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'In the COVID-19 era…’ is a refrain that, in a few short months, has become one of the most well-worn catchphrases in medical literature, such has been the unprecedented impact of the current pandemic. The imperative to gain an understanding of, and identify treatments for, COVID-19 in a time-critical fashion has brought both the best and worst of medical research to the fore. Expeditious approaches to data dissemination have been adopted, including a surge in data submitted to preprint repositories, while the feasibility of rapid, pragmatic and well-conducted multicentre randomised controlled trials has been amply demonstrated. Conversely, we have seen the potential negative consequences of inaccurate or spurious studies that emerge despite the traditional bastion of peer review. In between these two extremes lie a host of observational data of varying clinical utility.
It is within this middle spectrum that most current studies related to cardiology and COVID-19 reside. It is fair to say that direct cardiac sequelae of COVID-19 were not initially of paramount clinical concern, given that it is primarily a respiratory illness. Latterly, there has been intense debate on social media and in the press regarding the possibility of myocardial involvement, whether this is unique to SARS-CoV-2 infection as opposed to other respiratory viral illnesses, and whether this holds any clinical relevance. Perhaps more quantifiable has been the effect of COVID-19 and subsequent mitigation strategies on the routine workload and case mix of day-to-day acute cardiology, of which myocardial infarction forms a large, and familiar, part. As cardiologists, the management of acute myocardial ischaemia is at the heart of our clinical practice, and urgent invasive management—rightly or wrongly—often takes precedence over other concomitant ailments. At the time of writing, a Pubmed search for articles including the terms ‘COVID-19’ and ‘myocardial infarction’ in the title returned 104 results …