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Mathai SV, Apple SJ, Xu X, Pang L, Flatow E, Friedman A, Rios S, Benites Moya CJ, Alhuarrat MAD, Parker M, Sokol SI, Faillace RT. Differential Mortality Among Heart Failure Patients Across Different COVID-19 Surges in New York City. J Healthc Qual 2024; 46:197-202. [PMID: 38214648 DOI: 10.1097/jhq.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
ABSTRACT Learning from the healthcare system's response to the COVID-19 pandemic is essential to better prepare for potential future crises. We sought to assess mortality rates for patients admitted for acute decompensated heart failure (HF) and to analyze which factors demonstrated a statistically significant correlation with this primary endpoint. We performed a retrospective analysis of patients hospitalized with a primary diagnosis of acute decompensated HF within the New York City Health and Hospitals 11-hospital system across the different COVID surge periods. Mortality information was collected in 4,405 participants (mean [SD] age 70.54 [14.44] years, 1885 [42.87%] female).The highest mortality existed in the first surge (9.02%), then improved to near prepandemic levels (3.65%) in the second (3.91%) and third surges (5.94%, p < 0.0001). In-hospital mortality inversely correlated with receipt of a COVID-19 vaccination, but had no correlation with left ventricular ejection fraction or the number of vaccination doses. Mortality for acute decompensated HF patients improved after the first surge, suggesting that hospitals adequately adapted to provide quality care. As future infectious outbreaks may occur, emergency preparedness must ensure that adequate focus and resources remain for other clinical entities, such as HF, to ensure optimal care is delivered across all areas of illness.
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Trinh Z, Cogswell I, Causey K. Impacts of the COVID-19 pandemic on healthcare utilization among Home Care Aides in Washington, U.S. Home Health Care Serv Q 2024:1-26. [PMID: 38940018 DOI: 10.1080/01621424.2024.2369079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
This study assesses the impacts of the COVID-19 pandemic on healthcare access for Washington State Home Care Aides (HCAs). Analyzing 62 months of medical claims data from over 35,000 HCAs, the research reveals significant healthcare disruptions during the early pandemic, especially in outpatient settings. However, healthcare utilization rebounded swiftly, surpassing pre-COVID levels as new variants emerged. Furthermore, the analysis indicated significant decreases in healthcare utilization for respiratory conditions in later stages of the pandemic, suggesting that the implementation of non-pharmaceutical and pharmaceutical interventions played a crucial role in preventing the transmission of respiratory diseases. Notably, behavioral health-related utilization among HCAs increased significantly throughout most pandemic phases, underscoring the importance of enhancing behavioral health support during public health crises. This research represents the first comprehensive study unveiling the effects of the COVID-19 pandemic on HCAs' healthcare access and opening avenues for further research and policy development to support this essential workforce.
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Affiliation(s)
- Zhenhui Trinh
- Health Benefits Trust, SEIU 775 Benefits Group, Seattle, USA
| | - Ian Cogswell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Kate Causey
- Research, Insights & Innovation, SEIU 775 Benefits Group, Seattle, USA
- Department of Public Health, University of Washington
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3
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Mellacheruvu SP, Lekkala SP, Khela PS, Singh G, Gill KS, Vaghani UP, Jitta SR, Hingora MJ, Patel M, Dadana S, Desai R. Was there a weekend effect on mortality rates for hospitalized patients with COVID-19 and acute myocardial infarction? Insights from the National Inpatient Sample, 2020. J Med Life 2024; 17:286-291. [PMID: 39044923 PMCID: PMC11262605 DOI: 10.25122/jml-2023-0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/12/2024] [Indexed: 07/25/2024] Open
Abstract
Our study aimed to assess the effect of weekend versus weekday hospital admissions on all-cause mortality in patients with acute myocardial infarction (AMI) and COVID-19 during the COVID-19 pandemic. We analyzed data from the National Inpatient Sample (NIS) 2020, identifying patients with co-existing AMI and COVID-19 admitted on weekdays and weekends. Baseline demographics, comorbidities, and outcomes were assessed. A multivariable regression analysis was conducted, adjusting for confounders to determine the odds of all-cause mortality. Among 74,820 patients, 55,145 (73.7%) were admitted on weekdays, while 19,675 (26.3%) were admitted on weekends. Weekend admissions showed slightly higher proportions of men (61.3% vs. 60%) and whites (56.3% vs. 54.9%) with a median age of 73 years (range: 62-82). The overall all-cause mortality had an odds ratio (OR) of 1.00 (95% CI, 0.92-1.09; P = 0.934). After adjusting for covariates, there was no significant associations between mortality and hospital type (rural: OR = 1.04; 95% CI, 0.78-1.39; P = 0.789; urban teaching: OR = 1.04; 95% CI, 0.94-1.14; P = 0.450) or geographic region (Northeast: OR = 1.16; 95% CI, 0.96-1.39; P = 0.12; Midwest: OR = 0.99; 95% CI, 0.83-1.17; P = 0.871; South: OR = 0.97; 95% CI, 0.85-1.12; P = 0.697; West: OR = 0.94; 95% CI, 0.77-1.15; P = 0.554). There was no significant difference in the rate of all-cause mortality among patients admitted for AMI and COVID-19 between weekdays and weekends.
