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Jasiczek J, Doroszko A, Trocha T, Trocha M. Role of the RAAS in mediating the pathophysiology of COVID-19. Pharmacol Rep 2024; 76:475-486. [PMID: 38652364 PMCID: PMC11126499 DOI: 10.1007/s43440-024-00596-3] [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: 12/19/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
The renin-angiotensin-aldosterone system (RAAS) holds a position of paramount importance as enzymatic and endocrine homeostatic regulator concerning the water-electrolyte and acid-base balance. Nevertheless, its intricacy is influenced by the presence of various complementary angiotensins and their specific receptors, thereby modifying the primary RAAS actions. Angiotensin-converting enzyme 2 (ACE2) acts as a surface receptor for SARS-CoV-2, establishing an essential connection between RAAS and COVID-19 infection. Despite the recurring exploration of the RAAS impact on the trajectory of COVID-19 along with the successful resolution of many inquiries, its complete role in the genesis of delayed consequences encompassing long COVID and cardiovascular thrombotic outcomes during the post-COVID phase as well as post-vaccination, remains not fully comprehended. Particularly noteworthy is the involvement of the RAAS in the molecular mechanisms underpinning procoagulant processes throughout COVID-19. These processes significantly contribute to the pathogenesis of organ complications as well as determine clinical outcomes and are discussed in this manuscript.
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Affiliation(s)
- Jakub Jasiczek
- Department of Cardiology, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a, Wrocław, 51-124, Poland
| | - Adrian Doroszko
- Department of Cardiology, 4th Military Hospital, Faculty of Medicine, Wroclaw University of Science and Technology, Weigla 5, Wrocław, 50-981, Poland
| | - Tymoteusz Trocha
- Faculty of Medicine, Wroclaw Medical University, Borowska 213, Wrocław, 50-556, Poland.
| | - Małgorzata Trocha
- Clinical Department of Diabetology and Internal Disease, Wroclaw Medical University, Borowska 213, Wrocław, 50-556, Poland
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2
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Ponzoni M, Morabito G, Corrao G, Gerosa G, Cantarutti A, Rea F. The COVID-19 Pandemic Was Associated with a Change in Therapeutic Management and Mortality in Heart Failure Patients. J Clin Med 2024; 13:2625. [PMID: 38731152 PMCID: PMC11084396 DOI: 10.3390/jcm13092625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/23/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Heart failure (HF)-related mortality has been exacerbated by the COVID-19 pandemic; however, it is unclear how healthcare reassessment has contributed to the excess mortality versus SARS-CoV-2 infection itself. We aimed to assess how the pandemic affected the therapeutic management and prognosis of HF patients. Methods: We retrospectively reviewed the healthcare utilization databases of the Lombardy region (Italy) to identify all newly-diagnosed HF patients from January 2018 to December 2021. Outcomes were the utilization of HF therapies (Sacubitril/Valsartan; cardiac resynchronization therapy [CRT] and/or implantable cardioverter-defibrillator [ICD]; mechanical circulatory support [MCS]; heart transplantation [HTX]) and mortality. Cox regression models were fitted to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with the pandemic. Results: 36,130 and 17,263 patients were identified in the pre-pandemic and pandemic eras, respectively. The pandemic reduced Sacubitril/Valsartan utilization (HR = 0.77, 95% CI: 0.65-0.91) and CRT/ICD implantation (HR = 0.85, 95% CI: 0.78-0.92), but not MCS (HR = 1.11, 95% CI: 0.86-1.43) and HTX (HR = 0.88, 95% CI: 0.70-1.09). An increased mortality risk was observed during the pandemic (HR = 1.19, 95% CI: 1.15-1.23), which was attributable to SARS-CoV-2 infection (HR for non-COVID-19-related mortality = 1.01, 95% CI: 0.97-1.04). Conclusions: The COVID-19 pandemic was associated with a reduction in medical and interventional therapies for HF and an increase in mortality for HF patients.
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Affiliation(s)
- Matteo Ponzoni
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35128 Padua, Italy;
| | - Gabriella Morabito
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy; (G.M.); (G.C.); (A.C.); (F.R.)
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy; (G.M.); (G.C.); (A.C.); (F.R.)
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35128 Padua, Italy;
| | - Anna Cantarutti
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy; (G.M.); (G.C.); (A.C.); (F.R.)
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Federico Rea
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy; (G.M.); (G.C.); (A.C.); (F.R.)
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
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3
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Saloň A, Neshev R, Teraž K, Šimunič B, Peskar M, Marušič U, Pišot S, Šlosar L, Gasparini M, Pišot R, De Boever P, Schmid-Zalaudek K, Steuber B, Fredriksen PM, Nkeh-Chungag BN, Sourij H, Šerý O, Goswami N. A pilot study: Exploring the influence of COVID-19 on cardiovascular physiology and retinal microcirculation. Microvasc Res 2023; 150:104588. [PMID: 37468091 DOI: 10.1016/j.mvr.2023.104588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects the cardiovascular system. The current study investigated changes in heart rate (HR), blood pressure (BP), pulse wave velocity (PWV), and microcirculation in patients recovering from Coronavirus disease 2019 (COVID-19) infection. METHODOLOGY Out of 43 initially contacted COVID-19 patients, 35 (30 males, 5 females; age: 60 ± 10 years; and body mass index (BMI): 31.8 ± 4.9) participated in this study. Participants were seen on two occasions after hospital discharge; the baseline measurements were collected, either on the day of hospital discharge if a negative PCR test was obtained, or on the 10th day after hospitalization if the PCR test was positive. The second measurements were done 60 days after hospitalization. The vascular measurements were performed using the VICORDER® device and a retinal blood vessel image analysis. RESULTS A significant increase in systolic BP (SBP) (from 142 mmHg, SD: 15, to 150 mmHg, SD: 19, p = 0.041), reduction in HR (from 76 bpm, SD: 15, to 69 bpm, SD: 11, p = 0.001), and narrower central retinal vein equivalent (CRVE) (from 240.94 μm, SD: 16.05, to 198.05 μm, SD: 17.36, p = 0.013) were found. Furthermore, the trends of increasing PWV (from 11 m/s, SD: 3, to 12 m/s, SD: 3, p = 0.095) and decreasing CRAE (from 138.87 μm, SD: 12.19, to 136.77 μm, SD: 13.19, p = 0.068) were recorded. CONCLUSION The present study investigated cardiovascular changes following COVID-19 infection at two-time points after hospital discharge (baseline measurements and 60 days post-hospitalization). Significant changes were found in systolic blood pressure, heart rate, and microvasculature indicating that vascular adaptations may be ongoing even weeks after hospitalization from COVID-19 infection. Future studies could involve conducting additional interim assessments during the active infection and post-infection periods.
