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1
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Vlase CM, Gutu C, Bogdan Goroftei RE, Boghean A, Iordachi TFD, Arbune AA, Arbune M. Echocardiographic Left Ventricular Function in the Third Year After COVID-19 Hospitalization: A Follow-Up Pilot Study in South-East of Romania. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:333. [PMID: 40005449 PMCID: PMC11857121 DOI: 10.3390/medicina61020333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/21/2025] [Accepted: 02/11/2025] [Indexed: 02/27/2025]
Abstract
Background and Objectives: Cardiac involvement in COVID-19 has been confirmed during the acute stage of the infection. However, the prevalence and spectrum of post-infectious cardiac dysfunction remain incompletely clarified. The objective of our study was to evaluate the frequency of echocardiographic changes 2 years after hospitalization for moderate and severe COVID-19 in patients with no previously known cardiac pathology. Material and Methods: We conducted a retrospective cohort study analyzing severity markers of COVID-19 infection and echocardiographic parameters assessed ≥2 years after the acute illness, based on recent guideline recommended algorithm for echocardiographic diagnostic of left ventricular (LV) dysfunction. Results: The study included 50 Caucasian patients, 60% male, 54% aged < 65 years, and 32% with severe forms of the disease. The primary comorbidities were hypertension, obesity, and diabetes. COVID-19 severity correlated with the computed tomography (CT) lung lesion score and a neutrophil-to-lymphocyte ratio >6 but was not associated with post-COVID-19 echocardiographic changes. Left ventricular ejection fraction (LVEF) was reduced in only 18% of cases, but global longitudinal strain (GLS) impairment was observed in 46% of patients, contributing to the LV systolic subclinical dysfunction in 61%. Impaired LV diastolic disfunction with normal pressure filling was present in 30.61% of cases and with elevated pressure 10.2%. Conclusions: COVID-19 is an independent predictive factor for GLS impairment, which can indicate myocardial contractile dysfunction, even in patients with asymptomatic heart disease. This underscores the importance of regular echocardiographic monitoring for patients recovering from moderate to severe COVID-19.
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Affiliation(s)
- Constantin-Marinel Vlase
- Medical Clinic Department, Dunarea de Jos University, 800008 Galati, Romania; (C.-M.V.); (M.A.)
- “Dr. Aristide Serfioti” Military Emergency Hospital, 800008 Galati, Romania;
| | - Cristian Gutu
- Medical Clinic Department, Dunarea de Jos University, 800008 Galati, Romania; (C.-M.V.); (M.A.)
- “Dr. Aristide Serfioti” Military Emergency Hospital, 800008 Galati, Romania;
| | - Roxana Elena Bogdan Goroftei
- Medical Clinic Department, Dunarea de Jos University, 800008 Galati, Romania; (C.-M.V.); (M.A.)
- Clinic Emergency Children Hospital, 800487 Galati, Romania
| | - Andreea Boghean
- Doctoral School of Biomedical Sciences, Dunarea de Jos University, 800008 Galati, Romania
| | | | - Anca-Adriana Arbune
- Multidisciplinary Integrated Center for Dermatological Interface Research, 800010 Galati, Romania;
- Neurology Department, Fundeni Clinical Institute, 077086 Bucharest, Romania
| | - Manuela Arbune
- Medical Clinic Department, Dunarea de Jos University, 800008 Galati, Romania; (C.-M.V.); (M.A.)
- Infectious Diseases Clinic I, Infectious Diseases Clinic Hospital Galati, 800179 Galati, Romania
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2
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Krogulec D, Bieńkowski C, Kowalska JD, Bednarska A, Wojtycha-Kwaśnica B, Jurek N, Ząbek P, Czeszko-Paprocka H, Mrozińska M, Paciorek M, Pihowicz A, Horban A. Cardiovascular complications in the course of COVID-19 - lessons learned and implications for the future care of patients with viral respiratory diseases: Data from a single center retrospective observational study. Heart Lung 2024; 68:116-125. [PMID: 38944910 DOI: 10.1016/j.hrtlng.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/10/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Factors associated with cardiovascular complications of COVID-19 remain understudied. OBJECTIVES Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19. METHODS We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19. RESULTS Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17-1.92], p = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99-1.05], p = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37-5.70], p = 0.004), nicotinism (2.49 [1.37-4.49], p = 0.002), and eGFR<60 ml/min/1.73m2 (2.44 [1.08-5.59], p = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97-19.3], p = 0.044), hemiplegia (12.67 [3.12-46.1], p < 0.001), nicotinism (3.36 [1.30-10.4], p = 0.013) and higher C-reactive protein concentration (1.01 [1.00-1.01], p = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05-1.10], p < 0.001) and higher d-dimers (1.04 [1.02-1.05], <0.001). CONCLUSIONS The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients' populations, including a pro-active approach in diagnosis.
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Affiliation(s)
- Dominika Krogulec
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | - Carlo Bieńkowski
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
| | - Justyna D Kowalska
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | - Agnieszka Bednarska
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | | | - Natalia Jurek
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | - Piotr Ząbek
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | | | - Monika Mrozińska
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | - Marcin Paciorek
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | - Andrzej Pihowicz
- Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
| | - Andrzej Horban
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland
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3
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Zheng Q, Shen Q, Shu Z, Chang K, Zhong K, Yan Y, Ke J, Huang J, Su R, Xia J, Zhou X. Deep representation learning from electronic medical records identifies distinct symptom based subtypes and progression patterns for COVID-19 prognosis. Int J Med Inform 2024; 191:105555. [PMID: 39089210 DOI: 10.1016/j.ijmedinf.2024.105555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/17/2024] [Accepted: 07/14/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVE Symptoms are significant kind of phenotypes for managing and controlling of the burst of acute infectious diseases, such as COVID-19. Although patterns of symptom clusters and time series have been considered the high potential prediction factors for the prognosis of patients, the elaborated subtypes and their progression patterns based on symptom phenotypes related to the prognosis of COVID-19 patients still need be detected. This study aims to investigate patient subtypes and their progression patterns with distinct features of outcome and prognosis. METHODS This study included a total of 14,139 longitudinal electronic medical records (EMRs) obtained from four hospitals in Hubei Province, China, involving 2,683 individuals in the early stage of COVID-19 pandemic. A deep representation learning model was developed to help acquire the symptom profiles of patients. K-means clustering algorithm is used to divide them into distinct subtypes. Subsequently, symptom progression patterns were identified by considering the subtypes associated with patients upon admission and discharge. Furthermore, we used Fisher's test to identify significant clinical entities for each subtype. RESULTS Three distinct patient subtypes exhibiting specific symptoms and prognosis have been identified. Particularly, Subtype 0 includes 44.2% of the whole and is characterized by poor appetite, fatigue and sleep disorders; Subtype 1 includes 25.6% cases and is characterized by confusion, cough with bloody sputum, encopresis and urinary incontinence; Subtype 2 includes 30.2% cases and is characterized by dry cough and rhinorrhea. These three subtypes demonstrate significant disparities in prognosis, with the mortality rates of 4.72%, 8.59%, and 0.25% respectively. Furthermore, symptom cluster progression patterns showed that patients with Subtype 0 who manifest dark yellow urine, chest pain, etc. in the admission stage exhibit an elevated risk of transforming into the more severe subtypes with poor outcome, whereas those presenting with nausea and vomiting tend to incline towards entering the milder subtype. CONCLUSION This study has proposed a clinical meaningful approach by utilizing the deep representation learning and real-world EMR data containing symptom phenotypes to identify the COVID-19 subtypes and their progression patterns. The results would be potentially useful to help improve the precise stratification and management of acute infectious diseases.
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Affiliation(s)
- Qiguang Zheng
- School of Computer and Information Technology, Beijing Jiaotong University, China
| | - Qifan Shen
- School of Computer and Information Technology, Beijing Jiaotong University, China
| | - Zixin Shu
- School of Computer and Information Technology, Beijing Jiaotong University, China
| | - Kai Chang
- School of Computer and Information Technology, Beijing Jiaotong University, China
| | - Kunyu Zhong
- School of Computer and Information Technology, Beijing Jiaotong University, China
| | - Yuhang Yan
- School of Computer and Information Technology, Beijing Jiaotong University, China
| | - Jia Ke
- Hubei Provincial Hospital of Traditional Chinese Medicine, China
| | - Jingjing Huang
- Hubei Provincial Hospital of Traditional Chinese Medicine, China
| | - Rui Su
- Beijing Hospital of Traditional Chinese Medicine, China
| | - Jianan Xia
- School of Computer and Information Technology, Beijing Jiaotong University, China.
| | - Xuezhong Zhou
- School of Computer and Information Technology, Beijing Jiaotong University, China.
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Guarienti FA, Gonçalves JIB, Gonçalves JB, Antônio Costa Xavier F, Marinowic D, Machado DC. COVID-19: a multi-organ perspective. Front Cell Infect Microbiol 2024; 14:1425547. [PMID: 39492990 PMCID: PMC11527788 DOI: 10.3389/fcimb.2024.1425547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 09/18/2024] [Indexed: 11/05/2024] Open
Abstract
In this mini review, we explore the complex network of inflammatory reactions incited by SARS-CoV-2 infection, which extends its reach well beyond the respiratory domain to influence various organ systems. Synthesizing existing literature, it elucidates how the hyperinflammation observed in COVID-19 patients affects multiple organ systems leading to physiological impairments that can persist over long after the resolution of infection. By exploring the systemic manifestations of this inflammatory cascade, from acute respiratory distress syndrome (ARDS) to renal impairment and neurological sequelae, the review highlights the profound interplay between inflammation and organ dysfunction. By synthesizing recent research and clinical observations, this mini review aims to provide an overview of the systemic interactions and complications associated with COVID-19, underscoring the need for an integrated approach to treatment and management. Understanding these systemic effects is crucial for improving patient outcomes and preparing for future public health challenges.
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Affiliation(s)
- Fabiana Amaral Guarienti
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - João Ismael Budelon Gonçalves
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Júlia Budelon Gonçalves
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Fernando Antônio Costa Xavier
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Daniel Marinowic
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Denise Cantarelli Machado
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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5
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Krishna B, Metaxaki M, Sithole N, Landín P, Martín P, Salinas-Botrán A. Cardiovascular disease and covid-19: A systematic review. IJC HEART & VASCULATURE 2024; 54:101482. [PMID: 39189008 PMCID: PMC11345335 DOI: 10.1016/j.ijcha.2024.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/12/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024]
Abstract
Background Cardiovascular complications of COVID-19 are numerous and aspects of this phenomenon are not well known. The main objective of this manuscript is a systematic review of the acute and chronic cardiovascular complications secondary to COVID-19. Methods A systematic review of the literature through Medline via PubMed was conducted (2020-2024). Results There is a plethora of effects of COVID-19 on the heart in the acute setting. Here we discuss pathophysiology, myocardial infarctions, heart failure, Takotsubo Cardiomyopathy, myocardial injury, myocarditis and arrhythmias that are caused by COVID-19. Additionally, these cardiovascular injuries can linger and may be an underlying cause of some Long COVID symptoms. Conclusions Cardiovascular complications of COVID-19 are numerous and life-threatening. Long COVID can affect cardiovascular health. Microclotting induced by SARS-CoV-2 infection could be a therapeutic target for some aspects of Long Covid.
