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Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh; Biosecurity Research Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh.
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2021 (Engelska)Ingår i: Open heart, E-ISSN 2053-3624, Vol. 8, nr 1, artikel-id e001617Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
BMJ Publishing Group Ltd, 2021. Vol. 8, nr 1, artikel-id e001617
Nyckelord [en]
COVID-19, NSTEMI, STEMI
Nationell ämneskategori
Infektionsmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-90984DOI: 10.1136/openhrt-2021-001617ISI: 000637320900001PubMedID: 33811137Scopus ID: 2-s2.0-85103757614OAI: oai:DiVA.org:oru-90984DiVA, id: diva2:1544064
Anmärkning

Funding Agency:

Örebro University, Sweden - Sanofi Pasteur  

Tillgänglig från: 2021-04-14 Skapad: 2021-04-14 Senast uppdaterad: 2024-01-16Bibliografiskt granskad

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Cajander, SaraFröbert, Ole
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