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Affiliation(s)
- Adam Saloň
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Austria; Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Ruslan Neshev
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Austria
| | - Kaja Teraž
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia; Faculty of Sport, University of Ljubljana, Slovenia
| | - Boštjan Šimunič
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Manca Peskar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia; Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Uroš Marušič
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia; Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Saša Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia; Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Mladen Gasparini
- Department of General Surgery, General Hospital Izola, Izola, Slovenia
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | | | - Karin Schmid-Zalaudek
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Austria
| | - Bianca Steuber
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Austria
| | - Per Morten Fredriksen
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Health Sciences, Walter Sisulu University PBX1, 5117 Mthatha, South Africa
| | - Harald Sourij
- Internal Medicine, Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
| | - Omar Šerý
- Laboratory of Neurobiology and Molecular Psychiatry, Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Veveří 97, 602 00 Brno, Czech Republic
| | - Nandu Goswami
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Austria; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
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Jin X, Yang H, Ma W, Yuan Y, Li T. Elevated High Sensitivity Cardiac Troponin T is Nonlinearly Associated with Poor Prognosis in Aging COVID-19 Patients: A Retrospective Study. Infect Drug Resist 2023; 16:5155-5163. [PMID: 37581166 PMCID: PMC10423578 DOI: 10.2147/idr.s422492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023] Open
Abstract
Objective To evaluate the relationship between high-sensitivity cardiac troponin T (hs-cTnT) and prognosis in elderly patients with coronavirus disease 2019 (COVID-19). Methods This study recruited 1399 COVID-19 patients aged 65 years or older admitted to Taizhou Hospital or Enze Hospital in Zhejiang Province from December 15, 2022, to January 4, 2023. The Cox regression model was used to evaluate the relationship between hs-cTnT level and in-hospital death. The logistic regression model was used to evaluate the relationship between hs-cTnT level and major adverse events. The restricted cubic spline (RCS) model is used for nonlinear analysis. Results The increase of peak hs-cTnT was associated with the increased risk of death (HR 9.49; 95% CI 1.19-75.48; trend p = 0.012) and major adverse events (OR 20.59; 95% CI 10.41-40.71; trend p < 0.001). RCS model showed the association between peak hs-cTnT and death and major adverse events were nonlinear (P for non-line < 0.001). Starting from the limit of quantification of hs-cTnT (3ng/L), the risk of death and major adverse events had a steep S-shaped increase until hs-cTnT reached the 90th percentile point (hs-cTnT = 131 ng/L), followed by a plateau period. Peak hs-cTnT has good predictive value for death and major adverse events, with AUC of 0.834 and 0.804, respectively. Conclusion Peak hs-cTnT has high predictive value for the risk of in-hospital death and major adverse events in elderly patients with COVID-19. The association between peak hs-cTnT and death and major adverse events were nonlinear.
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Affiliation(s)
- Xiaxia Jin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Haideng Yang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Weiwei Ma
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Yuan Yuan
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Tao Li
- Department of Cardiovascular Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
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5
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Kempers EK, Chen Q, Visser C, van Gorp ECM, Klok FA, Cannegieter SC, Kruip MJHA. Changes in incidence of hospitalization for cardiovascular diseases during the COVID-19 pandemic in The Netherlands in 2020. Sci Rep 2023; 13:12832. [PMID: 37553430 PMCID: PMC10409797 DOI: 10.1038/s41598-023-39573-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
This population-based cohort study aimed to describe changes in incidence of cardiovascular disease (CVD) hospital diagnoses during the COVID-19 pandemic in The Netherlands compared with the pre-pandemic period. We used Dutch nationwide statistics about hospitalizations to estimate incidence rate ratios (IRR) of hospital diagnoses of CVD during the first and second COVID-19 waves in The Netherlands in 2020 versus the same periods in 2019. Compared with 2019, the incidence rate of a hospital diagnosis of ischemic stroke (IRR 0.87; 95% CI 0.79-0.95), major bleeding (IRR 0.74; 95% CI 0.68-0.82), atrial fibrillation (IRR 0.73; 95% CI 0.65-0.82), myocardial infarction (IRR 0.78; 95% CI 0.72-0.84), and heart failure (IRR 0.74; 95% CI 0.65-0.85) declined during the first wave, but returned to pre-pandemic levels throughout 2020. However, the incidence rate of a hospital diagnosis of pulmonary embolism (PE) increased during both the first and second wave in 2020 compared with 2019 (IRR 1.30; 95% CI 1.15-1.48 and IRR 1.31; 95% CI 1.19-1.44, respectively). In conclusion, we observed substantial declines in incidences of CVD during the COVID-19 pandemic in The Netherlands in 2020, especially during the first wave, with an exception for an increase in incidence of PE. This study contributes to quantifying the collateral damage of the COVID-19 pandemic.
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Affiliation(s)
- Eva K Kempers
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Qingui Chen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Chantal Visser
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Eric C M van Gorp
- Department of Viroscience, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Infectious Diseases, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frederikus A Klok
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Suzanne C Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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Jyotsna F, Ikram J, Nageeta F, Komal F, Anjlee F, Patel H, Nassri T, Kumari M, Kumar R, Shah SU, Kashif M, Varrassi G, Kumar S, Patel T. Unlocking the Potential of Immunotherapy in Cardiovascular Disease: A Comprehensive Review of Applications and Future Directions. Cureus 2023; 15:e42790. [PMID: 37664375 PMCID: PMC10469982 DOI: 10.7759/cureus.42790] [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: 07/22/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Immunotherapy has emerged as a pioneering therapeutic approach that harnesses the immune system's abilities to combat diseases, particularly in the field of oncology where it has led to significant advancements. However, despite its significant impact in the field of oncology, the potential of immunotherapy in the context of cardiovascular disease (CVD) has not been thoroughly investigated. The purpose of this narrative review is to address the existing knowledge and potential uses of immunotherapy in the field of cardiovascular disease (CVD), with the intention of filling the existing gap in understanding. Furthermore, the review thoroughly examines the future prospects of this swiftly advancing field, providing insights into the aspects that necessitate further investigation and addressing the forthcoming challenges. The review is organized into four distinct sections to enhance comprehension. The first section introduces immunotherapy, presenting the fundamental concepts and principles. The second section explores the immunomodulatory mechanisms in cardiovascular disease (CVD), with a specific focus on the intricate interplay between the immune system and the development of cardiovascular pathogenesis. The utilization of immunotherapy in specific cardiovascular conditions will be examined, investigating the application of immunotherapy in the context of different cardiovascular diseases. The future prospects and challenges in immunotherapy for cardiovascular diseases will be discussed, highlighting the potential areas for future research and addressing the barriers that must be overcome to effectively implement immunotherapeutic interventions in the management of cardiovascular diseases.