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Affiliation(s)
- B.A. Krishna
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - M. Metaxaki
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - N. Sithole
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- Department of Infectious Diseases, Cambridge University, Cambridge, United Kingdom
| | - P. Landín
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | - P. Martín
- Department of Respiratory Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - A. Salinas-Botrán
- Department of Infectious Diseases, Hospital Clínico San Carlos, Madrid, Spain
- Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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6
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Rouzrokh P, Rezaee M, Mohammadipour Z, Tavana S, Khaheshi I, Sheikhy A, Faghihi Langroudi T. The association of radiologic right heart strain indices with the severity of pulmonary parenchymal involvement and prognosis in patients with COVID-19. J Cardiovasc Thorac Res 2024; 16:171-178. [PMID: 39430277 PMCID: PMC11489638 DOI: 10.34172/jcvtr.33094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 07/27/2024] [Indexed: 10/22/2024] Open
Abstract
Introduction It has been demonstrated that an increase in the diameter of the right ventricle or pulmonary artery in COVID-19 patients could be associated with the severity of lung involvement and may lead to unfavorable outcomes, particularly in the presence of pulmonary vascular diseases. This study investigated the relationship between these right heart strain features, the extent of lung involvement, and their prognostic values in patients without vascular comorbidities. Methods This study selected 154 consecutive patients with positive chest computed tomography (CT) findings and no evidence of concurrent pulmonary disease. Clinical characteristics and adverse outcomes in in-hospital settings were collected retrospectively. Diameters of cardiac ventricles and arteries, along with lung opacification scores, were obtained using CT pulmonary angiography (CTPA) findings, and the association of these variables was evaluated. Results An increase in pulmonary artery (PA) to ascending aorta (AO) diameter ratio and lung parenchymal damage were significantly and positively correlated (P=0.017), but increased right ventricle (RV) to left ventricle (LV) diameter ratio showed no association with the extent of chest opacification (P=0.098). Evaluating the prognostic ability of both ratios using logistic regression and receiver operating characteristic (ROC) analysis proved no significant class separation in regards to predicting adverse outcomes (PA/AO: OR:1.081, P Value:0.638, RV/LV: OR:1.098, P Value:0.344). Conclusion In COVID-19 patients without vascular comorbidities, a higher PA/AO diameter ratio was significantly associated with increased lung involvement severity on CT imaging but not with adverse in-hospital outcomes. Conversely, an increased RV/LV ratio on CTPA did not correlate significantly with adverse outcomes or the severity of parenchymal lung damage.
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Affiliation(s)
- Parsa Rouzrokh
- Shahid Beheshti University of Medical Sciences, School of Medicine, Tehran, Iran
| | - Malihe Rezaee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadipour
- Shahid Beheshti University of Medical Sciences, School of Medicine, Tehran, Iran
| | - Sasan Tavana
- Department of Pulmonary Medicine, Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhy
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Taraneh Faghihi Langroudi
- Radiology Department, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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7
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Ruck JM, Bush EL. Use of Extracorporeal Membrane Oxygenation for Patients with Coronavirus Disease 2019 Infection. Adv Surg 2024; 58:249-273. [PMID: 39089781 PMCID: PMC11294677 DOI: 10.1016/j.yasu.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic was a cataclysmic event that infected over 772 million and killed over 6.9 million people worldwide. The pandemic pushed hospitals and society to their limits and resulted in incredibly severe respiratory disease in millions of people. This severe respiratory disease often necessitated maximum medical therapy, including the use of extracorporeal membrane oxygenation. While our understanding of COVID-19 and its treatment continue to evolve, we review the current evidence to guide the care of patients with severe COVID-19 infection.
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Affiliation(s)
- Jessica M Ruck
- Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Errol L Bush
- Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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8
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Devera JL, Wee CP, Sohn J. Strain imaging as a prognostic indicator for complications in COVID-19 patients. Int J Cardiovasc Imaging 2024; 40:1835-1846. [PMID: 39012400 PMCID: PMC11473545 DOI: 10.1007/s10554-024-03170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 06/22/2024] [Indexed: 07/17/2024]
Abstract
The goal of this study was to determine the potential for right ventricular (RV) and left ventricular (LV) strain to predict cardiopulmonary complications of COVID-19. We identified 276 patients with COVID-19 who underwent transthoracic echocardiography within 30 days of COVID-19 diagnosis at our institution. Patients were excluded if they had a history of any primary outcomes before COVID-19 diagnosis or insufficient imaging. LV global longitudinal strain (GLS) and RV GLS were obtained using 2-dimensional speckle-tracking echocardiography. Primary outcomes were death, pulmonary embolism, congestive heart failure (CHF), cardiomyopathy, pulmonary fibrosis, pulmonary hypertension, acute respiratory distress syndrome (ARDS), and myocardial infarction (MI) occurring after COVID-19 diagnosis. In the final analysis of 163 patients, mean RV GLS and LV GLS were reduced, and 43.6% developed at least one primary outcome. There were significant differences in LV GLS distribution in terms of CHF, cardiomyopathy, and MI in bivariate analysis. However, LV GLS was not significantly associated with CHF after adjusting for LV ejection fraction and RV fractional area change, nor with MI after adjusting for troponin T. RV GLS was significantly associated with ARDS after adjusting for other variables. In the risk stratification of patients with COVID-19, strain imaging can provide incremental prognostic information, as worsened RV GLS is associated with the development of ARDS.
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Affiliation(s)
- Justin L Devera
- Division of Cardiovascular Medicine, University of California Davis, Sacramento, CA, USA.
| | - Choo P Wee
- Division of Biostatistics, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Jina Sohn
- Division of Cardiovascular Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
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9
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Van Name J, Wu K, Xi L. Myocarditis - A silent killer in athletes: Comparative analysis on the evidence before and after COVID-19 pandemic. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:232-239. [PMID: 39234482 PMCID: PMC11369839 DOI: 10.1016/j.smhs.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 09/06/2024] Open
Abstract
Myocarditis is a rare cardiomyocyte inflammatory process, typically caused by viruses, with potentially devastating cardiac sequalae in both competitive athletes and in the general population. Investigation into myocarditis prevalence in the Coronavirus disease 2019 (COVID-19) era suggests that infection with Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is an independent risk factor for myocarditis, which is confirmed mainly through cardiovascular magnetic resonance imaging. Recent studies indicated that athletes have a decreased risk of myocarditis after recent COVID-19 infection compared to the general population. However, given the unique nature of competitive athletics with their frequent participation in high-intensity exercise, athletes possess distinct factors of susceptibility for the development of myocarditis and its subsequent severe cardiac complications (e.g., sudden cardiac death, fulminant heart failure, etc.). Under this context, this review focuses on comparing myocarditis in athletes versus non-athletes, owing special attention to the distinct clinical presentations and outcomes of myocarditis caused by different viral pathogens such as cytomegalovirus, Epstein-Barr virus, human herpesvirus-6, human immunodeficiency virus, and Parvovirus B19, both before and after the COVID-19 pandemic, as compared with SARS-CoV-2. By illustrating distinct clinical presentations and outcomes of myocarditis in athletes versus non-athletes, we also highlight the critical importance of early detection, vigilant monitoring, and effective management of viral and non-viral myocarditis in athletes and the necessity for further optimization of the return-to-play guidelines for athletes in the COVID-19 era, in order to minimize the risks for the rare but devastating cardiac fatality.
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Affiliation(s)
- Jonathan Van Name
- Virginia Commonwealth University School of Medicine (M.D. Class 2024), Richmond, VA, 23298, USA
| | - Kainuo Wu
- Virginia Commonwealth University School of Medicine (M.D. Class 2024), Richmond, VA, 23298, USA
| | - Lei Xi
- Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0204, USA
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10
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Srivastava A, Nalroad Sundararaj S, Bhatia J, Singh Arya D. Understanding long COVID myocarditis: A comprehensive review. Cytokine 2024; 178:156584. [PMID: 38508059 DOI: 10.1016/j.cyto.2024.156584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/21/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
Infectious diseases are a cause of major concern in this twenty-first century. There have been reports of various outbreaks like severe acute respiratory syndrome (SARS) in 2003, swine flu in 2009, Zika virus disease in 2015, and Middle East Respiratory Syndrome (MERS) in 2012, since the start of this millennium. In addition to these outbreaks, the latest infectious disease to result in an outbreak is the SARS-CoV-2 infection. A viral infection recognized as a respiratory illness at the time of emergence, SARS-CoV-2 has wreaked havoc worldwide because of its long-lasting implications like heart failure, sepsis, organ failure, etc., and its significant impact on the global economy. Besides the acute illness, it also leads to symptoms months later which is called long COVID or post-COVID-19 condition. Due to its ever-increasing prevalence, it has been a significant challenge to treat the affected individuals and manage the complications as well. Myocarditis, a long-term complication of coronavirus disease 2019 (COVID-19) is an inflammatory condition involving the myocardium of the heart, which could even be fatal in the long term in cases of progression to ventricular dysfunction and heart failure. Thus, it is imperative to diagnose early and treat this condition in the affected individuals. At present, there are numerous studies which are in progress, investigating patients with COVID-19-related myocarditis and the treatment strategies. This review focuses primarily on myocarditis, a life-threatening complication of COVID-19 illness, and endeavors to elucidate the pathogenesis, biomarkers, and management of long COVID myocarditis along with pipeline drugs in detail.
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Affiliation(s)
- Arti Srivastava
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | | | - Jagriti Bhatia
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Dharamvir Singh Arya
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India.
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11
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Weisleder H, Jacobson E, Frishman WH, Dhand A. Cardiac Manifestations of Viral Infections, Including COVID-19: A Review. Cardiol Rev 2024; 32:124-130. [PMID: 36730913 DOI: 10.1097/crd.0000000000000481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Viral infections have been linked to a variety of cardiac pathology, which may include acute myocarditis, dilated cardiomyopathy, heart failure, cardiogenic shock, pericarditis, acute coronary syndromes, and arrhythmias. We performed a systematic review of literature focusing on the cardiovascular effects of various viral infections, as well as providing an update on the current understanding of the pathophysiology of Coronavirus disease-2019 (COVID-19). Cardiac manifestations of viral illnesses are usually self-limiting, have variable clinical presentations, and require sufficient clinical suspicion for diagnosis and optimal management.
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Affiliation(s)
| | | | | | - Abhay Dhand
- From the New York Medical College, Valhalla, NY
- Department of Medicine and Surgery, Westchester Medical Center, Valhalla, NY
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12
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Sebastian SA, Co EL, Mahtani A, Padda I, Anam M, Mathew SS, Shahzadi A, Niazi M, Pawar S, Johal G. Heart Failure: Recent Advances and Breakthroughs. Dis Mon 2024; 70:101634. [PMID: 37704531 DOI: 10.1016/j.disamonth.2023.101634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Heart failure (HF) is a common clinical condition encountered in various healthcare settings with a vast socioeconomic impact. Recent advancements in pharmacotherapy have led to the evolution of novel therapeutic agents with a decrease in hospitalization and mortality rates in HF with reduced left ventricular ejection fraction (HFrEF). Lately, the introduction of artificial intelligence (AI) to construct decision-making models for the early detection of HF has played a vital role in optimizing cardiovascular disease outcomes. In this review, we examine the newer therapies and evidence behind goal-directed medical therapy (GDMT) for managing HF. We also explore the application of AI and machine learning (ML) in HF, including early diagnosis and risk stratification for HFrEF.