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Affiliation(s)
| | | | - Puneeteshwar Singh Khela
- Department of Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Gurjot Singh
- Department of Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Karanvir Singh Gill
- Department of Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | | | - Sahas Reddy Jitta
- Department of Internal Medicine, Mercy Hospital, St Louis, Missouri, USA
| | - Mohmed Junaid Hingora
- Department of Internal Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, India
| | - Manali Patel
- Department of Internal Medicine, Gastroenterology and Internal Medicine Specialists, Lake Barrington, Illinois
| | - Sriharsha Dadana
- Department of Hospital Medicine, Cheyenne Regional Medical Center, Cheyenne, USA
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Liu J, Cepeda M, Frangaj B, Shimbo D. The Burden of Cardiovascular Disease in the Post-COVID Era. Prim Care 2024; 51:1-11. [PMID: 38278564 DOI: 10.1016/j.pop.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
In 2019, before the COVID-19 pandemic, cardiovascular disease (CVD) was the leading cause of death. Since 2020, the pandemic has had far-reaching effects on the landscape of health care including CVD prevention and management. Recent decreases in life expectancy in the United States could potentially be explained by issues related to disruptions in CVD prevention and control of CVD risk factors from the COVID-19 pandemic. This article reviews the effects of the SARS-CoV-2 virus and the accompanying pandemic on CVD risk factor prevention and management in the United States. Potential solutions are also proposed for these patients.
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Affiliation(s)
- Justin Liu
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 60 Haven Avenue (Tower 1), Level B2 (Lobby Level) - Office Suite B234, New York, NY 10032, USA
| | - Maria Cepeda
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 60 Haven Avenue (Tower 1), Level B2 (Lobby Level) - Office Suite B234, New York, NY 10032, USA
| | - Brulinda Frangaj
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 60 Haven Avenue (Tower 1), Level B2 (Lobby Level) - Office Suite B234, New York, NY 10032, USA
| | - Daichi Shimbo
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 60 Haven Avenue (Tower 1), Level B2 (Lobby Level) - Office Suite B234, New York, NY 10032, USA.
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5
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Farmakis D, Richter D, Chronopoulou G, Goumas G, Kountouras D, Mastorakou A, Papingiotis G, Hahalis G, Tsioufis K. High-sensitivity cardiac troponin I for cardiovascular risk stratification in apparently healthy individuals. Hellenic J Cardiol 2024; 75:74-81. [PMID: 37743017 DOI: 10.1016/j.hjc.2023.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023] Open
Abstract
Troponin I and T as cardiac-specific biomarkers are highly useful tools not only in the diagnosis of acute coronary syndromes but also as independent predictors of several other clinical conditions. High-sensitivity cardiac troponin (hs-cTn) assays allow the detection of considerably low concentrations of cardiac troponin in apparently healthy and asymptomatic individuals, being a candidate tool for cardiovascular risk stratification in the general population. A group of Greek experts summarized the bulk of evidence regarding the use of hs-cTnI as a predictor of cardiovascular events and mortality in apparently healthy individuals and its additive value on top of existing risk stratification methods. This document could serve as a guide for the incorporation of hs-cTnI as an additional risk stratification tool in cardiovascular prevention strategies in apparently healthy individuals.
