Clinical and laboratory manifestations of COVID-19 combined with myocardial infarction

The article is devoted to the study of clinical and laboratory aspects of the new coronavirus infection COVID-19, combined with myocardial infarction. Materials and methods. A retrospective analysis of inpatient records of patients with COVID-19 and myocardial infarction hospitalized in 2022–2023 in the cardiac resuscitation and intensive care department of the State Budgetary Healthcare Institution of the Republic of Mordovia “Republican Clinical Hospital No. 4” in Saransk was carried out. General clinical indicators (biochemical, coagulogram), instrumental research data (electrocardiogram, coronarogram, echocardiography, computed tomography) were studied, statistical analysis was performed. Objective: To study the clinical picture and results of laboratory and instrumental studies in patients with a new coronavirus infection combined with myocardial infarction. Research results and conclusion. We found that myocardial infarction developed more often in the older age group (75 %) and in half of the cases had anterior-septal-apical-lateral localization, occurring with the same frequency both simultaneously with the onset of COVID-19 and 1–2 weeks after the disease and in the absence of COVID-19 symptoms (laboratory-confirmed cases). Myocardial infarction was most often manifested by burning/pressing pain behind the sternum, shortness of breath, sudden onset of lower limb edema, and a feeling of shortness of breath. With the development of myocardial infarction, complications developed: postinfarction aneurysm, pulmonary edema, cardiogenic shock, as well as various rhythm disturbances: paroxysmal atrial fibrillation, complete right bundle branch block, ventricular fibrillation, first degree atrioventricular block, paroxysmal supraventricular tachycardia, and supraventricular extrasystole. It was important to establish multimorbidity in patients with myocardial infarction – a combination of cardiovascular diseases with diabetes and obesity. The Charlson comorbidity index (as a method for assessing the risk of death in the presence of comorbid pathology) in men reached maximum (7 points) at the age of 70–79 years, in women – in the group of 80–89 years (9 points). The laboratory studies revealed an increased level of D-dimer, ferritin, myoglobin, C-reactive protein, troponin, and lactate dehydrogenase, which confirmed the presence of hypercoagulation and acute myocardial injury.

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