Previous meta-analyses have focused on investigating the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on outcomes in STEMI patients. We aimed to examine the outcomes and prognosis following ST-segment elevation myocardial infarction (STEMI) among those with COVID-19 compared with those without COVID-19.
PubMed and Embase were searched from inception till November 2021. We included only those studies that compared our primary outcome, in-hospital mortality, between COVID-19-positive and COVID-19-negative cohorts with primarily out-of-hospital STEMI. We conducted a random-effects meta-analysis to investigate the association between COVID-19 infection and mortality as well as other clinical outcomes.
A total of 11 observational studies were included in our meta-analysis. Most of the studies were of sufficiently high quality. Our findings show that a diagnosis of COVID-19 in STEMI patients is associated with a large increase in mortality (OR 4.07; 95% CI: 2.48-6.69) and poorer clinical outcomes but with no increase in door-to-balloon (D2B) time (MD 9.45 minutes, 95% CI: -1.25 to 20.15 minutes).
In this meta-analysis, a diagnosis of COVID-19 was found to greatly increase the risk of mortality. An early assessment of COVID-19 status in STEMI patients is needed followed by urgent management.