Comparison of Coronary Artery Involvement and Mortality in STEMI Patients With and Without SARS-CoV-2 During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Ravi A. Thakker, Ayman Elbadawi, Khaled F. Chatila, Sachin S. Goel, David Reynoso, Rafic F. Berbarie, Syed Gilani, Umamahesh Rangasetty, Wissam Khalife

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Background: Cardiovascular injury with SARS-CoV-2 infection is well known. Several studies have outlined baseline characteristics in patients presenting with STEMI and SARS-CoV-2. Paucity in data exists in selective coronary involvement in patients with STEMI and SARS-CoV-2 during the COVID-19 pandemic. Methods: A systematic search and meta-analysis of studies meeting the inclusion and exclusion criteria obtained from MEDLINE, Scopus, and Cochrane databases was performed utilizing PRISMA criteria. The main outcome was likelihood of coronary artery involvement among patients with STEMI and SARS-CoV-2 versus without SARS-CoV-2. The primary adverse outcome measured was in-hospital mortality.Results: The final analysis included 5 observational studies with a total of 2,266 patients. There was no statistical significance in LM (OR 1.40; 95% CI: 0.68, 2.90), LAD (OR 1.09; 95% CI 0.83, 1.43), LCX (OR 1.17; 95% CI: 0.75, 1.85), or RCA (OR 0.59; 95% CI: 0.30, 1.17) disease among the 2 groups. LAD disease was the most prevalent coronary involvement among patients with STEMI and SARS-CoV-2 (49.6%). Higher in-hospital mortality was observed in the STEMI and SARS-CoV-2 group (OR 5.24; 95% CI: 3.63, 7.56). Conclusions: Our analysis demonstrated no statistical significance in selective coronary involvement in patients with STEMI and SARS-CoV-2 during the COVID-19 pandemic. The higher mortality among patients with SARS-CoV-2 and STEMI has been noted in prior studies with concerns being late presentation due to fear of infection, delayed care time, and poor resource allocation. Focus should be placed on identifying and managing comorbidities to reduce mortality.

Original languageEnglish (US)
Article number101032
JournalCurrent Problems in Cardiology
Volume47
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • (CAD), coronary artery disease
  • (COVID-19), coronavirus disease 2019
  • (LAD), left anterior descending
  • (LCX), left circumflex
  • (LM), left main
  • (OR), odds ratio
  • (PRISMA), Preferred Reporting Items for Systematic Reviews and Meta-Analyses
  • (RCA), right coronary artery
  • (SARS-CoV-2), severe acute respiratory syndrome coronavirus 2
  • (STEMI), ST segment elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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