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Affiliation(s)
- Dimitrios Farmakis
- Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
| | | | | | | | - Dimitrios Kountouras
- Center for Preventive Medicine & Longevity, Bioiatriki Healthcare Group, Athens, Greece
| | | | | | | | - Konstantinos Tsioufis
- First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University Medical School, Athens, Greece
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6
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Colantonio LD, Wang Z, Jones J, Dhalwani NN, Shannon ED, Liu C, Kalich BA, Muntner P, Rosenson RS, Bittner V. Low-Density Lipoprotein Cholesterol Testing Following Myocardial Infarction Hospitalization Among Medicare Beneficiaries. JACC. ADVANCES 2024; 3:100753. [PMID: 38939806 PMCID: PMC11198160 DOI: 10.1016/j.jacadv.2023.100753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/26/2023] [Accepted: 10/13/2023] [Indexed: 06/29/2024]
Abstract
Background Low-density lipoprotein cholesterol (LDL-C) is used to guide lipid-lowering therapy after a myocardial infarction (MI). Lack of LDL-C testing represents a missed opportunity for optimizing therapy and reducing cardiovascular risk. Objectives The purpose of this study was to estimate the proportion of Medicare beneficiaries who had their LDL-C measured within 90 days following MI hospital discharge. Methods We conducted a retrospective cohort study of Medicare beneficiaries ≥66 years of age with an MI hospitalization between 2016 and 2020. The primary analysis used data from all beneficiaries with fee-for-service coverage and pharmacy benefits (532,767 MI hospitalizations). In secondary analyses, we used data from a 5% random sample of beneficiaries with fee-for-service coverage without pharmacy benefits (10,394 MI hospitalizations), and from beneficiaries with Medicare Advantage (176,268 MI hospitalizations). The proportion of beneficiaries who had their LDL-C measured following MI hospital discharge was estimated accounting for the competing risk of death. Results In the primary analysis (mean age 76.9 years, 84.4% non-Hispanic White), 29.9% of beneficiaries had their LDL-C measured within 90 days following MI hospital discharge. Among Hispanic, Asian, non-Hispanic White, and non-Hispanic Black beneficiaries, the 90-day postdischarge LDL-C testing was 33.8%, 32.5%, 30.0%, and 26.0%, respectively. Postdischarge LDL-C testing within 90 days was highest in the Middle Atlantic (36.4%) and lowest in the West North Central (23.4%) U.S. regions. In secondary analyses, the 90-day postdischarge LDL-C testing was 26.9% among beneficiaries with fee-for-service coverage without pharmacy benefits, and 28.6% among beneficiaries with Medicare Advantage coverage. Conclusions LDL-C testing following MI hospital discharge among Medicare beneficiaries was low.
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Affiliation(s)
- Lisandro D. Colantonio
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Zhixin Wang
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jenna Jones
- Center for Observational Research, Amgen Inc, Thousand Oaks, California, USA
| | - Nafeesa N. Dhalwani
- Center for Observational Research, Amgen Inc, Thousand Oaks, California, USA
| | - Erin D. Shannon
- Center for Observational Research, Amgen Inc, Thousand Oaks, California, USA
| | - Cici Liu
- ICON Clinical Research Inc, Blue Bell, Pennsylvania, USA
| | | | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert S. Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vera Bittner
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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7
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Hulíková Tesárková K, Dzúrová D. Impacts of COVID-19 pandemic through decomposition of life expectancy according to leading causes and place of death in Czechia. Sci Rep 2023; 13:20731. [PMID: 38007583 PMCID: PMC10676350 DOI: 10.1038/s41598-023-47949-1] [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: 07/26/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023] Open
Abstract
While the direct effects of the pandemic are well documented, less is known about the indirect ones, including changes in healthcare provision or human behavior. This paper aims to study the impact of indirect consequences on mortality, focusing on two leading causes (cardiovascular diseases, COVID-19) and places of death in Czechia, during the COVID-19 pandemic, one of the most severely affected European countries. The analysis was performed using data from the Czech Statistical Office and the Institute of Health Information and Statistics. The study compares annual mortality changes during three time periods: pre-pandemic (2018-2019), pandemic beginning and peaking (2020-2021), and pandemic fading (2022). Pandemic years were covered by the WHO public health emergency of international concern. Abridged life tables were computed, and Pollard's decomposition was used to calculate the contributions of causes and places of death on annual differences in life expectancy. Seasonal decomposition of monthly time series revealed an increase in cardiovascular mortality at home or in social care facilities corresponding to limitations in healthcare. While COVID-19 had a systemic negative effect on life expectancy during the pandemic, the impact of cardiovascular mortality according to place of death changed over time. This study contributes to the evidence base of systemic risks during health crises and emergency response.
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Affiliation(s)
- Klára Hulíková Tesárková
- Department of Demography and Geodemography, Faculty of Sciences, Charles University, Prague, Czechia
| | - Dagmar Dzúrová
- Department of Social Geography and Regional Development, Faculty of Sciences, Charles University, Prague, Czechia.