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Affiliation(s)
| | - Edzel Lorraine Co
- University of Santo Tomas Faculty of Medicine and Surgery, Manila, Philippines
| | - Arun Mahtani
- Richmond University Medical Center/Mount Sinai, Staten Island, New York, USA
| | - Inderbir Padda
- Richmond University Medical Center/Mount Sinai, Staten Island, New York, USA
| | - Mahvish Anam
- Deccan College of Medical Sciences, Hyderabad, India
| | | | | | - Maha Niazi
- Royal Alexandra Hospital, Edmonton, Canada
| | | | - Gurpreet Johal
- Department of Cardiology, University of Washington, Valley Medical Center, Seattle, Washington, USA
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13
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Frikha H, Chrifi-Alaoui L, Fokapu O, Meddeb-Makhlouf A, Zarai F. QTc-Based Machine Learning Analysis of COVID-19 and Post-COVID-19 Patients. 2023 IEEE INTERNATIONAL CONFERENCE ON ENABLING TECHNOLOGIES: INFRASTRUCTURE FOR COLLABORATIVE ENTERPRISES (WETICE) 2023:1-6. [DOI: 10.1109/wetice57085.2023.10477841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Affiliation(s)
- Hounaida Frikha
- National School of Electronics and Telecommunications of Sfax,NTS'COM research unit Sfax,Sfax,Tunisia
| | - Larbi Chrifi-Alaoui
- Technology University of Picardie Jules Verne Cuffies,Laboratory of Innovative,France
| | - Odette Fokapu
- UMR CNRS 7338 Biomécanique and Bioingénierie University of Technology of Compiègne,Compiégne,France
| | - Amel Meddeb-Makhlouf
- National School of Electronics and Telecommunications of Sfax,NTS'COM research unit Sfax,Sfax,Tunisia
| | - Faouzi Zarai
- National School of Electronics and Telecommunications of Sfax,NTS'COM research unit Sfax,Sfax,Tunisia
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14
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Mazandarani M, Sharififar R, Lashkarbolouk N, Ghorbani S. Evaluation of cardiac diagnostic tests findings based on pro-BNP levels in COVID-19 pregnant patients. BMC Infect Dis 2023; 23:790. [PMID: 37957564 PMCID: PMC10644487 DOI: 10.1186/s12879-023-08764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Pro-b-type natriuretic peptide (Pro-BNP) is an inflammatory marker that indicates cardiac damage and inflammation. The elevation of this marker in COVID-19 patients can be used as a predictive factor in the prognosis of these patients. METHOD Our cross-sectional study investigated the evaluation of cardiac diagnostic test findings based on pro-BNP levels in pregnant COVID-19 patients in Sayyad Shirazi Hospital, Gorgan, Iran, in 2020-2022. A hundred and ten pregnant patients diagnosed with COVID-19 infection were evaluated for cardiac diagnostic tests (electrocardiogram (ECG) and echocardiography (Echo)) and pro-BNP levels. Data were analyzed using SPSS 25 software. Chi-square and Student's t-test will be used to test and compare the relationship between variables and compare them. A P-value less than 0.05 is considered statistically significant. The chi-square test was used to compare the ratio of qualitative variables among the groups if the presuppositions of chi-square distribution were established. Otherwise, Fisher's exact test was used. RESULT The mean age of participants were 31.06 ± 5.533 years and 49.1% of patients had pro-BNP levels above the cut-off value for predicting an adverse outcome of COVID-19. The mean ± standard deviation of pro-BNP levels in the low group was 46.125 ± 17.523 pg/mL and in the high group was 878.814 ± 1038.060 pg/mL. This study revealed that patients with higher pro-BNP plasma levels had a significant relation between, myocardial infarction (MI), pericardial effusion (PE), urgent Caesarean section (C/S), and mortality. In addition, no significant relation between gravid, trimester, vaccination, arrhythmia, heart block, and valves diseases with high pro-BNP levels was found. CONCLUSION The current research showed that pro-BNP levels can be used as a diagnostic and valuable prognostic tool in pregnant women to diagnose cardiac complications by using ECG and Echo.
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Affiliation(s)
- Mahdi Mazandarani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan University of Medical Sciences, Gorgan, Iran
| | - Rahmat Sharififar
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Narges Lashkarbolouk
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Golestan University of Medical Sciences, Gorgan, Iran.
| | - Somayeh Ghorbani
- Assistant Professor of Biostatistics, Golestan University of Medical Sciences, Gorgan, Iran
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15
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Aspromonte N, Zaninotto M, Aimo A, Fumarulo I, Plebani M, Clerico A. Measurement of Cardiac-Specific Biomarkers in the Emergency Department: New Insight in Risk Evaluation. Int J Mol Sci 2023; 24:15998. [PMID: 37958981 PMCID: PMC10648028 DOI: 10.3390/ijms242115998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this article review is to analyze some models and clinical issues related to the implementation of accelerated diagnostic protocols based on specific cardiac biomarkers in patients admitted to the emergency department (ED) with symptoms compatible with acute cardiac disorders. Four specific clinical issues will be discussed in detail: (a) pathophysiological and clinical interpretations of circulating hs-cTnI and hs-cTnT levels; (b) the clinical relevance and estimation of the biological variation of biomarkers in patients admitted to the ED with acute and severe diseases; (c) the role and advantages of the point-of-care testing (POCT) methods for cardiac-specific biomarkers in pre-hospital and hospital clinical practice; and (d) the clinical role of specific cardiac biomarkers in patients with acute heart failure (AHF). In order to balance the risk between a hasty discharge versus the potential harms caused by a cardiac assessment in patients admitted to the ED with suspected acute cardiovascular disease, the measurement of specific cardiac biomarkers is essential for the early identification of the presence of myocardial dysfunction and/or injury and to significantly reduce the length and costs of hospitalization. Moreover, specific cardiac biomarkers (especially hs-cTnI and hs-cTnT) are useful predictors of mortality and major adverse cardiovascular events (MACE) in patients admitted to the ED with suspected acute cardiovascular disease. To guide the implementation of the most rapid algorithms for the diagnosis of Non-ST-Elevation Myocardial Infarction (NSTEMI) into routine clinical practice, clinical scientific societies and laboratory medicine societies should promote collaborative studies specifically designed for the evaluation of the analytical performance and, especially, the cost/benefit ratio resulting from the use of these clinical protocols and POCT methods in the ED clinical practice.
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Affiliation(s)
- Nadia Aspromonte
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (N.A.); (I.F.)
- Department of Cardiovascular and Thoracic Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Martina Zaninotto
- Department of Laboratory Medicine, University-Hospital of Padova, 35129 Padova, Italy;
| | - Alberto Aimo
- CNR Foundation—Regione Toscana G. Monasterio, 56127 Pisa, Italy;
| | - Isabella Fumarulo
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (N.A.); (I.F.)
- Department of Cardiovascular and Thoracic Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Mario Plebani
- Department of Medicine-DIMED, University of Padova, 35129 Padova, Italy;
| | - Aldo Clerico
- CNR Foundation—Regione Toscana G. Monasterio, 56127 Pisa, Italy;
- Coordinator of the Study Group on Cardiac Biomarkers of the Italian Societies of Laboratory Medicine, 56127 Pisa, Italy
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16
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Ntchana A, Shrestha S, Pippin M. Cardiovascular Complications of COVID-19: A Scoping Review of Evidence. Cureus 2023; 15:e48275. [PMID: 38054135 PMCID: PMC10695704 DOI: 10.7759/cureus.48275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 12/07/2023] Open
Abstract
This scoping review sought to identify the nature and extent of clinical evidence regarding the acute and long-term cardiovascular complications associated with COVID-19. Forty-nine studies published between 2020 and 2023 were selected for review. The studies were divided into two groups. The referential group included 22 studies. The second group of 27 studies was used for a detailed review to assess the strength of the evidence. The aggregate evidence indicates that the most common cardiac complications associated with COVID-19 include but are not limited to acute pericarditis, acute myocardial injury, acute myocarditis, various arrhythmias, microvascular angiopathy, left ventricular dysfunction, heart failure, acute cardiac injury, and acute coronary syndrome. Clinical and epidemiological implications of the findings are investigated, and future research recommendations are proposed.
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Affiliation(s)
- Armand Ntchana
- Family Medicine-Alexandria, Louisiana State University Health Sciences Center, Alexandria, USA
| | - Sanjay Shrestha
- Family Medicine-Alexandria, Louisiana State University Health Sciences Center, Alexandria, USA
| | - Micah Pippin
- Family Medicine-Alexandria, Louisiana State University Health Sciences Center, Alexandria, USA
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17
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Mehrban S, Omidvar R, Jalali SS, Pouraliakbar H, Favaedi M, Almasi S. Transient constrictive pericarditis: A complication of COVID-19 infection or first presentation of systemic lupus erythematous? A case report. Radiol Case Rep 2023; 18:3032-3036. [PMID: 37359249 PMCID: PMC10284064 DOI: 10.1016/j.radcr.2023.05.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/11/2023] [Accepted: 05/28/2023] [Indexed: 06/28/2023] Open
Abstract
Cardiovascular disorders are significantly associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Herein, we describe a case of myopericarditis and subsequent transient constrictive pericarditis after coronavirus disease 2019 (COVID-19). Three weeks following a mild SARS-CoV-2 illness, a 53-year-old woman was referred to the hospital with acute pleuritic chest pain, which was not attributable to any known cause and was only temporarily relieved. The pain persisted for the next few weeks until her second COVID-19 infection, which occurred 5 months after her first affliction. This time, Transthoracic echocardiography (TTE) revealed mild pericardial effusion, and cardiac magnetic resonance imaging (CMR) confirmed myopericarditis, leading to the administration of anti-inflammatory therapy for the patient. Despite a relative resolution of symptoms, her second CMR performed 8 months later revealed active perimyocarditis with transient constrictive pericarditis (CP). Additionally, fluorescent antinuclear antibody (FANA) and antimitochondrial Ab M2 (AMA) were tested positive for the first time. Thereafter, the patient was started on concurrent anti-inflammatory and immunosuppressant therapies, which were effective after 3 months. The transient CP was resolved, and there was no sign of active pericarditis on her last echocardiography. Acute pericarditis and its subsequent constrictive pericarditis are infrequent adverse outcomes of COVID-19. The unique feature of this case is the uncertainty regarding the underlying reason for cardiac complications, whether it is the first presentation of systemic lupus erythematosus (SLE) or viral-induced myopericarditis followed by a consequent transient CP.
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Affiliation(s)
- Saghar Mehrban
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Razieh Omidvar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Somayeh Sadat Jalali
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Maryam Favaedi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, 1995614331, Iran
| | - Simin Almasi
- Department of Rheumatology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
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18
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Kandhasami M, Panchanathan S, Rajendran J, Laksham KB. High Sensitivity C-Reactive Protein as a Prognostic Indicator of Cardiovascular Disease in Severe Non-Diabetic COVID-19 Patients. Discoveries (Craiova) 2023; 11:e172. [PMID: 37744945 PMCID: PMC10515116 DOI: 10.15190/d.2023.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE The long-term extrapulmonary sequelae of COVID-19 after recovery from the critical stage at the intensive care unit (ICU) are still unclear. Some post-COVID symptoms are prevalent even after a one-year follow-up. To explore the relationship between high sensitivity C-reactive protein (hs-CRP) and hyperglycemia with cardiovascular diseases in non-diabetic COVID-19 patients. To determine whether increased fasting blood sugar (FBS) levels are associated with elevated hs-CRP and to explore whether hs-CRP can serve as a prognostic indicator to predict cardiovascular outcome. METHODS FBS and hs-CRP values of 26 non-diabetic COVID-19 patients were collected from their medical records at JIPMER hospital. In one-year follow-up of these 26 patients, 2mL of blood sample was collected for the analysis of FBS, HbA1c, and hs-CRP. RESULTS hs-CRP increased in 23% of follow-up patients who were at high risk, and 42.3% of participants were at average risk for cardiovascular disease. High and average-risk groups of survivors showed a positive correlation of hs-CRP with FBS and HbA1c levels, and these patients should be carefully monitored. CONCLUSION ICU survivors with elevated hs-CRP need periodic check-ups for cardiovascular diseases. We suggest that hs-CRP could be used as an early prognostic indicator of cardiovascular diseases and can reduce the risk.
