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Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens 2020; 35:4-11. [PMID: 32719447 PMCID: PMC7384729 DOI: 10.1038/s41371-020-0387-4] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/08/2020] [Accepted: 07/16/2020] [Indexed: 12/13/2022]
Abstract
Cardiac injury in patients infected with the novel Coronavirus (COVID-19) seems to be associated with higher morbimortality. We provide a broad review of the clinical evolution of COVID-19, emphasizing its impact and implications on the cardiovascular system. The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by overproduction of inflammatory cytokines (IL-6 and TNF-α) leading to systemic inflammation and multiple organ dysfunction syndrome, acutely affecting the cardiovascular system. Hypertension (56.6%) and diabetes (33.8%) are the most prevalent comorbidities among individuals with COVID-19, who require hospitalization. Furthermore, cardiac injury, defined as elevated us-troponin I, significantly relates to inflammation biomarkers (IL-6 and C-reactive protein (CRP), hyperferritinemia, and leukocytosis), portraying an important correlation between myocardial injury and inflammatory hyperactivity triggered by viral infection. Increased risk for myocardial infarction, fulminant myocarditis rapidly evolving with depressed systolic left ventricle function, arrhythmias, venous thromboembolism, and cardiomyopathies mimicking STEMI presentations are the most prevalent cardiovascular complications described in patients with COVID-19. Moreover, SARS-CoV-2 tropism and interaction with the RAAS system, through ACE2 receptor, possibly enhances inflammation response and cardiac aggression, leading to imperative concerns about the use of ACEi and ARBs in infected patients. Cardiovascular implications result in a worse prognosis in patients with COVID-19, emphasizing the importance of precocious detection and implementation of optimal therapeutic strategies.
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Aksoy H, Karadag AS, Wollina U. Angiotensin II receptors: Impact for COVID-19 severity. Dermatol Ther 2020; 33:e13989. [PMID: 32645228 PMCID: PMC7361069 DOI: 10.1111/dth.13989] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
COVID-19 is an outbreak of viral pneumonia which became a global health crisis, and the risk of morbidity and mortality of people with obesity are higher. SARS-CoV-2, the pathogen of COVID-19, enters into cells through binding to the Angiotensin Converting Enzyme (ACE) homolog-2 (ACE2). ACE2 is a regulator of two contrary pathways in renin angiotensin system (RAS): ACE-Ang-II-AT1R axis and ACE2-Ang 1-7-Mas axis. Viral entry process eventuates in downregulation of ACE2 and subsequent activation of ACE-Ang-II-AT1R axis. ACE-Ang II-AT1R axis increases lipid storage, reduces white-to-beige fat conversion and plays role in obesity. Conversely, adipose tissue is an important source of angiotensin, and obesity results in increased systemic RAS. ACE-Ang-II-AT1R axis, which has proinflammatory, profibrotic, prothrombotic, and vasoconstrictive effects, is potential mechanism of more severe SARS-CoV-2 infection. The link between obesity and severe COVID-19 may be attributed to ACE2 consumption and subsequent ACE-Ang-II-AT1R axis activation. Therefore, patients with SARS-CoV-2 infection may benefit from therapeutic strategies that activate ACE2-Ang 1-7-Mas axis, such as Ang II receptor blockers (ARBs), ACE inhibitors (ACEIs), Mas receptor agonists and ACE2.
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Affiliation(s)
- Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ayse Serap Karadag
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University, Dresden, Germany
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Inhibition of SARS-CoV-2 entry through the ACE2/TMPRSS2 pathway: a promising approach for uncovering early COVID-19 drug therapies. Eur J Clin Pharmacol 2020; 76:1623-1630. [PMID: 32696234 PMCID: PMC7372205 DOI: 10.1007/s00228-020-02963-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/16/2020] [Indexed: 10/26/2022]
Abstract
AIM The COVID-19 pandemic caused by infection with the novel coronavirus SARS-CoV-2 is urging the scientific community worldwide to intense efforts for identifying and developing effective drugs and pharmacologic strategies to treat the disease. Many of the drugs that are currently in (pre)clinical development are addressing late symptoms of the disease. This review focuses on potential pharmacologic intervention at an early stage of infection which could result in less-infected individuals and less cases with severe COVID-19 disease due to reduced virus entry into the cells. METHOD We scanned the literature for evidence on drugs that target the virus entry machinery into host cells and consist mainly of ACE2 and TMPRSS2, as well as other cellular molecules regulating ACE2 expression, such as ADAM-17 and calmodulin. RESULTS Several drugs/drug classes have been identified. Most of them are already used clinically for other indications. They include recombinant soluble ACE2, indirect ACE2 modulators (angiotensin receptor blockers, calmodulin antagonists, selective oestrogen receptor modifiers), TMPRSS2 inhibitors (camostat mesylate, nafamostat mesylate, antiandrogens, inhaled corticosteroids) and ADAM-17 enhancers (5-fluorouracil). CONCLUSION Several agents have potential for prophylactic and therapeutic intervention at the early stages of SARS-CoV-2 infection and COVID-19 disease and they should be urgently investigated further in appropriate preclinical models and clinical studies.
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Pan W, Zhang J, Wang M, Ye J, Xu Y, Shen B, He H, Wang Z, Ye D, Zhao M, Luo Z, Liu M, Zhang P, Gu J, Liu M, Li D, Liu J, Wan J. Clinical Features of COVID-19 in Patients With Essential Hypertension and the Impacts of Renin-angiotensin-aldosterone System Inhibitors on the Prognosis of COVID-19 Patients. Hypertension 2020; 76:732-741. [PMID: 32654555 DOI: 10.1161/hypertensionaha.120.15289] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (1:1 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8+ cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20-2.70]; matched cohort [2.24, 1.36-3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4+ cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.
