Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms
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...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001617.full |
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| author | Ole Fröbert Mustafizur Rahman C Raina MacIntyre Zubair Akhtar Fahmida Chowdhury Mohammad Abdul Aleem Probir Kumar Ghosh Mahmudur Rahman Mohammad Enayet Hossain Mariya Kibtiya Sumiya A K M Monwarul Islam Mir Jamal Uddin Sara Cajander |
| author_facet | Ole Fröbert Mustafizur Rahman C Raina MacIntyre Zubair Akhtar Fahmida Chowdhury Mohammad Abdul Aleem Probir Kumar Ghosh Mahmudur Rahman Mohammad Enayet Hossain Mariya Kibtiya Sumiya A K M Monwarul Islam Mir Jamal Uddin Sara Cajander |
| author_sort | Ole Fröbert |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-06615ea45bbf414d9a493d559352c35c |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-06615ea45bbf414d9a493d559352c35c2025-08-20T02:14:02ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2021-001617Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptomsOle Fröbert0Mustafizur Rahman1C Raina MacIntyre2Zubair Akhtar3Fahmida Chowdhury4Mohammad Abdul Aleem5Probir Kumar Ghosh6Mahmudur Rahman7Mohammad Enayet Hossain8Mariya Kibtiya Sumiya9A K M Monwarul Islam10Mir Jamal Uddin11Sara Cajander12Department of Clinical Medicine, Aarhus University Health, Aarhus, DenmarkInfectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladeshprofessor and programme headInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, Bangladesh1UCL Queen Square Institute of Neurology, London, UKInfectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshDepartment of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, BangladeshDepartment of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, BangladeshDepartment of Infectious Diseases, Orebro University, Orebro, SwedenObjective 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.https://openheart.bmj.com/content/8/1/e001617.full |
| spellingShingle | Ole Fröbert Mustafizur Rahman C Raina MacIntyre Zubair Akhtar Fahmida Chowdhury Mohammad Abdul Aleem Probir Kumar Ghosh Mahmudur Rahman Mohammad Enayet Hossain Mariya Kibtiya Sumiya A K M Monwarul Islam Mir Jamal Uddin Sara Cajander Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms Open Heart |
| title | Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
| title_full | Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
| title_fullStr | Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
| title_full_unstemmed | Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
| title_short | Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
| title_sort | undiagnosed sars cov 2 infection and outcome in patients with acute mi and no covid 19 symptoms |
| url | https://openheart.bmj.com/content/8/1/e001617.full |
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