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Affiliation(s)
- Mugundhan Kandhasami
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal-609602, Puducherry, India
| | - Subash Panchanathan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal-609602, Puducherry, India
| | - Jayanthi Rajendran
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, "Sri Balaji Vidyapeeth (Deemed -to be-University)," Puducherry-607402
| | - Karthik Balajee Laksham
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal-609602, Puducherry, India
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19
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Bailey E, Frishman WH. Mild-to-Moderate COVID-19 Infection and Myocarditis: A Review. Cardiol Rev 2023; 31:173-175. [PMID: 35576368 DOI: 10.1097/crd.0000000000000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has taken a massive toll on healthcare systems internationally. Severe illness has been seen in a range of patient populations, but those living with cardiovascular disease have suffered to a greater extent, likely because of their comorbidities. In patients with diabetes, hypertension, heart failure, and other chronic illnesses, COVID-19 has manifested severe illnesses such as coagulopathies, myocarditis, and arrhythmias, complicating the disease course for those already suffering from underlying illness. There have been numerous studies done exploring the cardiovascular complications of COVID-19. Some of the more concerning findings have revealed a correlation between severe illness and the increasing likelihood for developing cardiovascular manifestations. However, what is more concerning were the studies revealing the presence of myocarditis and other cardiac sequelae in previously healthy patients with mild or asymptomatic COVID-19. The goal of this article is to review the literature to compile information available about whether there is a significant risk of myocarditis in those patients who do not develop severe initial COVID-19 disease.
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Affiliation(s)
- Eric Bailey
- From the Department of Medicine, New York University Grossman School of Medicine, New York, NY
| | - William H Frishman
- Departments of Medicine and Cardiology, New York Medical College/Westchester Medical Center, Valhalla, NY
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20
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Luo S, Zhang X, Xiao X, Luo W, Yang Z, Tang S, Huang W. Exploring Potential Biomarkers and Molecular Mechanisms of Ischemic Cardiomyopathy and COVID-19 Comorbidity Based on Bioinformatics and Systems Biology. Int J Mol Sci 2023; 24:ijms24076511. [PMID: 37047484 PMCID: PMC10094917 DOI: 10.3390/ijms24076511] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Cardiovascular complications combined with COVID-19 (SARS-CoV-2) lead to a poor prognosis in patients. The common pathogenesis of ischemic cardiomyopathy (ICM) and COVID-19 is still unclear. Here, we explored potential molecular mechanisms and biomarkers for ICM and COVID-19. Common differentially expressed genes (DEGs) of ICM (GSE5406) and COVID-19 (GSE164805) were identified using GEO2R. We performed enrichment and protein–protein interaction analyses and screened key genes. To confirm the diagnostic performance for these hub genes, we used external datasets (GSE116250 and GSE211979) and plotted ROC curves. Transcription factor and microRNA regulatory networks were constructed for the validated hub genes. Finally, drug prediction and molecular docking validation were performed using cMAP. We identified 81 common DEGs, many of which were enriched in terms of their relation to angiogenesis. Three DEGs were identified as key hub genes (HSP90AA1, HSPA9, and SRSF1) in the protein–protein interaction analysis. These hub genes had high diagnostic performance in the four datasets (AUC > 0.7). Mir-16-5p and KLF9 transcription factor co-regulated these hub genes. The drugs vindesine and ON-01910 showed good binding performance to the hub genes. We identified HSP90AA1, HSPA9, and SRSF1 as markers for the co-pathogenesis of ICM and COVID-19, and showed that co-pathogenesis of ICM and COVID-19 may be related to angiogenesis. Vindesine and ON-01910 were predicted as potential therapeutic agents. Our findings will contribute to a deeper understanding of the comorbidity of ICM with COVID-19.
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21
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Short and Long-Term Cardiovascular Sequelae after SARS-CoV-2 Infection: A Narrative Review Focusing on Athletes. Viruses 2023; 15:v15020493. [PMID: 36851707 PMCID: PMC9968090 DOI: 10.3390/v15020493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/23/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Cardiovascular (CV) involvement after severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection was found to be frequent among the general population, especially in the pre-vaccination era, and particularly for hospitalized patients or those who experienced a more severe course of the disease. The spectrum of CV disease varies; however, acute myocarditis is particularly fearsome for the athletic population due to the possible associated risk of malignant arrhythmias during training. Alarming percentages of CV injuries, even in young and healthy athletes with a benign course of the disease, arose from a few initial studies limited to case series. Subsequent single-center studies and larger observational registries reported a lower prevalence of SARS-CoV2 CV involvement in athletes. Studies showing the occurrence of CV adverse events during follow-up periods are now available. The objective of our narrative review is to provide an updated summary of the literature on CV involvement after coronavirus disease 2019, both in the early post-infection period and over a longer period of time, with a focus on athletic populations.
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22
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Ghasemi H, Kazemian S, Nejadghaderi SA, Shafie M. Takotsubo syndrome and COVID‐19: A systematic review. Health Sci Rep 2023; 6:e972. [PMID: 36479387 PMCID: PMC9718950 DOI: 10.1002/hsr2.972] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/30/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
Background and Aims Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is characterized by acute and transient left ventricular dysfunction and has increased during the COVID-19 pandemic. Herein, we aim to review studies on TTS that were associated with COVID-19 infection, vaccine, and other COVID-19-related etiologies including psychosocial stressors. Methods We systematically searched PubMed, EMBASE, and Scopus up to May 12, 2022. We included case reports, case series, and original articles that reported at least one TTS case associated with COVID-19, or TTS cases after receiving COVID-19 vaccines, or TTS cases secondary to psychological stress due to the COVID-19 pandemic. The quality assessment was conducted using the Joanna Briggs Institute checklist. Results Sixty-seven articles including 102 cases were included. Hypertension was the most frequently accompanying comorbidity (N = 67 [65.6%]) and the mean left ventricular ejection fraction was 36.5%. Among COVID-19 patients, the in-hospital mortality rate was 33.3%. On the other hand, only one COVID-19-negative individual expired (2.3%). The most common presenting clinical symptom was dyspnea in 42 (73.6%) patients. the mean time interval from the first symptom to admission was 7.2 days. The most common chest imaging finding was ground-glass opacity which was reported in 14 (31.1%) participants. The most common abnormalities were T-wave inversion in 35 (43.2%) and ST-segment elevation in 30 (37%). Brain natriuretic peptide and troponin were elevated in 94.7% and 95.9% of participants, respectively. Conclusion The TTS in patients with COVID-19 is almost rare, whereas it could lead to a great mortality and morbidity. An individual with COVID-19, especially an elderly woman, presented with dyspnea in addition to a rise in brain natriuretic peptide and troponin should be evaluated for TTS.
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Affiliation(s)
- Hoomaan Ghasemi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
- Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran
| | - Sina Kazemian
- Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran
- Cardiac Primary Prevention Research Center (CPPRC), Tehran Heart Center Tehran University of Medical Sciences Tehran Iran
| | - Seyed Aria Nejadghaderi
- Research Center for Integrative Medicine in Aging, Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran
- Systematic Review and Meta‐Analysis Expert Group (SRMEG) Universal Scientific Education and Research Network (USERN) Tehran Iran
| | - Mahan Shafie
- School of Medicine Tehran University of Medical Sciences Tehran Iran
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23
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El-Medany A, Kandoole V, Lonsdale N, Doolub G, Felekos I. In-stent Thrombosis and COVID-19 Infection: Current Insights on the Mechanistic Relationship. Curr Cardiol Rev 2023; 19:e120522204669. [PMID: 35549872 PMCID: PMC10201881 DOI: 10.2174/1573403x18666220512142019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/16/2022] [Accepted: 03/02/2022] [Indexed: 02/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been demonstrated as a major risk factor in inducing coronary stent thrombosis due to its propensity to create a pro-thrombotic state. This review explores the mechanisms that may contribute to the increased thrombosis risk seen in COVID-19. Furthermore, we discuss the patient and haematological factors that predispose to an increased risk of stent thrombosis, as well as the role of certain antiplatelet and anticoagulation therapies, including ticagrelor and enoxaparin, that may reduce the likelihood and severity of in-stent thrombosis, in SARS-CoV-2 infection. To counter the proinflammatory and pro-thrombotic state shown in COVID-19, anti-thrombotic therapy in the future may be optimised using point-of-care platelet inhibition testing and inflammation-modifying therapies. Large-scale randomised trials with long-term follow-up are increasingly necessary to assess the intersection of COVID-19 and stent optimisation as well as the reduction of stent thrombosis after drug-eluting stent (DES) implantation.
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Affiliation(s)
- Ahmed El-Medany
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
| | - Vanessa Kandoole
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
| | - Nicholas Lonsdale
- Weston General Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Gemina Doolub
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
| | - Ioannis Felekos
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
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24
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Hossein Heydari A, Ghaffari S, Khani Z, Heydari S, Eskandari Z, Esmaeil Heidari M. MiR-21 and Tocilizumab interactions improve COVID-19 myocarditis outcomes. Ther Adv Cardiovasc Dis 2023; 17:17539447231182548. [PMID: 37427793 DOI: 10.1177/17539447231182548] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Myocarditis is now one of the most fatal and morbid complications of COVID-19. Many scientists have recently concentrated on this problem. OBJECTIVES This study assessed the effects of Remdesivir (RMS) and Tocilizumab (TCZ) in COVID-19 myocarditis. DESIGN Observational, cohort study. METHODS Patients with COVID-19 myocarditis were enrolled in the study and divided into three groups, TCZ-treated, RMS-treated, and Dexamethasone-treated patients. After 7 days of treatment, patients were reassessed for improvement. RESULTS TCZ significantly improved patients' ejection fraction in 7 days, but it had limited efficacy. RMS improved inflammatory characteristics of the disease, but RMS-treated patients showed exacerbated cardiac function over 7 days, and the mortality rate with RMS was higher than TCZ. TCZ protects the heart by decreasing the miR-21 expression rate. CONCLUSION Using Tocilizumab in early diagnosed COVID-19 myocarditis patients can save their cardiac function after hospitalization and decrease the mortality rate. miR-21 level determines the outcome and responsiveness of COVID-19 myocarditis to treatment.
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Affiliation(s)
- Amir Hossein Heydari
- School of Medicine, Zanjan University of Medical Science, Karmandan District, Mahdavi, Zanjan, Zanjan Province, Iran
| | - Saeid Ghaffari
- School of Medicine, Zanjan University of Medical Science, Zanjan, Zanjan Province, Iran
| | - Zahra Khani
- School of Medicine, Zanjan University of Medical Science, Zanjan, Zanjan Province, Iran
| | - Sophia Heydari
- Shahid Beheshti Hospital, Zanjan University of Medical Science, Zanjan, Zanjan Province, Iran
| | - Zakaria Eskandari
- Shahid Beheshti Hospital, Zanjan University of Medical Science, Zanjan, Zanjan Province, Iran
| | - Mohammad Esmaeil Heidari
- Department of Electrical Engineering, Henry Samueli School of Engineering, University of California, Los Angeles, CA, USA
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Semiz S. COVID19 biomarkers: What did we learn from systematic reviews? Front Cell Infect Microbiol 2022; 12:1038908. [PMID: 36583110 PMCID: PMC9792992 DOI: 10.3389/fcimb.2022.1038908] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID19) pandemic continues to represent a substantial public health concern. It can rapidly progress to severe disease, with poor prognosis and a high mortality risk. An early diagnosis and specific prognostic tools can help healthcare providers to start interventions promptly, understand the likely prognosis and to identify and treat timely individuals likely to develop severe disease with enhanced mortality risk. Here we focused on an impressive set of systematic reviews and meta-analyses that were performed since the start of the COVID19 pandemic and summarized their results related to the levels of hematologic, inflammatory, immunologic biomarkers as well as markers of cardiac, respiratory, hepatic, gastrointestinal and renal systems and their association with the disease progression, severity and mortality. The evidence outlines the significance of specific biomarkers, including inflammatory and immunological parameters (C-reactive protein, procalcitonin, interleukin-6), hematological (lymphocytes count, neutrophil-to-lymphocyte ratio, D-dimer, ferritin, red blood cell distribution width), cardiac (troponin, CK-MB, myoglobin), liver (AST, ALT, total bilirubin, albumin) and lung injury (Krebs von den Lungen-6) that can be used as prognostic biomarkers to aid the identification of high-risk patients and the prediction of serious outcomes, including mortality, in COVID19. Thus, these parameters should be used as essential tools for an early risk stratification and adequate intervention in improving disease outcomes in COVID19 patients.
