In collaboration with the National Institute of cardiovascular diseases (NICVD) hospital and Orebro University of Sweden, icddr, b have conducted research to determine the prevalence and three-month outcomes of SARS-CoV-2 infection in patients with myocardial infarction who do not meet the World Health Organization’s (WHO) clinical criteria for suspected COVID-19 (e.g. fever, cough, sneezing etc).

According to the National Heart, Lung and Blood Institute of the United States, myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.

COVID-19, caused by infection with the SARS-CoV-2 virus, is associated with symptoms such as fever, cough, shortness of breath and pneumonia which may ultimately lead to death. Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.

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Aside from the symptoms mentioned previously, the COVID-19 can be related to cardiac events such as coronary thrombosis and cardiac arrests.

The study in question, which has been reported on the icddr, b website, was conducted during the first wave of the COVID-19 pandemic when the Bangladesh daily testing positivity rate was at a peak of around 20%.

Between June to August 2020, the study enrolled 280 patients with myocardial infarction and between the ages of 23–95 at the NICVD. Of the total, 220 (79%) patients were male.

Among the 280 participants, asymptomatic COVID-19 positivity in patients was 13%. Furthermore, generalised weakness was found as the second most frequent reported symptom (47%) and was significantly more often among SARS-CoV-2 infected participants.

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After three months, a slightly higher mortality was observed among SARS-CoV-2 positive patients compared with SARS-CoV-2 negative patients (14% vs 11%). Moreover, the proportion of recurrent MIs was numerically higher (5%) vs (3%) among SARS-CoV-2 negative participants.

The study reportedly found a substantial rate of undiagnosed SARS-CoV-2 infection (COVID-19) in patients with MI who would not have been routinely tested because they do not meet the WHO criteria for COVID-19 symptoms.  

The findings highlight the need for screening of all patients with myocardial infarction and adopting preventive measures for frontline healthcare workers, including cardiologists, to avoid spread of COVID-19 in hospital environments.