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Affiliation(s)
- Wei Pan
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Jishou Zhang
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Menglong Wang
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Jing Ye
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Yao Xu
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Bo Shen
- Department of Medical Affairs (B.S., H.H.), Renmin Hospital of Wuhan University, China
| | - Hua He
- Department of Medical Affairs (B.S., H.H.), Renmin Hospital of Wuhan University, China
| | - Zhen Wang
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Di Ye
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Mengmeng Zhao
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Zhen Luo
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Mingxiao Liu
- Medical Quality Management Office (Mingxiao Liu), Renmin Hospital of Wuhan University, China
| | - Pingan Zhang
- Department of Clinical Laboratory (P.Z., J.G.), Renmin Hospital of Wuhan University, China
| | - Jian Gu
- Department of Clinical Laboratory (P.Z., J.G.), Renmin Hospital of Wuhan University, China
| | - Menglin Liu
- Department of Emergency (Menglin Liu), Renmin Hospital of Wuhan University, China
| | - Dan Li
- Department of Pediatrics (D.L.), Renmin Hospital of Wuhan University, China
| | - Jianfang Liu
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
| | - Jun Wan
- From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.,Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).,Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.)
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and (select (case when (5705=1121) then null else ctxsys.drithsx.sn(1,5705) end) from dual) is null-- ehdm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and (select (case when (2527=2527) then null else ctxsys.drithsx.sn(1,2527) end) from dual) is null] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 4130=(select upper(xmltype(chr(60)||chr(58)||chr(113)||chr(122)||chr(118)||chr(107)||chr(113)||(select (case when (4130=4130) then 1 else 0 end) from dual)||chr(113)||chr(106)||chr(98)||chr(106)||chr(113)||chr(62))) from dual)-- dlpk] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 rlike (select (case when (3027=3027) then 0x31302e313033382f7334313539312d3032302d303936382d33 else 0x28 end))-- ezyj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 2832 in (select (char(113)+char(122)+char(118)+char(107)+char(113)+(select (case when (2832=2832) then char(49) else char(48) end))+char(113)+char(106)+char(98)+char(106)+char(113)))-- enfp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 7056=3908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 3729=3729-- zcki] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 rlike (select (case when (2548=8312) then 0x31302e313033382f7334313539312d3032302d303936382d33 else 0x28 end))-- pcpc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and (select 8647 from(select count(*),concat(0x717a766b71,(select (elt(8647=8647,1))),0x716a626a71,floor(rand(0)*2))x from information_schema.plugins group by x)a)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 3417=convert(int,(select char(113)+char(122)+char(118)+char(107)+char(113)+(select (case when (3417=3417) then char(49) else char(48) end))+char(113)+char(106)+char(98)+char(106)+char(113)))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 order by 1-- jhum] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 4759=1516-- ixhq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 order by 1#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 or row(2503,2130)>(select count(*),concat(0x717a766b71,(select (elt(2503=2503,1))),0x716a626a71,floor(rand(0)*2))x from (select 8109 union select 2815 union select 8856 union select 2310)a group by x)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and (select (case when (5910=5910) then null else cast((chr(66)||chr(67)||chr(108)||chr(97)) as numeric) end)) is null] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 order by 1-- hhqo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 3729=3729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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237
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and row(5860,4293)>(select count(*),concat(0x717a766b71,(select (elt(5860=5860,1))),0x716a626a71,floor(rand(0)*2))x from (select 8546 union select 6875 union select 9784 union select 9603)a group by x)-- wxdl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 rlike (select (case when (3027=3027) then 0x31302e313033382f7334313539312d3032302d303936382d33 else 0x28 end))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 or row(2503,2130)>(select count(*),concat(0x717a766b71,(select (elt(2503=2503,1))),0x716a626a71,floor(rand(0)*2))x from (select 8109 union select 2815 union select 8856 union select 2310)a group by x)-- oiws] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 4849=(select (case when (4849=5701) then 4849 else (select 5701 union select 8346) end))-- jjqi] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 1453=utl_inaddr.get_host_address(chr(113)||chr(122)||chr(118)||chr(107)||chr(113)||(select (case when (1453=1453) then 1 else 0 end) from dual)||chr(113)||chr(106)||chr(98)||chr(106)||chr(113))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 or (select 2501 from(select count(*),concat(0x717a766b71,(select (elt(2501=2501,1))),0x716a626a71,floor(rand(0)*2))x from information_schema.plugins group by x)a)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 3417=convert(int,(select char(113)+char(122)+char(118)+char(107)+char(113)+(select (case when (3417=3417) then char(49) else char(48) end))+char(113)+char(106)+char(98)+char(106)+char(113)))-- uudh] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY, Freedberg DE, Kirtane AJ, Parikh SA, Maurer MS, Nordvig AS, Accili D, Bathon JM, Mohan S, Bauer KA, Leon MB, Krumholz HM, Uriel N, Mehra MR, Elkind MSV, Stone GW, Schwartz A, Ho DD, Bilezikian JP, Landry DW. Extrapulmonary manifestations of COVID-19. Nat Med 2020. [DOI: 10.1038/s41591-020-0968-3 and 7381=(select (case when (7381=7381) then 7381 else (select 9289 union select 2024) end))-- gggv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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