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Kushima H, Shimizu S, Koide Y, Kawamura A, Ishii H. A case of pericarditis in a middle-aged woman with COVID-19. Clin Case Rep 2022; 10:e6769. [PMID: 36545549 PMCID: PMC9764107 DOI: 10.1002/ccr3.6769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
The frequency of pericarditis as a complication in COVID-19 patients without underlying disease is not well known. We report a case of COVID-19 presenting with pericarditis without myocarditis or severe respiratory symptoms in a middle-aged woman, who had neither underlying disease nor previous diagnosis of COVID-19.
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Affiliation(s)
- Hisako Kushima
- Department of Respiratory MedicineFukuoka University Chikushi HospitalChikushinoJapan
- Department of Infection Control and PreventionFukuoka University Chikushi HospitalChikushinoJapan
| | - Sayaka Shimizu
- Department of Cardiovascular DiseasesFukuoka University Chikushi HospitalChikushinoJapan
| | - Yohei Koide
- Department of Respiratory MedicineFukuoka University Chikushi HospitalChikushinoJapan
- Department of Infection Control and PreventionFukuoka University Chikushi HospitalChikushinoJapan
| | - Akira Kawamura
- Department of Cardiovascular DiseasesFukuoka University Chikushi HospitalChikushinoJapan
| | - Hiroshi Ishii
- Department of Respiratory MedicineFukuoka University Chikushi HospitalChikushinoJapan
- Department of Infection Control and PreventionFukuoka University Chikushi HospitalChikushinoJapan
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Cardiac Safety of Imatinib for the Treatment of COVID-19: A Secondary Analysis of a Randomized, Double-Blind, Placebo-Controlled Trial. J Cardiovasc Pharmacol 2022; 80:783-791. [PMID: 35976136 DOI: 10.1097/fjc.0000000000001344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/11/2022] [Indexed: 12/13/2022]
Abstract
ABSTRACT Although previous studies support the clinical benefit of imatinib regarding respiratory status in hospitalized patients with COVID-19, potential cardiotoxicity may limit its clinical application. This study aimed to investigate the cardiac safety of imatinib in COVID-19. In the CounterCOVID study, 385 hospitalized hypoxemic patients with COVID-19 were randomly assigned to receive 10 days of oral imatinib or placebo in a 1:1 ratio. Patients with a corrected QT interval (QTc) >500 ms or left ventricular ejection fraction <40% were excluded. Severe cardiac adverse events were monitored for 28 days or until death occurred. Electrocardiogram measurements and cardiac biomarkers were assessed repeatedly during the first 10 days. A total of 36 severe cardiac events occurred, with a similar incidence in both treatment groups. No differences were observed in the computer-generated Bazett, manually interpreted Bazett, or Fridericia-interpreted QTcs. No clinically relevant alterations in other electrocardiogram parameters or plasma high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations were observed. Similar findings were observed in a subgroup of 72 patients admitted to the intensive care unit. In the univariate and multivariable linear mixed models, treatment with imatinib was not significantly associated with QT interval duration, hs-cTnT, or NT-proBNP levels. In conclusion, imatinib treatment did not result in more cardiac events, QT interval prolongation, or altered hs-cTnT or NT-proBNP levels. This suggests that treatment with imatinib is safe in hospitalized patients with COVID-19 with a QTc duration of less than 500 ms and left ventricular ejection fraction >40%.
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Consequences of COVID-19 on the cardiovascular and renal systems. Sleep Med 2022; 100:31-38. [PMID: 35994936 PMCID: PMC9345655 DOI: 10.1016/j.sleep.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 01/11/2023]
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Zhan Y, Yue H, Liang W, Wu Z. Effects of COVID-19 on Arrhythmia. J Cardiovasc Dev Dis 2022; 9:jcdd9090292. [PMID: 36135437 PMCID: PMC9504579 DOI: 10.3390/jcdd9090292] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/19/2022] [Accepted: 09/01/2022] [Indexed: 01/08/2023] Open
Abstract
The World Health Organization announced that COVID-19, with SARS-CoV-2 as its pathogen, had become a pandemic on 11 March 2020. Today, the global epidemic situation is still serious. With the development of research, cardiovascular injury in patients with COVID-19, such as arrhythmia, myocardial injury, and heart failure, is the second major symptom in addition to respiratory symptoms, and cardiovascular injury is related to the prognosis and mortality of patients. The incidence of arrhythmia in COVID-19 patients ranges from 10% to 20%. The potential mechanisms include viral infection-induced angiotensin-converting enzyme 2 expression change, myocarditis, cytokine storm, cardiac injury, electrophysiological effects, hypoxemia, myocardial strain, electrolyte abnormalities, intravascular volume imbalance, drug toxicities and interactions, and stress response caused by virus infection. COVID-19 complicated with arrhythmia needs to be accounted for and integrated in management. This article reviews the incidence, potential mechanisms, and related management measures of arrhythmia in COVID-19 patients.
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Affiliation(s)
| | | | | | - Zhong Wu
- Correspondence: ; Tel.: +86-028-85422897
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Ho JYK, Siu ICH, Ng KHL, Tam M, Chow SCY, Lim K, Kwok MWT, Wan S, Fujikawa T, Wong RHL. Retrospective record review on timing of COVID-19 vaccination and cardiac surgery. J Card Surg 2022; 37:3634-3638. [PMID: 36054404 PMCID: PMC9538689 DOI: 10.1111/jocs.16883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/28/2022]
Abstract
Background Novel clinical challenges are faced by cardiac surgeons under the coronavirus disease 2019 (COVID‐19) pandemic. Amidst the uncertainties faced due to the socioeconomic and public health impact, there is little evidence surrounding COVID‐19 vaccination in patients undergoing cardiac surgery. Timing of vaccination and postvaccination adverse effects are required parameters to discuss with cardiac surgical patients. Methods This is a single‐center, retrospective observational study. All patients who underwent adult cardiac surgery at the Prince of Wales Hospital, Hong Kong from January 2021 to December 2021 were included. Postoperative clinical outcomes, COVID‐19 vaccination status, and vaccination‐related adverse effects were collected. Results A total of 426 patients; 117 (27%) underwent isolated coronary artery bypass grafting, 111 (26%) underwent valvular surgery, and 97 (23%) underwent aortic surgery. Patients received either Sinovac CoronaVac or Pfizer BNT162b2 vaccine. Overall vaccination rate with at least 1 dose was 52% (n = 212), 15% (n = 63) received the first dose before surgery, 36% (n = 149) received the first dose vaccination after surgery. Rate of completion with second and third doses of vaccination were 22% (n = 89) and 4.9% (n = 20), respectively. The mean timing of first dose of vaccine after surgery was 216 ± 84 days from operation. Three (1.4%) patients recorded vaccination‐related complications. Conclusions COVID‐19 vaccination is safe in patients who received major cardiac surgery, with low adverse effects recorded and no vaccine‐related mortality observed. A time frame of 3–6 months after cardiac surgery receiving COVID‐19 vaccination is reasonable and could serve as a guidance for future COVID‐19 vaccination booster programs.
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Affiliation(s)
- Jacky Y K Ho
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Ivan C H Siu
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Karen H L Ng
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Matthew Tam
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Simon C Y Chow
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Kevin Lim
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Micky W T Kwok
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Song Wan
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Takuya Fujikawa
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Randolph H L Wong
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Vidusa L, Kalejs O, Maca-Kaleja A, Strumfa I. Role of Endomyocardial Biopsy in Diagnostics of Myocarditis. Diagnostics (Basel) 2022; 12:diagnostics12092104. [PMID: 36140505 PMCID: PMC9497694 DOI: 10.3390/diagnostics12092104] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Endomyocardial biopsy as the cornerstone of diagnostics has been re-evaluated throughout the years, leaving unanswered questions on the precedence of it. The reported incidence of myocarditis has increased during the pandemic of coronavirus disease 2019 (COVID-19), reinforcing discussions on appropriate diagnostics of myocarditis. By analysis of evidence-based literature published within the last demi-decade, we aimed to summarize the most recent information in order to evaluate the current role of endomyocardial biopsy in diagnostics and management of myocarditis. For the most part, research published over the last five years showed ongoing uncertainty regarding the use, informativeness, safety and necessity of performing a biopsy. Special circumstances, such as fulminant clinical course or failure to respond to empirical treatment, were reconfirmed as justified indications, with a growing applicability of non-invasive diagnostic approaches for most other cases. We concluded that endomyocardial biopsy, if performed properly and with adjunct diagnostic methods, holds a critical role for treatment correction in specific histological subtypes of myocarditis and for differential diagnosis between immune-mediated myocarditis and secondary infections due to immunosuppressive treatment. A high level of possible misdiagnosing was detected, indicating the need to review terminology used to describe findings of myocardial inflammation that did not meet Dallas criteria.
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Affiliation(s)
- Liga Vidusa
- Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
| | - Oskars Kalejs
- Department of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
- Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia
| | - Aija Maca-Kaleja
- Department of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
- Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia
| | - Ilze Strumfa
- Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
- Correspondence:
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Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review. Ann Med Surg (Lond) 2022; 80:103995. [PMID: 35721785 PMCID: PMC9197790 DOI: 10.1016/j.amsu.2022.103995] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 01/09/2023] Open
Abstract
Objective This systematic review aimed at estimating the prevalence of post-acute COVID-19 symptoms in view of published literature that studied prolonged clinical manifestations after recovery from acute COVID-19 infection. Methods Relevant databases were searched for extraction of articles. For data synthesis, based on the distribution of quantitative variables, they were expressed as mean ± standard deviation (SD) or median and interquartile range (IQR). Qualitative variables were presented as frequency (n) and percentages (%). Results Twenty-one articles qualified for the final analysis. The most common persistent clinical manifestations were fatigue (54.11%), dyspnea (24.38%), alopecia (23.21%), hyperhidrosis (23.6%), insomnia (25.98%), anxiety (17.29%), and arthralgia (16.35%). In addition to these symptoms, new-onset hypertension, diabetes, neuropsychiatric disorders, and bladder incontinence were also reported. Conclusion Clinical features of post-acute COVID-19 infection can manifest even after 60 days of initial infection. Multidisciplinary care along with regular follow-up must be provided to such patients.
Clinical features of post-acute COVID-19 infection can manifest even after 60 days of initial infection. Prolonged symptoms and signs are being reported in observational studies and case reports every day. Although such symptoms are usually experienced in survivors of critical illness, the post-acute effects of COVID-19 are equally being reported in patients with mild severity of disease who do not require hospitalization. Necessary future research includes stratification of these post-acute effects with gender, age, and comorbid conditions in acute, subacute, and chronic phases of the disease.
