Background: Since COVID-19 is also associated with hypercoagulation and thrombosis, multiple early reports and questions were raised about the likely increased risk of acute myocardial infarction (AMI) developing in patients with risk factors. Present study was aimed to compare the outcome of COVID 19 positive and COVID 19 negative STEMI (ST elevation myocardial infarction) during covid pandemic. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients presenting with symptoms of acute myocardial infarction and ECG diagnosis of acute STEMI (ST elevation myocardial infarction), RTPCR was done on admission, patients were shifted to COVID ICU if report was positive. Results: In this present study 154 patients were studied. 

Majority of them were from the 51-60 years age group. Out of the all-risk factors, IHD (pvalue=0.049) and OLD PVD (p-value=0.024) in covid (+) are significantly more than covid (-) patients. Single PTCA and multivessel PTCA are slightly more in Covid (-) patients as compared to covid (+) patients. There was no significant difference in complications of Covid positive and Covid negative STEMI as treated promptly with pharmacoinvasive treatment i.e., thrombolysis on admission then planned PTCA. Covid (+) patients needed more inotropes than covid (-) group. Use of BIPAP ventilation was more in covid positive patients. In covid (-), there are 34 (27 %) cardiogenic shock patients and in covid (+) there are 9 (33%) cardiogenic shock patients. Significantly more deaths in Covid positive cardiogenic shock patients. Significantly more angioplasty done in Covid negative group. 

One year follow up Mortality was 2.3% and 7.4% in Covid negative and positive groups respectively. 1.5 year follow up Mortality was 3.7% and 4.7% in Covid positive and negative groups respectively Conclusion: Covid positive patients needed more inotropes, more Thrombotic lesions, more use of BIPAP ventilation, more deaths in covid positive cardiogenic shock patients as compared to covid negative cardiogenic shock patients.