Concurrent Stroke and Myocardial Infarction After Mild COVID-19 Infection

Introduction: The concurrency of both, acute stroke and acute myocardial infarction in normal conditions, outside the pandemic is rare. Coagulopathy has been associated with the inflammatory phase of coronavirus disease (COVID-19) and might be involved in this concurrency. Cases Report: We describe 2 patients with previous mild or no symptoms of COVID-19, admitted for acute stroke with recent/simultaneous myocardial infarction in whom admission polymerase chain reaction was negative but serologic testing diagnosed COVID-19. In these patients, concurrent stroke and myocardial infarction could have been promoted by COVID-19 infection. Management and evolution are detailed, and their contacts to confirm the COVID-19 infection. Pathogenic analysis of possible hypercoagulation state is described suggesting the hypothesis of endothelial dysfunction as the strongest mechanism involved in thrombus formation after the acute phase of COVID-19 infection. Conclusions: Our experience with these cases suggests that patients with mild symptoms can also present thromboembolic complications once the acute phase of COVID-19 infection has passed.

Automated summary

The article describes two cases of patients with mild or asymptomatic COVID-19 symptoms who developed acute stroke and concurrent myocardial infarction, despite negative PCR tests but confirmed through serological testing. This suggests that COVID-19 infection may promote the simultaneous occurrence of stroke and myocardial infarction.