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Essone PN, Adegbite BR, Mbadinga MJM, Mbouna AV, Lotola-Mougeni F, Alabi A, Edoa JR, Lell B, Alabi AS, Adegnika AA, Ramharter M, Siawaya JFD, Grobusch MP, Kremsner PG, Agnandji ST. Creatine kinase-(MB) and hepcidin as candidate biomarkers for early diagnosis of pulmonary tuberculosis: a proof-of-concept study in Lambaréné, Gabon. Infection 2022; 50:897-905. [PMID: 35133607 PMCID: PMC9338130 DOI: 10.1007/s15010-022-01760-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/15/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND The present study aimed to evaluate the diagnostic utility of creatine kinase-MB (CK-MB), hepcidin (HEPC), phospholipase A2 group IIA (PLa2G2A), and myosin-binding protein C (MYBPC1) for tuberculosis (TB). These four biomarkers are differentially regulated between quiescent Mycobacterium tuberculosis (Mtb) infected individuals (non-progressors to TB disease) and Mtb-infected TB disease progressors 6 months before the onset of symptoms. METHODS We enrolled samples from patients experiencing moderate-to-severe pulmonary infections diseases including 23 TB cases confirmed by smear microscopy and culture, and 34 TB-negative cases. For each participant, the serum levels of the four biomarkers were measured using ELISA. RESULTS The levels of CK-MB and HEPC were significantly reduced in patients with active TB disease. CK-MB median level was 2045 pg/ml (1455-4000 pg/ml) in active TB cases and 3245 pg/ml (1645-4000 pg/ml) in non-TB pulmonary diseases. Using the receiver operating characteristic curve (ROC) analysis, HEPC and CK-MB had the Area Under the Curve (AUC) of 79% (95% CI 67-91%) and 81% (95% CI 69-93%), respectively. Both markers correlated with TB diagnosis as a single marker. PLa2G2A and MYBPC1 with AUCs of 48% (95% CI 36-65%) and 62% (95% CI 48-76%) did not performed well as single biomarkers. The three markers'model (CK-MB-HEPC-PLa2G2A) had the highest diagnostic accuracy at 82% (95% CI 56-82%) after cross-validation. CONCLUSION CK-MB and HEPC levels were statistically different between confirmed TB cases and non-TB cases. This study yields promising results for the rapid diagnosis of TB disease using a single marker or three biomarkers model.
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Affiliation(s)
- Paulin N Essone
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany.
- Unité de Recherche et de Diagnostics Spécialisés, Laboratoire National de Santé Publique/Centre Hospitalier Universitaire Mère Enfant Fondation Jeanne EBORI, Libreville, Gabon.
| | - Bayode R Adegbite
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location Amsterdam, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Armel V Mbouna
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Ayodele Alabi
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean R Edoa
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location Amsterdam, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
| | - Abraham S Alabi
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany
| | - Ayola A Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and Department of Internal Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joel F D Siawaya
- Unité de Recherche et de Diagnostics Spécialisés, Laboratoire National de Santé Publique/Centre Hospitalier Universitaire Mère Enfant Fondation Jeanne EBORI, Libreville, Gabon
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location Amsterdam, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany
| | - Selidji T Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research Tübingen, Tübingen, Germany.
- The African Society of Clinical Trials and the African Congress for Clinical Trials, Lambaréné, Gabon.
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Tajarernmuang P, Trongtrakul K, Chaiwong W, Nantsupawat T, Deesomchok A, Chanayat P, Niyatiwatchanchai N, Theerakittikul T, Limsukon A, Pothirat C, Liwsrisakun C, Bumroongkit C. Bradycardia and Heart Rate Fluctuation Are Associated with a Prolonged Intensive Care Unit Stay in Patients with Severe COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070950. [PMID: 35888669 PMCID: PMC9319932 DOI: 10.3390/medicina58070950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 12/15/2022]
Abstract
Background and Objective: Bradycardia has been observed among patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is suspected to be associated with poorer outcomes. Heart rate (HR) fluctuation has been found to be correlated with a greater mortality rate in critically ill patients. The association of bradycardia and HR fluctuation with the outcome of severe coronavirus disease 2019 (COVID-19) patients has not been clarified. Therefore, we aimed to examine whether bradycardia and HR fluctuation correlated with poor outcomes in patients with severe COVID-19. Materials and Methods: We conducted a secondary analysis from a prospective data collection of patients admitted to the intensive care unit, between April and June 2021, at Chiang Mai University Hospital. Results: The results showed that 62 of 86 patients (72.1%) had bradycardia, defined by HR < 60 beats per minute (bpm). The number of patients with high HR fluctuation, defined as the difference in HR during admission ≥ 40 bpm, was greater among the bradycardia group than in the non-bradycardia group (70.9% vs. 14.7%, p = 0.015, respectively). The patients with bradycardia had greater levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In addition, a greater proportion of patients with bradycardia received interleukin-6 inhibitors and hemoperfusion as a rescue therapy than those with non-bradycardia. After adjusting for age, gender, body mass index, CRP, and mechanical ventilator; bradycardia and the high HR fluctuation were significantly associated with a longer length of stay in the intensive care unit (ICU-LOS), with adjusted risk ratios of 2.67, 95% CI; 1.02, 6.94, p = 0.045 and 2.88, 95% CI; 1.22, 6.78, p = 0.016, respectively. Conclusion: We found that bradycardia and a high heart rate fluctuation were associated with a poorer ICU outcome in terms of longer ICU-LOS among the patients with severe COVID-19.
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Affiliation(s)
- Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
- Correspondence: ; Tel.: +66-81-992-8133
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Teerapat Nantsupawat
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Athavudh Deesomchok
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Panida Chanayat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Nutchanok Niyatiwatchanchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Atikun Limsukon
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
| | - Chaiwat Bumroongkit
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.T.); (W.C.); (A.D.); (P.C.); (N.N.); (T.T.); (A.L.); (C.P.); (C.L.); (C.B.)
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Mariani S, De Piero ME, Ravaux JM, Saelmans A, Kawczynski MJ, van Bussel BCT, Di Mauro M, Willers A, Swol J, Kowalewski M, Li T, Delnoij TSR, van der Horst ICC, Maessen J, Lorusso R. Temporary mechanical circulatory support for COVID-19 patients: A systematic review of literature. Artif Organs 2022; 46:1249-1267. [PMID: 35490367 PMCID: PMC9325561 DOI: 10.1111/aor.14261] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/10/2021] [Accepted: 04/06/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Myocardial damage occurs in up to 25% of coronavirus disease 2019 (COVID-19) cases. While veno-venous extracorporeal life support (V-V ECLS) is used as respiratory support, mechanical circulatory support (MCS) may be required for severe cardiac dysfunction. This systematic review summarizes the available literature regarding MCS use rates, disease drivers for MCS initiation, and MCS outcomes in COVID-19 patients. METHODS PubMed/EMBASE were searched until October 14, 2021. Articles including adults receiving ECLS for COVID-19 were included. The primary outcome was the rate of MCS use. Secondary outcomes included mortality at follow-up, ECLS conversion rate, intubation-to-cannulation time, time on ECLS, cardiac diseases, use of inotropes, and vasopressors. RESULTS Twenty-eight observational studies (comprising both ECLS-only populations and ECLS patients as part of larger populations) included 4218 COVID-19 patients (females: 28.8%; median age: 54.3 years, 95%CI: 50.7-57.8) of whom 2774 (65.8%) required ECLS with the majority (92.7%) on V-V ECLS, 4.7% on veno-arterial ECLS and/or Impella, and 2.6% on other ECLS. Acute heart failure, cardiogenic shock, and cardiac arrest were reported in 7.8%, 9.7%, and 6.6% of patients, respectively. Vasopressors were used in 37.2%. Overall, 3.1% of patients required an ECLS change from V-V ECLS to MCS for heart failure, myocarditis, or myocardial infarction. The median ECLS duration was 15.9 days (95%CI: 13.9-16.3), with an overall survival of 54.6% and 28.1% in V-V ECLS and MCS patients. One study reported 61.1% survival with oxy-right ventricular assist device. CONCLUSION MCS use for cardiocirculatory compromise has been reported in 7.3% of COVID-19 patients requiring ECLS, which is a lower percentage compared to the incidence of any severe cardiocirculatory complication. Based on the poor survival rates, further investigations are warranted to establish the most appropriated indications and timing for MCS in COVID-19.
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Affiliation(s)
- Silvia Mariani
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Maria Elena De Piero
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Justine M. Ravaux
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Alexander Saelmans
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
| | - Michal J. Kawczynski
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Bas C. T. van Bussel
- Department of Intensive Care MedicineMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Care And Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtThe Netherlands
| | - Michele Di Mauro
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Anne Willers
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Justyna Swol
- Department of Pneumology, Allergology and Sleep MedicineParacelsus Medical UniversityNurembergGermany
| | - Mariusz Kowalewski
- Clinical Department of Cardiac SurgeryCentral Clinical Hospital of the Ministry of Interior and Administration, Centre of Postgraduate Medical EducationWarsawPoland
| | - Tong Li
- Department of Cardiothoracic, Transplantation and Vascular SurgeryHannover Medical SchoolHannoverGermany
| | - Thijs S. R. Delnoij
- Department of Intensive Care MedicineMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Department of Cardiology, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
| | - Iwan C. C. van der Horst
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
- Department of Intensive Care MedicineMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
| | - Jos Maessen
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
| | - Roberto Lorusso
- Cardio‐Thoracic Surgery Department, Heart and Vascular CentreMaastricht University Medical Centre (MUMC)MaastrichtThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)MaastrichtThe Netherlands
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Schneider M. The Role of Biomarkers in Hospitalized COVID-19 Patients With Systemic Manifestations. Biomark Insights 2022; 17:11772719221108909. [PMID: 35783222 PMCID: PMC9243490 DOI: 10.1177/11772719221108909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/06/2022] [Indexed: 01/08/2023] Open
Abstract
The following article aims to review COVID-19 biomarkers used in hospital
practice. It is apparent that COVID-19 is not simply a pulmonary disease but has
systemic manifestations. For this reason, biomarkers must be used in the
management of diagnosed patients to provide holistic care. Patients with
COVID-19 have been shown to have pulmonary, hepatobiliary, cardiovascular,
neurologic, and renal injury, along with coagulopathy and a distinct cytokine
storm. Biomarkers can effectively inform clinicians of systemic organ injury due
to COVID-19. Furthermore, biomarkers can be used in predictive models for severe
COVID-19 in admitted patients. The utility of doing so is to allow for risk
stratification and utilization of proper treatment protocols. In addition,
COVID-19 biomarkers in the pediatric population are discussed, specifically in
predicting Multisystem Inflammatory Syndrome. Ultimately, biomarkers can be used
as predictive tools to allow clinicians to identify and adequately manage
patients at increased risk for worse outcomes from COVID-19. Both literature
review and anecdotal evidence has shown that severe COVID-19 is a systemic
disease, and understanding associated biomarkers are crucial for hospitalized
patients’ proper clinical decision-making. For example, the cytokine storm
releases inflammatory markers in different organ systems such as the pulmonary,
hepatobiliary, hematological, cardiac, neurological, and renal systems. This
review summarizes the latest research of COVID-19 that can help inform
healthcare professionals how to better mitigate morbidity and mortality
associated with this disease and provides information about certain systemic
biomarkers that can be incorporated into hospital practice to provide more
comprehensive care for hospitalized COIVD-19 patients.
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Affiliation(s)
- Michael Schneider
- University of Queensland Ochsner Clinical School, New Orleans, LA, USA
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Histopathological and molecular links of COVID-19 with novel clinical manifestations for the management of coronavirus-like complications. Inflammopharmacology 2022; 30:1219-1257. [PMID: 35637319 PMCID: PMC9150634 DOI: 10.1007/s10787-022-00999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) causes transmissible viral illness of the respiratory tract prompted by the SARS-CoV-2 virus. COVID-19 is one of the worst global pandemics affecting a large population worldwide and causing catastrophic loss of life. Patients having pre-existing chronic disorders are more susceptible to contracting this viral infection. This pandemic virus is known to cause notable respiratory pathology. Besides, it can also cause extra-pulmonary manifestations. Multiple extra-pulmonary tissues express the SARS-CoV-2 entry receptor, hence causing direct viral tissue damage. This insightful review gives a brief description of the impact of coronavirus on the pulmonary system, extra-pulmonary systems, histopathology, multiorgan consequences, the possible mechanisms associated with the disease, and various potential therapeutic approaches to tackle the manifestations.
