The Association between Post-COVID-19 Myocardial Infarction and Antiphospholipid Syndrome

Mohammed, Abdallah Elaiw; Abd Elwahab, Nada Mohamed; Mahmoud, Hossam E.M.; Sayed, Reham Farouq

doi:10.21608/svuijm.2023.233228.1674

The Association between Post-COVID-19 Myocardial Infarction and Antiphospholipid Syndrome

Document Type : Original research articles

Authors

¹ Clinical &Chemical Pathology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

² Internal Medicine Department, Cardiology division, Faculty of Medicine, South Valley University, Qena, Egypt.

10.21608/svuijm.2023.233228.1674

Abstract

Background: Post-COVID-19 introduces various health challenges, including myocardial infarction (MI) linked to inflammation and coagulation, raising concerns for antiphospholipid syndrome (APS) patients. Elevated APS-related antibodies in some COVID-19 patients underscore the need for a comprehensive understanding of this cardiovascular interplay.
Objectives: To determine the association between Post-COVID-19 and Myocardial Infarction and Antiphospholipid Syndrome.
Patients and methods: This case-control study at Qena University Hospital explored the relationship between post-COVID-19 MI and APS, considering immune responses, genetics, and coexisting factors. Criteria included COVID-19 history, and MI symptoms, excluding certain conditions. Assessments included PCR, inflammatory markers, troponin I, coagulation profile, and specific antibody tests to detect Anticardiolipin-IgG, Anticardiolipin-IGM, anti nuclear anibody (ANA), and Anti-Double Strand (anti-DS).
Results: Gender differences weren't significant (p = 0.0691). Lab data showed significant ESR and CRP elevation in cases (p<0.0001, p=0.00767), and non-significant differences in serum calcium, platelet Count, hematocrit, and INR, with higher troponin I in cases (p=0.04349). Lupus anticoagulant levels were slightly higher in cases (p = 0.05148), while APS presence differed significantly (p = 0.000051). APS patients had more COVID-19 history (p = 0.000051). Among other parameters, ESR, and CRP correlated positively with APS, and D-dimer correlated with MI (r = 0.496, p < 0.0001).
Conclusion: APS was significantly associated with Post-COVID-19 Myocardial Infarction. Elevated antiphospholipid antibodies, altered laboratory parameters, and a higher history of COVID-19 infection were observed in MI cases after COVID-19. This suggests a potential link between APS and MI in COVID-19 recovery.

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