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Affiliation(s)
- Fnu Jyotsna
- Medicine, Dr. B.R. Ambedkar Medical College & Hospital, Mohali, IND
| | - Jibran Ikram
- Orthopaedics and Trauma, Rehman Medical Institute, Peshawar, PAK
| | - Fnu Nageeta
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Fnu Komal
- Medicine, Chandka Medical College, Larkana, PAK
| | - Fnu Anjlee
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Harshkumar Patel
- Internal Medicine, PDU (Pandit Dindayal Upadhyay) Medical College, Rajkot, IND
| | - Taleb Nassri
- Medicine, Heart and Vascular Institute, Dearborn, USA
| | - Meena Kumari
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Rajesh Kumar
- Business Intelligence and Data Analytics, Westcliff University, Irvine, USA
| | | | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical College, Wazirabad, PAK
| | | | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Tirath Patel
- Medicine, American University of Antigua, St. John, ATG
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Wan EYF, Mathur S, Zhang R, Yan VKC, Lai FTT, Chui CSL, Li X, Wong CKH, Chan EWY, Yiu KH, Wong ICK. Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: a prospective cohort in UK Biobank. Cardiovasc Res 2023; 119:1718-1727. [PMID: 36652991 DOI: 10.1093/cvr/cvac195] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/10/2022] [Accepted: 12/09/2022] [Indexed: 01/20/2023] Open
Abstract
AIMS This study aims to evaluate the short- and long-term associations between COVID-19 and development of cardiovascular disease (CVD) outcomes and mortality in the general population. METHODS AND RESULTS A prospective cohort of patients with COVID-19 infection between 16 March 2020 and 30 November 2020 was identified from UK Biobank, and followed for up to 18 months, until 31 August 2021. Based on age (within 5 years) and sex, each case was randomly matched with up to 10 participants without COVID-19 infection from two cohorts-a contemporary cohort between 16 March 2020 and 30 November 2020 and a historical cohort between 16 March 2018 and 30 November 2018. The characteristics between groups were further adjusted with propensity score-based marginal mean weighting through stratification. To determine the association of COVID-19 with CVD and mortality within 21 days of diagnosis (acute phase) and after this period (post-acute phase), Cox regression was employed. In the acute phase, patients with COVID-19 (n = 7584) were associated with a significantly higher short-term risk of CVD {hazard ratio (HR): 4.3 [95% confidence interval (CI): 2.6- 6.9]; HR: 5.0 (95% CI: 3.0-8.1)} and all-cause mortality [HR: 81.1 (95% CI: 58.5-112.4); HR: 67.5 (95% CI: 49.9-91.1)] than the contemporary (n = 75 790) and historical controls (n = 75 774), respectively. Regarding the post-acute phase, patients with COVID-19 (n = 7139) persisted with a significantly higher risk of CVD in the long-term [HR: 1.4 (95% CI: 1.2-1.8); HR: 1.3 (95% CI: 1.1- 1.6)] and all-cause mortality [HR: 5.0 (95% CI: 4.3-5.8); HR: 4.5 (95% CI: 3.9-5.2) compared to the contemporary (n = 71 296) and historical controls (n = 71 314), respectively. CONCLUSIONS COVID-19 infection, including long-COVID, is associated with increased short- and long-term risks of CVD and mortality. Ongoing monitoring of signs and symptoms of developing these cardiovascular complications post diagnosis and up till at least a year post recovery may benefit infected patients, especially those with severe disease.
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Affiliation(s)
- Eric Yuk Fai Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sukriti Mathur
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ran Zhang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vincent Ka Chun Yan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
| | - Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
| | - Celine Sze Ling Chui
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xue Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Carlos King Ho Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, No.1, Haiyuan 1st Road, Futian District, Shenzhen, China
- Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Kai Hang Yiu
- Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Cardiology Division, Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Special Administrative Region, China
- Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, No.1, Haiyuan 1st Road, Futian District, Shenzhen, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Aston Pharmacy School, Aston University, Aston Street, Birmingham B4 7ET, UK
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Zuin M, Rigatelli G, Bilato C, Pasquetto G, Mazza A. Risk of Incident New-Onset Arterial Hypertension After COVID-19 Recovery: A Systematic Review and Meta-analysis. High Blood Press Cardiovasc Prev 2023; 30:227-233. [PMID: 37060396 PMCID: PMC10105348 DOI: 10.1007/s40292-023-00574-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023] Open
Abstract
INTRODUCTION Arterial Hypertension (HT) has been described as a common comorbidity and independent risk factor of short-term outcome in COVID-19 patients. However, data regarding the risk of new-onset HT during the post-acute phase of COVID-19 are scant. AIM We assess the risk of new-onset HT in COVID-19 survivors within one year from the index infection by a systematic review and meta-analysis of the available data. METHODS Data were obtained searching MEDLINE and Scopus for all studies published at any time up to February 11, 2023, and reporting the long-term risk of new-onset HT in COVID-19 survivors. Risk data were pooled using the Mantel-Haenszel random effects models with Hazard ratio (HR) as the effect measure with 95% confidence interval (CI). Heterogeneity among studies was assessed using I2 statistic. RESULTS Overall, 19,293,346 patients (mean age 54.6 years, 54.6% males) were included in this analysis. Of them, 758,698 survived to COVID-19 infection. Over a mean follow-up of 6.8 months, new-onset HT occurred to 12.7 [95% CI 11.4-13.5] out of 1000 patients survived to COVID-19 infection compared to 8.17 [95% CI 7.34-8.53] out of 1000 control subjects. Pooled analysis revealed that recovered COVID-19 patients presented an increased risk of new-onset HT (HR 1.70, 95% CI 1.46-1.97, p < 0.0001, I2 = 78.9%) within seven months. This risk was directly influenced by age (p = 0.001), female sex (p = 0.03) and cancer (p < 0.0001) while an indirect association was observed using the follow-up length as moderator (p < 0.0001). CONCLUSIONS Our findings suggest that new-onset HT represents an important post-acute COVID-19 sequelae.
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Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy.
- Department of Cardiology, Arzignano General Hospital, Vincenza, Italy.
| | | | - Claudio Bilato
- Department of Cardiology, Arzignano General Hospital, Vincenza, Italy
| | | | - Alberto Mazza
- Department of Internal Medicine, Ospedale S. Maria degli Angeli, Adria, Italy
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Zuin M, Rigatelli G, Bilato C. Excess of heart failure-related deaths during the 2020 COVID-19 pandemic in Unites States. Heart Lung 2023; 58:104-107. [PMID: 36446263 PMCID: PMC9684122 DOI: 10.1016/j.hrtlng.2022.11.014] [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: 10/05/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND HF can be encountered at different stages in the course of COVID-19 disease. However, data regarding the HF-related mortality during COVID-19 pandemic are scant OBJECTIVE: We investigate the heart failure (HF)-related mortality rate in the US among patient with or without COVID-19 infection during the first two pandemic waves in 2020 and to compare them to those of previous years (2014-2019). METHODS Age-adjusted mortality rates (AAMR) per 100.000 person-years, with relative 95% confidence interval (CI) were determined using the free-available dataset for Multiple cause-of-death, provided by the Center for Disease Control. RESULTS Throughout the 2020, the first year of the COVID-19 pandemic, 522.848 HF-related deaths were registered (461.594 and 61.254 in subjects without and with COVID-19 infection, respectively). The overall HF-related AAMR was 124.6 (65% CI 123.4-125.6), reflecting an increased HF-related mortality of 13.2% and 25.9% compared to 2019 and 2018 (p < 0.0001). HF-related AAMR was 111.0 (95% CI: 110.7-111.4) and 14.8 (95% CI: 14.6-14.9) per 100.000 population for decedents without and with COVID-19 disease, respectively. The proportionate mortality of HF in COVID-19 patients was 11.7%. HF-related AAMR in COVID-19 patients was higher in men (18.0 per 100.000, 95% CI: 17.8-18.2), in patients aged more 65 years (104.0 per 100.000, 95% CI: 103.1-104.9), in African Americans (22.5 per 100.000, 95% CI: 22.0-22.3) and in those living in rural counties (18.4 per 100.000, 95% CI: 18.0-18.7). CONCLUSIONS A significant increase in the HF-related mortality during the 2020 was observed synchronously with the COVID-19 pandemic.
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Affiliation(s)
- Marco Zuin
- Department of Cardiology, West Vicenza Hospital, Arzignano, Italy; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
| | - Gianluca Rigatelli
- Department of Cardiology, Madre Teresa Hospital, Schiavonia, Padova, Italy
| | - Claudio Bilato
- Department of Cardiology, West Vicenza Hospital, Arzignano, Italy
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Chiappelli F, Fotovat L. Post acute CoViD-19 syndrome (PACS) - Long CoViD. Bioinformation 2022; 18:908-911. [PMID: 37654836 PMCID: PMC10465760 DOI: 10.6026/97320630018908] [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: 10/08/2022] [Accepted: 10/18/2022] [Indexed: 09/02/2023] Open
Abstract
Patients sero-positive for the Systemic Acute Respiratory Syndrome Corona virus2 (SARS-CoV2) virus develop the Corona Virus Disease 2019 (CoViD-19). CoViD-19 may be asymptomatic in some individuals, proffer mild symptoms in other patients, and can be a serious and even lethal disease in a sub-group of the population. The variables that determine the severity of CoViD-19 have not been fully characterized. What is clear is that the patients who survive CoViD-19 return to a state of sero-negativity for SARS-CoV2 generally within 3-5 weeks. However, several cases of repeated infection have been reported, and a large proportion of CoViD-19-recovered patients manifest multi-system and multi-organ symptomatic pathologies several weeks-to-months after resuming sero-negativity for SARS-CoV2. This new pathological condition, originally termed Long Covid, is now recognized as the Post Acute CoViD-19 Syndrome (PACS). The original principal clusters of signs and symptoms of PACS: likelihood of relapse and reinfection, physical fatigue and cognitive slowdown, may actually be broadened to include immune deregulation, cardiovascular disease and coagulation abnormalities. The development and evaluation of new and improved clinical interventions for PACS are critical and timely.
