Looking at the coronary-focused studies, the NACMI (North American COVID STEMI) registry was a collaborative effort between SCAI, Canadian Association of Interventional Cardiology (CAIC) and the American College of Cardiology (ACC). The goal of the registry was to develop a multi-center database of COVID-19 positive individuals or patients under investigation (PUI’s) presenting with ST elevation or new onset of left bundle branch block (LBBB) and compare them to a sex and aged-matched cohort from the Midwest STEMI Consortium. The registry was the largest COVID positive STEMI registry to date and included 64 sites across North America. Patients with COVID positive ST-elevation were more frequently Black, Hispanics and diabetics, more likely to present with cardiogenic shock and had lower EF compared to the control group. Primary PCI was used in 71% with similar door to balloon time to controls, and thrombolytics were given in only 6%. Mortality in COVID patients (32%) was far better than that reported in the New York series. These data suggest that primary PCI can be quickly and effectively used in COVID patients and appears to be the preferred treatment strategy.