Milošević, Aleksandra D. (56622640900)Aleksandra D. (56622640900)MiloševićPolovina, Marija M. (35273422300)Marija M. (35273422300)PolovinaJelic, Dario D. (57201640680)Dario D. (57201640680)JelicSimic, Damjan D. (58010380500)Damjan D. (58010380500)SimicViduljevic, Mihajlo M. (57266248400)Mihajlo M. (57266248400)ViduljevicMatic, Dragan M. (25959220100)Dragan M. (25959220100)MaticTomic, Milenko M. (58629586600)Milenko M. (58629586600)TomicAdzic, Tatjana N. (23099138200)Tatjana N. (23099138200)AdzicAsanin, Milika R. (8603366900)Milika R. (8603366900)Asanin2025-06-122025-06-122024https://doi.org/10.1177/08850666241232938https://www.scopus.com/inward/record.uri?eid=2-s2.0-85186262861&doi=10.1177%2f08850666241232938&partnerID=40&md5=4fb8797b4d8dec6577c1f319dd2f373ehttps://remedy.med.bg.ac.rs/handle/123456789/992Background: Patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19 infection have a worse clinical course and prognosis. The prognostic significance of the timing of STEMI in relation to COVID-19 infection was not investigated. Objectives: To assess whether the time of STEMI development in relation to COVID-19 infection (concurrent or following the infection) influenced the short-term prognosis. Methods: This was an observational study of consecutive COVID-19 patients with STEMI admitted to the COVID-hospital Batajnica (February 2021–March 2022). The patients were divided into the “STEMI first” group: patients with STEMI and a positive polymerase chain reaction test for COVID-19, and the “COVID-19 first” group: patients who developed STEMI during COVID-19 treatment. All patients underwent coronary angiography. The primary endpoint was in-hospital all-cause mortality. Results: The study included 87 patients with STEMI and COVID-19 (Mage, 66.7 years, 66% male). The “STEMI first” group comprised 54 (62.1%) patients, and the “COVID-19 first” group included 33 (37.9%) patients. Both groups shared a comparatively high burden of comorbidities, similar angiographic and procedural characteristics, and high percentages of performed percutaneous coronary interventions with stent implantation (90.7% vs. 87.9%). In-hospital mortality was significantly higher in the “COVID-19 first” group compared to the “STEMI first” group (51.5% vs. 27.8%). Following adjustment, the “COVID-19 first” group had a hazard ratio of 3.22 (95% confidence interval, 1.18–8.75, p =.022) for in-hospital all-cause death, compared with the “STEMI first” group (reference). Conclusion: Clinical presentation with COVID-19 infection, followed by STEMI (“COVID-19 first”), was associated with greater short-term mortality compared to patients presenting with STEMI and testing positive for COVID-19 (“STEMI first”). © The Author(s) 2024.all-cause mortalityCOVID-19outcomeprimary percutaneous coronary interventionprognosisST-segment elevation myocardial infarction