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Affiliation(s)
- Francesco Chiappelli
- Center for the Health Sciences, UCLA, Los Angeles, USA; Dental Group of Sherman Oaks, CA 91403, USA
| | - Lily Fotovat
- Center for the Health Sciences, UCLA, Los Angeles, USA; Dental Group of Sherman Oaks, CA 91403, USA
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11
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Whole-genome sequencing of SARS-CoV-2 reveals diverse mutations in circulating Alpha and Delta variants during the first, second, and third waves of COVID-19 in South Kivu, east of the Democratic Republic of the Congo. Int J Infect Dis 2022; 122:136-143. [PMID: 35598737 PMCID: PMC9119719 DOI: 10.1016/j.ijid.2022.05.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES We used whole-genome sequencing of SARS-CoV-2 to identify variants circulating in the Democratic Republic of the Congo and obtain molecular information useful for diagnosis, improving treatment, and general pandemic control strategies. METHODS A total of 74 SARS-CoV-2 isolates were sequenced using Oxford Nanopore platforms. Generated reads were processed to obtain consensus genome sequences. Sequences with more than 80% genome coverage were used for variant calling, phylogenetic analysis, and classification using Pangolin lineage annotation nomenclature. RESULTS Phylogenetic analysis based on Pangolin classification clustered South Kivu sequences into seven lineages (A.23.1, B.1.1.6, B.1.214, B.1.617.2, B.1.351, C.16, and P.1). The Delta (B.1.617.2) variant was the most dominant and responsible for outbreaks during the third wave. Based on the Wuhan reference genome, 289 distinct mutations were detected, including 141 missenses, 123 synonymous, and 25 insertions/deletions when our isolates were mapped to the Wuhan reference strain. Most of these point mutations were located within the coding sequences of the SARS-CoV-2 genome that includes spike, ORF1ab, ORF3, and nucleocapsid protein genes. The most common mutation was D614G (1841A>G) observed in 61 sequences, followed by L4715L (14143 C>T) found in 60 sequences. CONCLUSION Our findings highlight multiple introductions of SARS-CoV-2 into South Kivu through different sources and subsequent circulation of variants in the province. These results emphasize the importance of timely monitoring of genetic variation and its effect on disease severity. This work set a foundation for the use of genomic surveillance as a tool for future global pandemic management and control.
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Zuin M, Mugnai G, Zamboni A, Zakja E, Valle R, Turiano G, Themistoclakis S, Scarpa D, Saccà S, Roncon L, Rizzetto F, Purita P, Polo A, Pantano I, Mugnolo A, Molon G, Meneghin S, Mancuso D, Lia M, Grassi G, Cutolo A, Chirillo F, Bozzini P, Bonapace S, Anselmi M, Rigatelli G, Bilato C. Decline of Admission for Acute Coronary Syndromes and Acute Cardiovascular Conditions during COVID-19 Pandemic in Veneto Region. Viruses 2022; 14:v14091925. [PMID: 36146731 DOI: 10.3390/v1409192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 05/27/2023] Open
Abstract
Background: The present study aimed to examine longitudinal trends in hospitalizations for acute coronary syndrome (ACS) before and during the COVID-19 pandemic, by reviewing the data from 13 hospitals of the Veneto Region, in the north-east of Italy. Methods: We performed a multicenter, retrospective analysis including all the consecutive patients presenting with ACS and other acute cardiovascular (CV) conditions (defined as heart failure, arrhythmias, cardiac arrest and venous thromboembolism) hospitalized in 13 different hospitals of the Veneto Region covering a population of 2,554,818 inhabitants, during the first (between 15 March 2020 and 30 April 2020) and second (between 15 November 2020 and 30 December 2020) COVID-19 pandemic waves (the 2020 cohort). Data were compared with those obtained at the same time-windows of years 2018 and 2019 (the historical cohorts). Results: Compared to the historical cohorts, a significant decrease in the number of ACS cases was observed in 2020 (−27.3%, p = 0.01 and −32%, p < 0.001, comparing 2018 versus 2020 and 2019 and 2020, respectively). The proportion of patients hospitalized for acute CV conditions decreased during the first and second wave COVID-19 pandemic when compared to the historical cohorts (−36.5%, p < 0.001 and −40.6%, p < 0.001, comparing 2018 versus 2020 and 2019 and 2020, respectively). Pearson’s correlation evidenced a significant inverse relationship between the number of COVID-19 cases and both ACS hospital admissions (r = −0.881, p = 0.005) and hospitalizations for acute CV conditions (r = −0.738, p = 0.01), respectively. Conclusions: The decrease in hospitalizations for ACS and other acute CV conditions will strongly affect future patients’ management since undiagnosed nonfatal CV events represent a source of increased (and unknown) CV morbidity and mortality.
