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Abstract There have been numerous reports of cardiovascular involvement since the severe coronavirus disease 2019 (COVID-19) outbreak in early 2020, including acute coronary syndrome and other cardiac complications. COVID-19 is caused by SARS-CoV-2 and has been shown to predispose patients to a pro thrombotic state, involving both the venous and arterial circulations as well as both micro vascular and macro vascular systems and this pro thrombotic state has been shown to be associated with poor prognosis in patients with COVID-19 pneumonia The SARS-CoV-2 virus is known to cause direct myocardial injury and induce arrhythmias and acute coronary syndromes (ACS) through various mechanisms; they include the direct invasion of myocardial cells by the virus, stress-induced cardiomyopathy, ischemic injury caused by atherosclerotic plaque rupture, cytokine storm-induced inflammatory response, and hypoxia created by severe lung involvement. So, this study was conducted as a retrospective cohort study at Suez Canal University hospitals, involving 94 participants divided into 2 groups: group 1 (STEMI patients who had COVID-19) and group 2 (STEMI patients who not had COVID-19) aiming to understand the association between COVID- 19 and STEMI outcome. Data was collected from all subjects who fulfill the inclusion and exclusion criteria reviewing the patients’ retrospective data on records from January 2020 to June 2022 and data included patient demographics (age, gender), comorbidities, existing medications, laboratory tests (complete blood count-coagulation profile and D-Dimer- CRP- CK, CK-MB,Troponin I ,LDH, serum ferritin, serum sodium |