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Salinas-Botrán A, Sanz-Cánovas J, Pérez-Somarriba J, Pérez-Belmonte LM, Cobos-Palacios L, Rubio-Rivas M, de-Cossío-Tejido S, Ramos-Rincón JM, Méndez-Bailón M, Gómez-Huelgas R. Clinical characteristics and risk factors for mortality upon admission in patients with heart failure hospitalized due to COVID-19 in Spain. Rev Clin Esp 2022; 222:255-265. [PMID: 34629304 PMCID: PMC8497960 DOI: 10.1016/j.rceng.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/17/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND There are few studies on patients with heart failure (HF) hospitalized for COVID-19. Our aim is to describe the clinical characteristics of patients with HF hospitalized for COVID-19 and identify risk factors for in-hospital mortality upon admission. METHODS We conducted a retrospective, multicenter study in patients with HF hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). A multivariate logistic regression analysis was performed to identify admission factors associated with in-hospital mortality. RESULTS A total of 1718 patients were analyzed (56.5% men; median age 81.4 years). The overall case fatality rate was 47.6% (n = 819). The independent risk factors at admission for in-hospital mortality were: age (adjusted odds ratio [AOR]: 1.03; 95% confidence interval [95%CI]: 1.02-1.05; p < 0.001); severe dependence (AOR: 1.62; 95%CI: 1.19-2.20; p = 0.002); tachycardia (AOR: 1.01; 95%CI: 1.00-1.01; p = 0.004); and high C-reactive protein (AOR: 1.004; 95%CI:1.002-1.004; p < 0.001), LDH (AOR: 1.001; 95%CI: 1.001-1.002; p < 0.001), and serum creatinine levels (AOR: 1.35; 95%CI: 1.18-1.54; p < 0.001). CONCLUSIONS Patients with HF hospitalized for COVID-19 have a high in-hospital mortality rate. Some simple clinical and laboratory tests can help to identify patients with a worse prognosis.
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Affiliation(s)
- A Salinas-Botrán
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - J Sanz-Cánovas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | - J Pérez-Somarriba
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - L M Pérez-Belmonte
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain.
| | - L Cobos-Palacios
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | - M Rubio-Rivas
- Servicio de Medicina Interna, Hospital Universitario Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S de-Cossío-Tejido
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J M Ramos-Rincón
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - M Méndez-Bailón
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
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Salinas-Botrán A, Sanz-Cánovas J, Pérez-Somarriba J, Pérez-Belmonte LM, Cobos-Palacios L, Rubio-Rivas M, de-Cossío-Tejido S, Ramos-Rincón JM, Méndez-Bailón M, Gómez-Huelgas R. [Clinical characteristics and risk factors for mortality upon admission in patients with heart failure hospitalized due to COVID-19 in Spain]. Rev Clin Esp 2022; 222:255-265. [PMID: 34305156 PMCID: PMC8285252 DOI: 10.1016/j.rce.2021.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/17/2021] [Indexed: 01/12/2023]
Abstract
Background There are few studies on patients with heart failure (HF) hospitalized for COVID-19. Our aim is to describe the clinical characteristics of patients with HF hospitalized for COVID-19 and identify risk factors for in-hospital mortality upon admission. Methods We conducted a retrospective, multicenter study in patients with HF hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). A multivariate logistic regression analysis was performed to identify admission risk factors associated with in-hospital mortality. Results A total of 1,718 patients were analyzed (56.5% men; median age 81.4 years). The overall case fatality rate was 47.6% (n=819). The independent risk factors at admission for in-hospital mortality were: age (adjusted odds ratio [AOR]: 1.03; 95% confidence interval [95%CI]: 1.02-1.05; p< .001); severe dependence (AOR: 1.62; 95%CI: 1.19-2.20; p=.002); tachycardia (AOR: 1.01; 95%CI: 1.00-1.01; p=.004); and high C-reactive protein (AOR: 1.004; 95%CI:1.002-1.004; p< .001), LDH (AOR: 1.001; 95%CI: 1.001-1.002; p< .001), and serum creatinine levels (AOR: 1.35; 95%CI: 1.18-1.54; p< .001). Conclusions Patients with HF hospitalized for COVID-19 have a high in-hospital mortality rate. Some simple clinical and laboratory tests can help to identify patients with a worse prognosis.
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Affiliation(s)
- A Salinas-Botrán
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J Sanz-Cánovas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
| | - J Pérez-Somarriba
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - L M Pérez-Belmonte
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
| | - L Cobos-Palacios
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
| | - M Rubio-Rivas
- Servicio de Medicina Interna, Hospital Universitario Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - S de-Cossío-Tejido
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
| | - J M Ramos-Rincón
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Alicante, España
| | - M Méndez-Bailón
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, España
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Najafi R, Mamizadeh N, Hosseini SH, Roushenas S, Bazhdan L. A challenging case of COVID-19: a COVID-19 positive adolescent presented with severe diabetic ketoacidosis, resistant hypertension. BMC Endocr Disord 2022; 22:90. [PMID: 35382801 PMCID: PMC8981183 DOI: 10.1186/s12902-022-00979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/02/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus which causes COVID-19. It binds to the angiotensin-converting enzyme 2 (ACE2) receptors, expressed in key metabolic organs and tissues, including pancreatic beta cells, adipose tissue, the small intestine, and kidneys. This condition has been linked to a variety of additional symptoms, including acute encephalopathy, changes in consciousness, and even gastrointestinal bleeding. CASE PRESENTATION In this study, we have reported a 13-year-old boy, 69 kg, with SARS-COV-2 infection. In this case, multiple systems, including the endocrine, renal, pulmonary, gastrointestinal, and nervous systems, were affected. CONCLUSIONS It is speculated that different manifestations of COVID-19 can be seen in clinical settings, and practitioners should be more cautious not to miss the chimeric characteristics of COVID-19 infection.
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Affiliation(s)
- Reza Najafi
- Department of Pediatric Endocrinology and Metabolism, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Nahid Mamizadeh
- Department of Pediatric Nephrology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
| | | | - Sima Roushenas
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Bazhdan
- Department of Pediatrics, School of Medicine, Emam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
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Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074279. [PMID: 35409960 PMCID: PMC8998516 DOI: 10.3390/ijerph19074279] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 12/31/2022]
Abstract
Background: To assess the event rates of myocarditis detected by Cardiac Magnetic Resonance (CMR) in athletes who recovered from COVID-19. Methods: A systematic literature search was performed to identify studies reporting abnormal CMR findings in athletes who recovered from COVID-19. Secondary analyses were performed considering increased serum high sensitivity troponin (hs-Tn) levels and electrocardiographic (ECG) and echocardiographic (ECHO) abnormalities. Results: In total, 7988 athletes from 15 studies were included in the analysis. The pooled event rate of myocarditis was 1% (CI 1–2%), reaching 4% in the sub-group analysis. In addition, heterogeneity was observed (I2 43.8%). The pooled event rates of elevated serum hs-Tn levels, abnormal ECG and ECHO findings were 2% (CI 1–5%), 3% (CI 1–10%) and 2% (CI 1–6%), respectively. ECG, ECHO and serum hs-Tn level abnormalities did not show any correlation with myocarditis. Conclusions: The prevalence of COVID-19-related myocarditis in the athletic population ranges from 1 to 4%. Even if the event rate is quite low, current screening protocols are helpful tools for a safe return to play to properly address CMR studies. Trial registration: the study protocol was registered in the PROSPERO database (registration number: CRD42022300819).
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Haryalchi K, Olangian‐Tehrani S, Asgari Galebin SM, Mansour‐Ghanaie M. The importance of myocarditis in Covid-19. Health Sci Rep 2022; 5:e488. [PMID: 35059506 PMCID: PMC8757483 DOI: 10.1002/hsr2.488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/07/2021] [Accepted: 12/21/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The outbreak of Covid-19 is a real threat to public health. It causes cardiovascular complications such as acute myocardial injury and myocarditis. Symptoms of myocarditis vary from chest pain, tachycardia, or chest tightness. Inotropes and/or vasopressors and mechanical ventilation are the protocols for cardiogenic shock in patients with myocarditis. Some previous studies stated that the mechanism of cardiac injury is not well defined but, it can be due to direct myocardial infection, respiratory failure or hypoxemia, and indirect injury from systemic inflammatory response separately or all three factors together. The pathologic processes included direct myocardial injury by virus binding to ACE2, systemic inflammation, altered myocardial demand-supply ratio, and plaque and coronary thrombosis. There are disagreements on the usage of corticosteroids in active-infection myocarditis. As everyday new complications of Covid-19 appear, there is a need for further research to overcome them. AIMS This narrative study aimed to assess the effect of Covid-19 on myocarditis.
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Affiliation(s)
- Katayoun Haryalchi
- Reproductive Health Research Center, Al‐zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
| | | | | | - Mandana Mansour‐Ghanaie
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al‐zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
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Salabei JK, Asnake ZT, Ismail ZH, Charles K, Stanger GT, Abdullahi AH, Abraham AT, Okonoboh P. COVID-19 and the Cardiovascular System: An Update. Am J Med Sci 2022; 364:139-147. [PMID: 35151635 PMCID: PMC8830924 DOI: 10.1016/j.amjms.2022.01.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/07/2022] [Accepted: 01/31/2022] [Indexed: 12/20/2022]
Abstract
As COVID-19 continues to cause an increasing number of deaths worldwide, it is important that providers stay abreast with new research related to the pathophysiology of COVID-19 disease presentation states and clinical management. It is now well recognized that COVID-19 affects extrapulmonary organs, particularly the cardiovascular system. For example, cardiogenic shock has been increasingly observed in patients with COVID-19, owing to the various mechanisms involved and the affinity of the SARS-CoV-2 virus to cells comprising the cardiovascular system. In this review, we have briefly discussed the link between the cardiovascular system and COVID-19 infection, focusing on underlying mechanisms including but not limited to cytokine storm, direct virus-induced myocarditis, and ST-elevation myocardial infarction leading to cardiogenic shock. We have highlighted the cardiovascular risk factors associated with disease prognostication in COVID-19 patients. We have also briefly discussed vasopressors and inotropes used for treating shock and presented their mechanism of action, contraindications, and side effects in the hopes of providing a quick reference to help the provider optimize management of COVID-19 patients presenting with cardiovascular complications such as shock.
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Affiliation(s)
- Joshua K Salabei
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA.
| | - Zekarias T Asnake
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
| | - Zeeshan H Ismail
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
| | - Kipson Charles
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
| | - Gregory-Thomas Stanger
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
| | - Abdullahi H Abdullahi
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
| | - Andrew T Abraham
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
| | - Peters Okonoboh
- Department of Internal Medicine, University of Central Florida School of Medicine/North Florida Regional Medical Center, Gainesville, USA
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Abstract
COVID 19, caused by SARS-CoV-2, is a highly infectious disease, mainly affects the respiratory system. In this article, we have presented a case of COVID-19, who presented solely with pericarditis without myocarditis, without any respiratory symptoms. The diagnosis was made based on clinical, electrocardiographic, radiological and biological findings. He was treated successfully with aspirin and colchicine. Our case highlights an atypical presentation of COVID-19, which should be kept in mind in the present pandemic and to diagnose and isolate early to limit the spread of infection.