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Affiliation(s)
- Marco Zuin
- Division of Cardiology, West Vicenza General Hospital, Via del Parco 1, 36071 Arzignano, Vicenza, Italy
| | - Giacomo Mugnai
- Division of Cardiology, West Vicenza General Hospital, Via del Parco 1, 36071 Arzignano, Vicenza, Italy
| | - Alberto Zamboni
- Division of Cardiology, Legnago General Hospital, 37045 Legnago, Verona, Italy
| | - Edlira Zakja
- Division of Cardiology, San Donà General Hospital, 30027 San Donà di Piave, Venezia, Italy
| | - Roberto Valle
- Division of Cardiology, Chioggia General Hospital, 30015 Chioggia, Venezia, Italy
| | - Giovanni Turiano
- Division of Cardiology, San Donà General Hospital, 30027 San Donà di Piave, Venezia, Italy
| | | | - Daniele Scarpa
- Division of Cardiology, Santi Giovanni & Paolo Hospital, 30122 Venezia, Venezia, Italy
| | - Salvatore Saccà
- Division of Cardiology, Mirano General Hospital, 30035 Mirano, Venezia, Italy
| | - Loris Roncon
- Department of Cardiology, Rovigo General Hospital, 45100 Rovigo, Rovigo, Italy
| | - Francesca Rizzetto
- Division of Cardiology, Verona University Hospital, 37100 Verona, Verona, Italy
| | - Paola Purita
- Division of Cardiology, Mirano General Hospital, 30035 Mirano, Venezia, Italy
| | - Angela Polo
- Division of Cardiology, San Bassiano Hospital, 36061 Bassano, Vicenza, Italy
| | - Ivan Pantano
- Division of Cardiology, Chioggia General Hospital, 30015 Chioggia, Venezia, Italy
| | - Antonio Mugnolo
- Division of Cardiology, Legnago General Hospital, 37045 Legnago, Verona, Italy
| | - Giulio Molon
- Division of Cardiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Verona, Italy
| | - Samuele Meneghin
- Division of Cardiology, Padua University Hospital, 35128 Padova, Padova, Italy
| | - Daniela Mancuso
- Division of Cardiology, Padua University Hospital, 35128 Padova, Padova, Italy
| | - Micaela Lia
- Division of Cardiology, Verona University Hospital, 37100 Verona, Verona, Italy
| | - Giuseppe Grassi
- Division of Cardiology, Santi Giovanni & Paolo Hospital, 30122 Venezia, Venezia, Italy
| | - Ada Cutolo
- Division of Cardiology, All'Angelo Hospital, 30174 Mestre, Venezia, Italy
| | - Fabio Chirillo
- Division of Cardiology, San Bassiano Hospital, 36061 Bassano, Vicenza, Italy
| | - Paolo Bozzini
- Division of Cardiology, Fracastoro Hospital, 37020 San Bonifacio, Verona, Italy
| | - Stefano Bonapace
- Division of Cardiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Verona, Italy
| | - Maurizio Anselmi
- Division of Cardiology, Fracastoro Hospital, 37020 San Bonifacio, Verona, Italy
| | - Gianluca Rigatelli
- Division of Cardiology, Madre Teresa Hospital, 35043 Padova, Schiavonia, Italy
| | - Claudio Bilato
- Division of Cardiology, West Vicenza General Hospital, Via del Parco 1, 36071 Arzignano, Vicenza, Italy
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Zuin M, Mugnai G, Zamboni A, Zakja E, Valle R, Turiano G, Themistoclakis S, Scarpa D, Saccà S, Roncon L, Rizzetto F, Purita P, Polo A, Pantano I, Mugnolo A, Molon G, Meneghin S, Mancuso D, Lia M, Grassi G, Cutolo A, Chirillo F, Bozzini P, Bonapace S, Anselmi M, Rigatelli G, Bilato C. Decline of Admission for Acute Coronary Syndromes and Acute Cardiovascular Conditions during COVID-19 Pandemic in Veneto Region. Viruses 2022; 14:v14091925. [PMID: 36146731 PMCID: PMC9502380 DOI: 10.3390/v14091925] [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] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The present study aimed to examine longitudinal trends in hospitalizations for acute coronary syndrome (ACS) before and during the COVID-19 pandemic, by reviewing the data from 13 hospitals of the Veneto Region, in the north-east of Italy. Methods: We performed a multicenter, retrospective analysis including all the consecutive patients presenting with ACS and other acute cardiovascular (CV) conditions (defined as heart failure, arrhythmias, cardiac arrest and venous thromboembolism) hospitalized in 13 different hospitals of the Veneto Region covering a population of 2,554,818 inhabitants, during the first (between 15 March 2020 and 30 April 2020) and second (between 15 November 2020 and 30 December 2020) COVID-19 pandemic waves (the 2020 cohort). Data were compared with those obtained at the same time-windows of years 2018 and 2019 (the historical cohorts). Results: Compared to the historical cohorts, a significant decrease in the number of ACS cases was observed in 2020 (−27.3%, p = 0.01 and −32%, p < 0.001, comparing 2018 versus 2020 and 2019 and 2020, respectively). The proportion of patients hospitalized for acute CV conditions decreased during the first and second wave COVID-19 pandemic when compared to the historical cohorts (−36.5%, p < 0.001 and −40.6%, p < 0.001, comparing 2018 versus 2020 and 2019 and 2020, respectively). Pearson’s correlation evidenced a significant inverse relationship between the number of COVID-19 cases and both ACS hospital admissions (r = −0.881, p = 0.005) and hospitalizations for acute CV conditions (r = −0.738, p = 0.01), respectively. Conclusions: The decrease in hospitalizations for ACS and other acute CV conditions will strongly affect future patients’ management since undiagnosed nonfatal CV events represent a source of increased (and unknown) CV morbidity and mortality.
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Affiliation(s)
- Marco Zuin
- Division of Cardiology, West Vicenza General Hospital, Via del Parco 1, 36071 Arzignano, Vicenza, Italy
- Correspondence: (M.Z.); (C.B.); Tel.: +39-0444-479106 (C.B.); Fax: +39-0444-931163 (C.B.)
| | - Giacomo Mugnai
- Division of Cardiology, West Vicenza General Hospital, Via del Parco 1, 36071 Arzignano, Vicenza, Italy
| | - Alberto Zamboni
- Division of Cardiology, Legnago General Hospital, 37045 Legnago, Verona, Italy
| | - Edlira Zakja
- Division of Cardiology, San Donà General Hospital, 30027 San Donà di Piave, Venezia, Italy
| | - Roberto Valle
- Division of Cardiology, Chioggia General Hospital, 30015 Chioggia, Venezia, Italy
| | - Giovanni Turiano
- Division of Cardiology, San Donà General Hospital, 30027 San Donà di Piave, Venezia, Italy
| | | | - Daniele Scarpa
- Division of Cardiology, Santi Giovanni & Paolo Hospital, 30122 Venezia, Venezia, Italy
| | - Salvatore Saccà
- Division of Cardiology, Mirano General Hospital, 30035 Mirano, Venezia, Italy
| | - Loris Roncon
- Department of Cardiology, Rovigo General Hospital, 45100 Rovigo, Rovigo, Italy
| | - Francesca Rizzetto
- Division of Cardiology, Verona University Hospital, 37100 Verona, Verona, Italy
| | - Paola Purita
- Division of Cardiology, Mirano General Hospital, 30035 Mirano, Venezia, Italy
| | - Angela Polo
- Division of Cardiology, San Bassiano Hospital, 36061 Bassano, Vicenza, Italy
| | - Ivan Pantano
- Division of Cardiology, Chioggia General Hospital, 30015 Chioggia, Venezia, Italy
| | - Antonio Mugnolo
- Division of Cardiology, Legnago General Hospital, 37045 Legnago, Verona, Italy
| | - Giulio Molon
- Division of Cardiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Verona, Italy
| | - Samuele Meneghin
- Division of Cardiology, Padua University Hospital, 35128 Padova, Padova, Italy
| | - Daniela Mancuso
- Division of Cardiology, Padua University Hospital, 35128 Padova, Padova, Italy
| | - Micaela Lia
- Division of Cardiology, Verona University Hospital, 37100 Verona, Verona, Italy
| | - Giuseppe Grassi
- Division of Cardiology, Santi Giovanni & Paolo Hospital, 30122 Venezia, Venezia, Italy
| | - Ada Cutolo
- Division of Cardiology, All’Angelo Hospital, 30174 Mestre, Venezia, Italy
| | - Fabio Chirillo
- Division of Cardiology, San Bassiano Hospital, 36061 Bassano, Vicenza, Italy
| | - Paolo Bozzini
- Division of Cardiology, Fracastoro Hospital, 37020 San Bonifacio, Verona, Italy
| | - Stefano Bonapace
- Division of Cardiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Verona, Italy
| | - Maurizio Anselmi
- Division of Cardiology, Fracastoro Hospital, 37020 San Bonifacio, Verona, Italy
| | - Gianluca Rigatelli
- Division of Cardiology, Madre Teresa Hospital, 35043 Padova, Schiavonia, Italy
| | - Claudio Bilato
- Division of Cardiology, West Vicenza General Hospital, Via del Parco 1, 36071 Arzignano, Vicenza, Italy
- Correspondence: (M.Z.); (C.B.); Tel.: +39-0444-479106 (C.B.); Fax: +39-0444-931163 (C.B.)
