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

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.