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Peiris S, Ordunez P, DiPette D, Padwal R, Ambrosi P, Toledo J, Stanford V, Lisboa T, Aldighieri S, Reveiz L. Cardiac Manifestations in Patients with COVID-19: A Scoping Review. Glob Heart 2022; 17:2. [PMID: 35174043 PMCID: PMC8757387 DOI: 10.5334/gh.1037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19), commonly affects the lungs, but the involvement of other organs, particularly the heart, is highly prevalent as has been reported in several studies. The overall aim of this review was to provide an in-depth description of the available literature related to the cardiac system and COVID-19 infection. It focuses on type and the frequency of cardiac manifestations, clinical parameters and cardiac biomarkers that support the prognosis of COVID-19 patients, and the cardiac adverse events and outcomes related to pharmacotherapy. Methods A scoping review was conducted searching Embase, PubMed, Epistomonikos, Medrxiv, BioRxiv databases, up to November 2020, for systematic reviews relevant to cardiac manifestations in adult COVID-19 patients. Relevant articles were screened and extracted to summarize key outcomes and findings. Results A total of 63 systematic reviews met the inclusion criteria. The overall frequency of acute cardiac injury ranged from 15% to 33% in the reporting studies. The main cardiac complications were arrhythmias (3.1% to 6.9% in non-severe patients, 33.0% to 48.0% in severe disease), acute coronary syndromes (6% to 33% in severe disease), and myocarditis. Most studies found no association with the use of Renin-angiotensin-aldosterone system inhibitors (RAASI) with COVID-19 outcomes such as susceptibility to infection, hospitalization, severity, and mortality. Conclusion This study provided an overview of the several cardiac complications associated with Covid-19. Cardiac injury, arrhythmias, myocarditis, cardiac failure, and acute coronary syndrome, are prevalent and clinically significant and associated with COVID-19 disease severity and mortality. Other studies are needed to clearly identify what is the part of viral heart infection and what is the part of cardiac injury secondary to acute respiratory failure and inflammation. In the therapeutic field, these systematic reviews gave heterogenous results. This underlines the importance of randomized trials to determine the right therapeutic approach.
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Affiliation(s)
- Sasha Peiris
- Incident Management Systems for COVID-19, Pan American Health Organization, Washington, DC, USA
- Health Emergencies Department, Pan American Health Organization, Washington, DC, USA
| | - Pedro Ordunez
- Noncommunicable Disease and Mental Health Department, Pan American Health Organization, Washington, DC, USA
| | - Donald DiPette
- Department of Medicine, University of South Carolina and University of South Carolina School of Medicine in Columbia, SC, USA
| | - Raj Padwal
- Department of Medicine, University of Alberta, Edmonton, Alberta, CA
| | - Pierre Ambrosi
- Department of Cardiology, Hôpital de la Timone, Marseille –Aix-Marseille Université, Marseille, FR
| | - Joao Toledo
- Incident Management Systems for COVID-19, Pan American Health Organization, Washington, DC, USA
- Health Emergencies Department, Pan American Health Organization, Washington, DC, USA
| | - Victoria Stanford
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Thiago Lisboa
- Instituto de Pesquisa HCOR – Hospital do Coração São Paulo, BR
| | - Sylvain Aldighieri
- Incident Management Systems for COVID-19, Pan American Health Organization, Washington, DC, USA
- Health Emergencies Department, Pan American Health Organization, Washington, DC, USA
| | - Ludovic Reveiz
- Incident Management Systems for COVID-19, Pan American Health Organization, Washington, DC, USA
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
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Rezabakhsh A, Sadat‐Ebrahimi S, Ala A, Nabavi SM, Banach M, Ghaffari S. A close-up view of dynamic biomarkers in the setting of COVID-19: Striking focus on cardiovascular system. J Cell Mol Med 2022; 26:274-286. [PMID: 34894069 PMCID: PMC8743667 DOI: 10.1111/jcmm.17122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 10/15/2021] [Accepted: 12/01/2021] [Indexed: 01/08/2023] Open
Abstract
Based on the recent reports, cardiovascular events encompass a large portion of the mortality caused by the COVID-19 pandemic, which drawn cardiologists into the management of the admitted ill patients. Given that common laboratory values may provide key insights into the illness caused by the life-threatening SARS-CoV-2 virus, it would be more helpful for screening, clinical management and on-time therapeutic strategies. Commensurate with these issues, this review article aimed to discuss the dynamic changes of the common laboratory parameters during COVID-19 and their association with cardiovascular diseases. Besides, the values that changed in the early stage of the disease were considered and monitored during the recovery process. The time required for returning biomarkers to basal levels was also discussed. Finally, of particular interest, we tended to abridge the latest updates regarding the cardiovascular biomarkers as prognostic and diagnostic criteria to determine the severity of COVID-19.
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Affiliation(s)
- Aysa Rezabakhsh
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
| | | | - Alireza Ala
- Emergency Medicine Research TeamTabriz University of Medical SciencesTabrizIran
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research CenterBaqiyatallah University of Medical SciencesTehranIran
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and HypertensionMedical University of LodzLodzPoland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI)LodzPoland
| | - Samad Ghaffari
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
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Sibiya N, Mbatha B, Arineitwe C, Onyekwuluje C, Ngubane P, Khathi A. Covid 19 May Limit the Use of Anti-hyperglycemic Agents. Does it Call for the Development of New Anti-hyperglycemic Agents? Curr Diabetes Rev 2022; 18:e060821195364. [PMID: 34365928 DOI: 10.2174/1573399817666210806114200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 01/08/2023]
Abstract
Diabetes mellitus has been identified as a major risk factor for developing severe COVID 19 complications. In this review article, the efforts were directed to provide insights and the possible extent to which some diabetic pharmacological interventions may exacerbate COVID 19 or may not be idyllic options for COVID 19 patients. Articles reviewed were identified using the Google scholar database, and search was done using the English language. Anti-hyperglycemic is associated with undesirable effects including episodes of hypoglycemia, diarrhea, lactic acidosis, and increased risks of cardiovascular and hepatic hazards. These undesirable effects associated with the anti-hyperglycemic agents possess a threat of developing severe COVID19 complications Therefore, this calls for more studies to understand the extent of the risks these agents possess in diabetic COVID 19 patients. Almost all the anti-hyperglycemic agents have the potential to worsen COVID 19, despite their class. COVID 19 may limit the options in terms of available anti-hyperglycemic agents which may not heighten the risk of developing severe COVID 19 complications. The research towards the discovery and development of new compounds and also new therapeutic targets for hyperglycemia should be encouraged and welcome.
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Affiliation(s)
- Ntethelelo Sibiya
- Pharmacology Division, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Bonisiwe Mbatha
- School of Laboratory Medicine, College of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Charles Arineitwe
- Pharmacology Division, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Chiamaka Onyekwuluje
- Pharmacology Division, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Phikelelani Ngubane
- School of Laboratory Medicine, College of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Andile Khathi
- School of Laboratory Medicine, College of Health Science, University of KwaZulu-Natal, Durban, South Africa
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Thomas P, Baldwin C, Beach L, Bissett B, Boden I, Cruz SM, Gosselink R, Granger CL, Hodgson C, Holland AE, Jones AY, Kho ME, van der Lee L, Moses R, Ntoumenopoulos G, Parry SM, Patman S. Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations. J Physiother 2022; 68:8-25. [PMID: 34953756 PMCID: PMC8695547 DOI: 10.1016/j.jphys.2021.12.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/25/2021] [Accepted: 12/13/2021] [Indexed: 12/15/2022] Open
Abstract
This document provides an update to the recommendations for physiotherapy management for adults with coronavirus disease 2019 (COVID-19) in the acute hospital setting. It includes: physiotherapy workforce planning and preparation; a screening tool for determining requirement for physiotherapy; and recommendations for the use of physiotherapy treatments and personal protective equipment. New advice and recommendations are provided on: workload management; staff health, including vaccination; providing clinical education; personal protective equipment; interventions, including awake proning, mobilisation and rehabilitation in patients with hypoxaemia. Additionally, recommendations for recovery after COVID-19 have been added, including roles that physiotherapy can offer in the management of post-COVID syndrome. The updated guidelines are intended for use by physiotherapists and other relevant stakeholders caring for adult patients with confirmed or suspected COVID-19 in the acute care setting and beyond.
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Affiliation(s)
- Peter Thomas
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Brisbane, Australia.
| | - Claire Baldwin
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lisa Beach
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Australia
| | - Bernie Bissett
- Discipline of Physiotherapy, University of Canberra, Canberra, Australia; Physiotherapy Department, Canberra Hospital, Canberra, Australia
| | - Ianthe Boden
- Physiotherapy Department, Launceston General Hospital, Launceston, Australia; School of Medicine, University of Tasmania, Launceston, Australia
| | - Sherene Magana Cruz
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
| | - Rik Gosselink
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Department of Critical Care, University Hospitals Leuven, Leuven, Belgium
| | - Catherine L Granger
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Australia; Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
| | - Carol Hodgson
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia; Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia; The George Institute for Global Health, Sydney, Australia
| | - Anne E Holland
- Central Clinical School, Monash University, Melbourne, Australia; Departments of Physiotherapy and Respiratory Medicine, Alfred Health, Melbourne, Australia
| | - Alice Ym Jones
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle E Kho
- School of Rehabilitation Science, McMaster University, Hamilton, Canada; St Joseph's Healthcare, Hamilton, Canada; The Research Institute of St Joe's, Hamilton, Canada
| | - Lisa van der Lee
- Physiotherapy Department, Fiona Stanley Hospital, Perth, Australia
| | - Rachael Moses
- NHS Leadership Academy, Leadership and Lifelong Learning, People Directorate, NHS England and Improvement, London, UK
| | | | - Selina M Parry
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
| | - Shane Patman
- Faculty of Medicine, Nursing and Midwifery, Health Sciences & Physiotherapy, The University of Notre Dame Australia, Perth, Australia
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Negreira-Caamaño M, Martínez-Del Río J, Águila-Gordo D, Mateo-Gómez C, Soto-Pérez M, Piqueras-Flores J. Cardiovascular events after COVID-19 hospitalization: long-term follow-up. REVISTA ESPAÑOLA DE CARDIOLOGÍA (ENGLISH EDITION) 2022; 75:100-102. [PMID: 34583913 PMCID: PMC8426288 DOI: 10.1016/j.rec.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jorge Martínez-Del Río
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Daniel Águila-Gordo
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Cristina Mateo-Gómez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Maeve Soto-Pérez
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Facultad de Medicina, Universidad de Castilla La-Mancha, Ciudad Real, Spain
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50
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Jafari-Oori M, Dehi M, Ebadi A, Moradian ST, jafari M. Incidence of cardiac complications following COVID-19 infection: An umbrella meta-analysis study. Heart Lung 2022; 52:136-145. [PMID: 35074740 PMCID: PMC8743575 DOI: 10.1016/j.hrtlng.2022.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 01/08/2023]
Abstract
Background COVID-19 causes fatal cardiac damages. Despite many overwhelming meta-analysis related to cardiac complications following COVID-19 disease, no umbrella meta-analysis study has been conducted. Objectives We aimed to report the summarized pooled incidences of cardiac complications in the overall, critically ill, and deceased patients, compare the cardiac complications between the severe/non-severe or deceased/non-deceased patients, and also compare poor outcomes between patients with/without acute myocardial injury (AMI). Methods PubMed, Scopus, web of science, Cochrane, ProQuest, Springer, Sage journals were searched before April 2021. After assessing the quality and duplicate data, data were run by the random/fixed-effect models, I2 heterogeneity index, Egger's test, and sensitivity analysis. Results After removing duplicate data, in the overall COVID-19 patients, the pooled incidence of AMI, heart failure, arrhythmia, cardiac arrest, and acute coronary syndrome (ACS) were 21%, 14%, 16%, 3.46%, and 1.3%, respectively. In the patients with severe disease, the pooled incidence of AMI and shock were 33 and 35%, respectively. Similarly, in the deceased COVID-19 patients, the pooled incidence rate of AMI and arrhythmia were 56% and 47.5%, respectively. The patients with severe disease were at higher risk of AMI (RR = 5.27) and shock (OR = 20.18) compared with the non-severe cases. Incidence of AMI was associated with transfer to the intensive care units (ICU) (RR = 2.92) and mortality (RR = 2.57, OR = 8.36), significantly. Conclusion Cardiac complications were found to be increased alarmingly in COVID-19 patients. Baseline and during hospitalization checking with electrocardiography, echocardiography, and measuring of cardiac biomarkers should be applied.
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