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Incident Atrial Fibrillation and In-Hospital Mortality in SARS-CoV-2 Patients. Biomedicines 2022; 10:biomedicines10081940. [PMID: 36009487 PMCID: PMC9406191 DOI: 10.3390/biomedicines10081940] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/15/2022] [Accepted: 07/29/2022] [Indexed: 12/15/2022] Open
Abstract
(1) Background: Among the different cardiovascular (CV) manifestations of the coronavirus disease 2019 (COVID-19), arrhythmia and atrial fibrillation (AF) in particular have recently received special attention. The aims of our study were to estimate the incidence of AF in patients hospitalized for COVID-19, and to evaluate its role as a possible predictor of in-hospital all-cause mortality. (2) Methods: We enrolled 3435 people with SARS-CoV2 infection admitted to three hospitals in Northern Italy from February 2020 to May 2021. We collected data on their clinical history, laboratory tests, pharmacological treatment and intensive care unit (ICU) admission. Incident AF and all-cause in-hospital mortality were considered as outcomes. (3) Results: 145 (4.2%) patients developed AF during hospitalization, with a median time since admission of 3 days (I-III quartile: 0, 12). Patients with incident AF were admitted more frequently to the ICU (39.3 vs. 12.4%, p < 0.001), and more frequently died (37.2 vs. 16.9%, p < 0.001). In the Cox regression model, the significant determinants of incident AF were age (HR: 1.041; 95% CI: 1.022, 1.060 per year), a history of AF (HR: 2.720; 95% CI: 1.508, 4.907), lymphocyte count (HR: 0.584; 95% CI: 0.384, 0.888 per 103/µL), estimated glomerular filtration rate (eGFR, HR: 0.988; 95% CI: 0.980, 0.996 per mL/min) and ICU admission (HR: 5.311; 95% CI: 3.397, 8.302). Incident AF was a predictor of all-cause mortality (HR: 1.405; 95% CI: 1.027, 1.992) along with age (HR: 1.057; 95% CI: 1.047, 1.067), male gender (HR: 1.315; 95% CI: 1.064; 1.626), dementia (HR: 1.373; 95% CI: 1.045, 1.803), lower platelet (HR: 0.997; 95% CI: 0.996, 0.998 per 103/µL) and lymphocyte counts (HR: 0.843; 95% CI: 0.725, 0.982 per 103/µL), C-Reactive protein values (HR: 1.004; 95% CI: 1.003, 1.005 per mg/L), eGFR (HR: 0.990; 95% CI: 0.986, 0.994 per mL/min), and ICU admission (HR: 1.759; 95% CI: 1.292, 2.395). (4) Conclusions: Incident AF is a common complication in COVID-19 patients during hospitalization, and its occurrence strongly predicts in-hospital mortality.
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de Kreutzenberg SV. Telemedicine for the Clinical Management of Diabetes; Implications and Considerations After COVID-19 Experience. High Blood Press Cardiovasc Prev 2022; 29:319-326. [PMID: 35579849 PMCID: PMC9111950 DOI: 10.1007/s40292-022-00524-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/07/2022] [Indexed: 12/15/2022] Open
Abstract
Telemedicine is a clinical approach that was seldom used in the day-to-day practice, if not only in certain settings, before the COVID-19 pandemic. As stated by the WHO, telemedicine is: the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies (ICT) for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, …. Telemedicine has actually represented the most useful and employed tool to maintain contacts between patients and physicians during the period of physical distance imposed by the pandemic, especially during the lockdown. Diabetes in particular, a chronic disease that often needs frequent confronting between patient and health professionals has taken advantage of the telehealth approach. Nowadays, technological tools are more and more widely used for the management of diabetes. In this review results obtained by telemendicine application in type 1 and type 2 diabetic individuals during COVID-19 are revised, and future perspectives for telemedicine use to manage diabetes are discussed.
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Hammad R, Elshafei A, Khidr EG, El-Husseiny AA, Gomaa MH, Kotb HG, Eltrawy HH, Farhoud H. Copeptin: a neuroendocrine biomarker of COVID-19 severity. Biomark Med 2022; 16:589-597. [PMID: 35350852 PMCID: PMC8966690 DOI: 10.2217/bmm-2021-1100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: To investigate the change in a serum level of copeptin, a neuroendocrine biomarker, in differentiating grades of COVID-19 severity on admission time and to find its diagnostic potential. Materials & Methods: 160 COVID-19 patients were classified according to disease severity into 80 mild to moderate and 80 severe patients. Serum copeptin level was assessed by ELISA on their admission time. Besides, serum CRP, ferritin and D-dimer were estimated. Results: Severe COVID-19 patients showed higher serum copeptin level in comparison to mild to moderate cases, with diagnostic potential to distinguish disease severity with 93.33% sensitivity and 100% specificity at cut-off value >18.5 Pmol/l. Conclusion: Serum copeptin was remarkably increased with COVID-19 severity with reasonable differentiation potential for recently admitted patients. We conducted a biochemical study on the role of copeptin – a biomarker of acute stress due to COVID-19 infection – in classification of COVID-19 severity on admission over 160 adult patients. Copeptin was highly elevated in severe cases more than the mild to moderate ones. So, it may be an early marker in admission departments to ease early clinical decisions and medical intervention.
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Affiliation(s)
- Reham Hammad
- Department of Clinical Pathology, Faculty of Medicine (Girls), Al-Azhar University, Cairo, 11884, Egypt
| | - Ahmed Elshafei
- Biochemistry & Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11884, Egypt
| | - Emad Gamil Khidr
- Biochemistry & Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11884, Egypt
| | - Ahmed A El-Husseiny
- Biochemistry & Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11884, Egypt
| | - Maher H Gomaa
- Biochemistry & Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11884, Egypt
| | - Hend G Kotb
- Internal Medicine Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo, 11884, Egypt
| | - Heba H Eltrawy
- Chest Diseases Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo, 11884, Egypt
| | - Hesham Farhoud
- Orthopedic Surgery Department, Dean of Faculty of Medicine (Girls), Al-Azhar University, Cairo, 11884, Egypt
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The Composition and Physical Properties of Clots in COVID-19 Pathology. Diagnostics (Basel) 2022; 12:diagnostics12030580. [PMID: 35328132 PMCID: PMC8947364 DOI: 10.3390/diagnostics12030580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 01/01/2023] Open
Abstract
Hemostasis is a finely tuned process of which dysregulation can lead either to bleeding or thrombotic complications. The latter is often caused by the hypercoagulable state as it is also seen in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, i.e., in COVID-19 patients. COVID-19 patients requiring hospitalization often suffer from thrombotic events that could not be predicted using routine coagulation assays. Recently, several studies have reported ROtational ThromboElastoMetry (ROTEM) as a promising tool to predict outcomes in COVID-19 patients. In this review we give an overview of ROTEM with a particular focus on the interpretation of the symmetrical clot formation curve in relation to coagulopathy in COVID-19 patients. Furthermore, we have introduced new parameters that might help to better distinguish between COVID-19 patients and outcomes.
