardial infarction (AMI) may have concomitant positive coronavirus disease 2019 (COVID-19). We aimed to compare the risk of in-hospital mortality in patients primarily hospitalized for AMI with or without concomitant COVID-19 positive status. Using the random-effects model, we conducted a systematic review and meta-analysis of published articles from December 1, 2019, to April 1, 2022. There were eight studies with 10,128 patients, including 612 patients with COVID and 9516 patients without COVID. A total of 261 patients (42.64%) with COVID-19 positive and 612 patients (6.43%) with negative COVID-19 status died in the hospital. Pooled data showed that patients with a primary diagnosis of AMI with COVID-19 infection had more than five times increased risk of in-hospital mortality compared to patients without COVID-19 (OR: 5.06, 95% CI: 3.61, 7.09; I[SUP]2[/SUP] = 35%, P < 0.001). However, pooled data from five studies with adjustment of baseline differences in patient demographics and characteristics, comorbidities, and in-hospital pharmacology revealed more than three times increased risk of in-hospital mortality compared to patients who had primary AMI without COVID-19 infection (aOR: 3.47, 95% CI: 2.21, 5.45; I[SUP]2[/SUP] = 0%, P < 0.001). In subgroup analysis, ST-elevation myocardial infarction (STEMI) had lower in-hospital mortality (OR 4.23, 95% CI: 3.31, 5.40; I[SUP]2[/SUP] = 0%, P < 0.001) compared to non-ST-segment elevation myocardial infarction (NSTEMI) (OR 9.97, 95% CI: 5.71, 17.41; I[SUP]2[/SUP] = 0%, P < 0.001) (p-value = 0.006). Our study shows that COVID-19 infection is associated with increased in-hospital mortality in patients with index hospitalization for AMI.
Keywords: Acute myocardial infarction; COVID-19; In-hospital mortality; Meta-analysis; Systematic review.