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Jirak P, van Almsick V, Dimitroulis D, Mirna M, Seelmaier C, Shomanova Z, Wernly B, Semo D, Dankl D, Mahringer M, Lichtenauer M, Hoppe UC, Reinecke H, Pistulli R, Larbig R, Motloch LJ. Dexamethasone Improves Cardiovascular Outcomes in Critically Ill COVID-19, a Real World Scenario Multicenter Analysis. Front Med (Lausanne) 2022; 9:808221. [PMID: 35186995 PMCID: PMC8847392 DOI: 10.3389/fmed.2022.808221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/12/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Severe COVID-19 pneumonia requiring intensive care treatment remains a clinical challenge to date. Dexamethasone was reported as a promising treatment option, leading to a reduction of mortality rates in severe COVID-19 disease. However, the effect of dexamethasone treatment on cardiac injury and pulmonary embolism remains largely elusive. METHODS In total 178 critically ill COVID-19 patients requiring intensive care treatment and mechanical ventilation were recruited in three European medical centres and included in the present retrospective study. One hundred thirteen patients (63.5%) were treated with dexamethasone for a median duration of 10 days (IQR 9-10). Sixty five patients (36.5%) constituted the non-dexamethasone control group. RESULTS While peak inflammatory markers were reduced by dexamethasone treatment, the therapy also led to a significant reduction in peak troponin levels (231 vs. 700% indicated as relative to cut off value, p = 0.001). Similar, dexamethasone resulted in significantly decreased peak D-Dimer levels (2.16 mg/l vs. 6.14 mg/l, p = 0.002) reflected by a significant reduction in pulmonary embolism rate (4.4 vs. 20.0%, p = 0.001). The antithrombotic effect of dexamethasone treatment was also evident in the presence of therapeutic anticoagulation (pulmonary embolism rate: 6 vs. 34.4%, p < 0.001). Of note, no significant changes in baseline characteristics were observed between the dexamethasone and non-dexamethasone group. CONCLUSION In severe COVID-19, anti-inflammatory effects of dexamethasone treatment seem to be associated with a significant reduction in myocardial injury. Similar, a significant decrease in pulmonary embolism, independent of anticoagulation, was evident, emphasizing the beneficial effect of dexamethasone treatment in severe COVID-19.
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Affiliation(s)
- Peter Jirak
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Vincent van Almsick
- Department of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, Münster, Germany
| | - Dimitrios Dimitroulis
- Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany
| | - Moritz Mirna
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Clemens Seelmaier
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Zornitsa Shomanova
- Department of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, Münster, Germany
| | - Bernhard Wernly
- Department of Anesthesiology, Perioperative Care, and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Center for Public Health and Healthcare Research, Paracelsus Medical University, Salzburg, Austria
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Dilvin Semo
- Department of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, Münster, Germany
| | - Daniel Dankl
- Department of Anesthesiology, Perioperative Care, and Intensive Care Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Magdalena Mahringer
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Uta C. Hoppe
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Holger Reinecke
- Department of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, Münster, Germany
| | - Rudin Pistulli
- Department of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Münster, Münster, Germany
| | - Robert Larbig
- Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany
- Department of Cardiology II - Electrophysiology, University Hospital Münster, Münster, Germany
| | - Lukas J. Motloch
- Clinic II for Internal Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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A Meta-Analysis: Coronary Artery Calcium Score and COVID-19 Prognosis. Med Sci (Basel) 2022; 10:medsci10010005. [PMID: 35225939 PMCID: PMC8883990 DOI: 10.3390/medsci10010005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/28/2022] Open
Abstract
Background: Multiple studies have investigated the correlations of mortality, mechanical ventilation, and intensive care unit (ICU) admissions with CAC scores. This analysis overviews the prognostic capability of CAC scoring in mortality, mechanical ventilation, and ICU admission for hospitalized COVID-19 patients. Methods: Online search was conducted on PubMed, Cochrane Library, and Scopus from inception to 22 November 2021 to identify studies involving CAC scores in relation to ICU admission, mechanical ventilation, and death rates. Results: A total of eight studies were analyzed. In the absence of CAC group compared with the presence of CAC score, there was an increase in mortality in the presence of CAC (RR 2.24, 95% CI, 1.41−3.56; p < 0.001). In the low CAC group and high CAC group, high CAC group had increase in mortality (RR 2.74; 95% CI, 1.94−3.86; p < 0.00001). There was no statistical difference in outcomes of mechanical ventilation and ICU admission between any of the groups. Conclusion: This meta-analysis strictly examined the outcomes of interest in death, mechanical ventilation, and ICU admission while comparing the CAC scores in patients with COVID-19. Given these findings, CAC scoring can aid in stratifying patients, thus allowing earlier interventions in rapidly developing illnesses.
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Megiorni F, Pontecorvi P, Gerini G, Anastasiadou E, Marchese C, Ceccarelli S. Sex-Related Factors in Cardiovascular Complications Associated to COVID-19. Biomolecules 2021; 12:biom12010021. [PMID: 35053169 PMCID: PMC8773922 DOI: 10.3390/biom12010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), the pandemic infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with an extremely heterogeneous spectrum of symptoms and signs. The clinical manifestations seem to be correlated with disease severity. COVID-19 susceptibility and mortality show a significant sex imbalance, with men being more prone to infection and showing a higher rate of hospitalization and mortality compared to women. Such variability can be ascribed to both sex-related biological factors and gender-related behavioral cues. This review will discuss the potential mechanisms accounting for sex/gender influence in vulnerability to COVID-19. Cardiovascular diseases play a central role in determining COVID-19 outcome, whether they are pre-existent or arose upon infection. We will pay particular attention to the impact of sex and gender on cardiovascular manifestations related to COVID-19. Finally, we will discuss the sex-dependent variability in some biomarkers for the evaluation of COVID-19 infection and prognosis. The aim of this work is to highlight the significance of gendered medicine in setting up personalized programs for COVID-19 prevention, clinical evaluation and treatment.
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Evaluation of Hepatic Biochemical Parameters during Antiviral Treatment in COVID-19 Patients. BIOLOGY 2021; 11:biology11010013. [PMID: 35053011 PMCID: PMC8772810 DOI: 10.3390/biology11010013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 02/07/2023]
Abstract
Simple Summary In order to treat COVID-19 disease, various drugs have been used as repurposed drugs, because no drug directly targets against the SARS-CoV-2 virus. The aim of this study was to evaluate the relationship between the drugs used for COVID-19 treatment and liver disturbances, in order to identify any change in liver enzymes during therapy. Patients admitted in an internal medicine department were treated with a complex therapeutic scheme, including antivirals. Beside the follow up for the evolution of the disease, we also monitored the potential occurrence of side effects, especially liver damage. Our results showed that none of the three antivirals that we used produced severe or significant liver disturbances. Our conclusion may be useful in guiding clinical practice, adding more information for the medical community. Abstract (1) Background: The antiviral treatment for COVID-19 disease started to be largely used in 2020 and has been found to be efficient, although it is not specific for SARS-CoV-2 virus. There were some concerns that it may produce liver damage or other side effects. (2) Methods: The aim of this study was to observe if antiviral therapy is affecting liver parameters or producing other side-effects in patients hospitalized for COVID-19 disease. The study included a group of patients hospitalized in the internal medicine department of Oradea Municipal Clinical Hospital, Romania, between August 2020–June 2021, diagnosed with SARS-CoV-2 viral infection by RT-PCR method or rapid antigen test. During hospitalization, patients were treated with a Lopinavir/Ritonavir (Kaletra) combination, or with Favipiravir or Remdesivir. In addition to monitoring the evolution of the disease (clinical and biochemical), also hepatic parameters were analyzed at admission, during hospitalization, and at discharge. (3) Results: In the group of studied patients, the mean value of aspartat aminotrensferase did not increase above normal at discharge, alanin aminotransferase increased, but below twice the normal values, and cholestasis registered a statistically insignificant slight increase. (4) Conclusions: In our study, we found that all three antivirals were generally well tolerated and their use did not alter liver function in a significant manner.
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22
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Heart Rate in Patients with SARS-CoV-2 Infection: Prevalence of High Values at Discharge and Relationship with Disease Severity. J Clin Med 2021; 10:jcm10235590. [PMID: 34884293 PMCID: PMC8658577 DOI: 10.3390/jcm10235590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 02/03/2023] Open
Abstract
The most common arrhythmia associated with COronaVIrus-related Disease (COVID) infection is sinus tachycardia. It is not known if high Heart Rate (HR) in COVID is simply a marker of higher systemic response to sepsis or if its persistence could be related to a long-term autonomic dysfunction. The aim of our work is to assess the prevalence of elevated HR at discharge in patients hospitalized for COVID-19 and to evaluate the variables associated with it. We enrolled 697 cases of SARS-CoV2 infection admitted in our hospital after February 21 and discharged within 23 July 2020. We collected data on clinical history, vital signs, laboratory tests and pharmacological treatment. Severe disease was defined as the need for Intensive Care Unit (ICU) admission and/or mechanical ventilation. Median age was 59 years (first-third quartile 49, 74), and male was the prevalent gender (60.1%). 84.6% of the subjects showed a SARS-CoV-2 related pneumonia, and 13.2% resulted in a severe disease. Mean HR at admission was 90 ± 18 bpm with a mean decrease of 10 bpm to discharge. Only 5.5% of subjects presented HR > 100 bpm at discharge. Significant predictors of discharge HR at multiple linear model were admission HR (mean increase = β = 0.17 per bpm, 95% CI 0.11; 0.22, p < 0.001), haemoglobin (β = −0.64 per g/dL, 95% CI −1.19; −0.09, p = 0.023) and severe disease (β = 8.42, 95% CI 5.39; 11.45, p < 0.001). High HR at discharge in COVID-19 patients is not such a frequent consequence, but when it occurs it seems strongly related to a severe course of the disease.
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Long-Term Cardiac Sequelae in Patients Referred into a Diagnostic Post-COVID-19 Pathway: The Different Impacts on the Right and Left Ventricles. Diagnostics (Basel) 2021; 11:diagnostics11112059. [PMID: 34829406 PMCID: PMC8623572 DOI: 10.3390/diagnostics11112059] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022] Open
Abstract
Most patients who had COVID-19 are still symptomatic after many months post infection, but the long-term outcomes are not yet well defined. The aim of our prospective/retrospective study was to define the cardiac sequelae of COVID-19 infection. This monocentric cohort study included 160 consecutive patients who had been discharged from the ward or from the outpatient clinic after a diagnosis of COVID-19 and subsequently referred for a follow-up visit. Clinical features’ data about the acute phase along with information about the follow-up visit, including ECG and Echocardiographic parameters, were recorded. At an average follow-up of 5 months, echocardiography showed morpho-functional characteristics of both right (RV) and left (LV) ventricles, such as RV dilation, increased pressure in the pulmonary circulation, and bi-ventricular systolic–diastolic dysfunction. When examined using multivariate analysis, independent of age, sex, and co-morbidities, RV and LV changes were significantly associated with chest High-Resolution computed tomography score and hemodynamic Instability (HI), and with C-reactive protein, respectively. Our results suggest that COVID-19 may impact RV and LV differently. Notably, the extent of the pneumonia and HI may affect RV, whereas the inflammatory status may influence LV. A long-term follow-up is warranted to refine and customize the most appropriate therapeutic strategies.
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Maloberti A, Biolcati M, Giannattasio C. Troponin elevation in COVID-19 patients: An important stratification biomarker with still some open questions. Int J Cardiol 2021; 341:107-109. [PMID: 34352353 PMCID: PMC8327562 DOI: 10.1016/j.ijcard.2021.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 01/18/2023]
Affiliation(s)
- Alessandro Maloberti
- Cardiac Rehabilitation, Cardiology 4, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.
| | - Marco Biolcati
- Cardiac Rehabilitation, Cardiology 4, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy
| | - Cristina Giannattasio
- Cardiac Rehabilitation, Cardiology 4, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
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25
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Factors Associated with Mortality among Elderly People in the COVID-19 Pandemic (SARS-CoV-2): A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158008. [PMID: 34360301 PMCID: PMC8345726 DOI: 10.3390/ijerph18158008] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 12/29/2022]
Abstract
The objective of this meta-analysis was to evaluate the factors associated with the mortality of elderly Italians diagnosed with coronavirus who resided in institutions or who were hospitalized because of the disease. Methods: A systematic review following the recommendations of The Joanna Briggs Institute (JBI) was carried out, utilizing the PEO strategy, i.e., Population, Exposure and Outcome. In this case, the population was the elderly aged over 65 years old, the exposure referred to the SARS-CoV-2 pandemic and the outcome was mortality. The National Center for Biotechnology Information (NCBI/PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), Excerpta Medica Database (EMBASE) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used until 31 July 2020. Results: Five Italian studies were included in this meta-analysis, with the number of elderly people included varying between 18 and 1591 patients. The main morbidities presented by the elderly in the studies were dementia, diabetes, chronic kidney disease and hypertension. Conclusions: The factors associated with the mortality of elderly Italian people diagnosed with SARS-CoV-2 who lived in institutions or who were hospitalized because of the disease were evaluated. It was found that dementia, diabetes, chronic kidney disease and hypertension were the main diagnosed diseases for mortality in elderly people with COVID-19.
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26
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Pirnay JP, Selhorst P, Hong SL, Cochez C, Potter B, Maes P, Petrillo M, Dudas G, Claes V, Van der Beken Y, Verbeken G, Degueldre J, Dellicour S, Cuypers L, T’Sas F, Van den Eede G, Verhasselt B, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, André E, Neirinckx P, Soentjens P, Baele G. Variant Analysis of SARS-CoV-2 Genomes from Belgian Military Personnel Engaged in Overseas Missions and Operations. Viruses 2021; 13:1359. [PMID: 34372565 PMCID: PMC8310367 DOI: 10.3390/v13071359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023] Open
Abstract
More than a year after the first identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of the 2019 coronavirus disease (COVID-19) in China, the emergence and spread of genomic variants of this virus through travel raise concerns regarding the introduction of lineages in previously unaffected regions, requiring adequate containment strategies. Concomitantly, such introductions fuel worries about a possible increase in transmissibility and disease severity, as well as a possible decrease in vaccine efficacy. Military personnel are frequently deployed on missions around the world. As part of a COVID-19 risk mitigation strategy, Belgian Armed Forces that engaged in missions and operations abroad were screened (7683 RT-qPCR tests), pre- and post-mission, for the presence of SARS-CoV-2, including the identification of viral lineages. Nine distinct viral genotypes were identified in soldiers returning from operations in Niger, the Democratic Republic of the Congo, Afghanistan, and Mali. The SARS-CoV-2 variants belonged to major clades 19B, 20A, and 20B (Nextstrain nomenclature), and included "variant of interest" B.1.525, "variant under monitoring" A.27, as well as lineages B.1.214, B.1, B.1.1.254, and A (pangolin nomenclature), some of which are internationally monitored due to the specific mutations they harbor. Through contact tracing and phylogenetic analysis, we show that isolation and testing policies implemented by the Belgian military command appear to have been successful in containing the influx and transmission of these distinct SARS-CoV-2 variants into military and civilian populations.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Philippe Selhorst
- Unit of Virology and Outbreak Research Team, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Barney Potter
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 21027 Ispra, Italy;
| | - Gytis Dudas
- Gothenburg Global Biodiversity Centre, 413 19 Gothenburg, Sweden;
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium;
| | - Bruno Verhasselt
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium;
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Emmanuel André
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
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