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8
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Rozman J, Yang Z, Spielmann N. Introduction to Mammalian Genome special issue: cardiovascular disease in the Mammalian Genome. Mamm Genome 2023; 34:105-106. [PMID: 37210431 PMCID: PMC10199735 DOI: 10.1007/s00335-023-09998-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- Jan Rozman
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Zhongzhou Yang
- School of Medicine, Nanjing University, 22 Hankou Road, Gulou District, Nanjing, 210093, China
| | - Nadine Spielmann
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
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9
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Boulos PK, Freeman SV, Henry TD, Mahmud E, Messenger JC. Interaction of COVID-19 With Common Cardiovascular Disorders. Circ Res 2023; 132:1259-1271. [PMID: 37167359 PMCID: PMC10171313 DOI: 10.1161/circresaha.122.321952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The onset and widespread dissemination of the severe acute respiratory syndrome coronavirus-2 in late 2019 impacted the world in a way not seen since the 1918 H1N1 pandemic, colloquially known as the Spanish Flu. Much like the Spanish Flu, which was observed to disproportionately impact young adults, it became clear in the early days of the coronavirus disease 2019 (COVID-19) pandemic that certain groups appeared to be at higher risk for severe illness once infected. One such group that immediately came to the forefront and garnered international attention was patients with preexisting cardiovascular disease. Here, we examine the available literature describing the interaction of COVID-19 with a myriad of cardiovascular conditions and diseases, paying particular attention to patients diagnosed with arrythmias, heart failure, and coronary artery disease. We further discuss the association of acute COVID-19 with de novo cardiovascular disease, including myocardial infarction due to coronary thrombosis, myocarditis, and new onset arrhythmias. We will evaluate various biochemical theories to explain these findings, including possible mechanisms of direct myocardial injury caused by the severe acute respiratory syndrome coronavirus-2 virus at the cellular level. Finally, we will discuss the strategies employed by numerous groups and governing bodies within the cardiovascular disease community to address the unprecedented challenges posed to the care of our most vulnerable patients, including heart transplant recipients, end-stage heart failure patients, and patients suffering from acute coronary syndromes, during the early days and height of the COVID-19 pandemic.
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Affiliation(s)
- Peter K. Boulos
- University of Colorado School of Medicine, Division of Cardiology, Aurora (P.K.B., S.V.F., J.C.M.)
| | - Scott V. Freeman
- University of Colorado School of Medicine, Division of Cardiology, Aurora (P.K.B., S.V.F., J.C.M.)
| | - Timothy D. Henry
- The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH (T.D.H.)
| | - Ehtisham Mahmud
- Sulpizio Cardiovascular Center, University of California San Diego, La Jolla (E.M.)
| | - John C. Messenger
- University of Colorado School of Medicine, Division of Cardiology, Aurora (P.K.B., S.V.F., J.C.M.)
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10
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Akhtar Z, Trent M, Moa A, Tan TC, Fröbert O, MacIntyre CR. The impact of COVID-19 and COVID vaccination on cardiovascular outcomes. Eur Heart J Suppl 2023; 25:A42-A49. [PMID: 36937372 PMCID: PMC10021497 DOI: 10.1093/eurheartjsupp/suac123] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
COVID-19 is an independent risk factor for cardiovascular disease. COVID-19 vaccination may prevent this, but in some cases, COVID-19 vaccination may cause myocarditis or pericarditis. Patients with COVID-19 may present with non-specific symptoms that have a cardiac origin. This review examines the cardiovascular complications of COVID-19 infection and the impact of COVID-19 vaccination. COVID-19 cardiovascular complications include myocardial injury, pericarditis, coagulopathy, myocardial infarction, heart failure, arrhythmias, and persistent post-acute risk of adverse cardiovascular outcomes. Diagnostic and referral pathways for non-specific symptoms, such as dyspnoea and fatigue, remain unclear. COVID-19 vaccination is cardioprotective overall but is associated with myopericarditis in young males, though at a lower rate than following SARS-CoV-2 infection. Increased awareness among primary care physicians of potential cardiovascular causes of non-specific post-COVID-19 symptoms, including in younger adults, such as fatigue, dyspnoea, and chest pain, is essential. We recommend full vaccination with scheduled booster doses, optimal management of cardiovascular risk factors, rapid treatment of COVID-19, and clear diagnostic, referral, and management pathways for patients presenting with non-specific symptoms to rule out cardiac complications.
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Affiliation(s)
- Zubair Akhtar
- Biosecurity Program, The Kirby Institute, University of New South Wales (UNSW), 2052, SydneyAustralia
- Programme on Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh 1212
| | - Mallory Trent
- Biosecurity Program, The Kirby Institute, University of New South Wales (UNSW), 2052, SydneyAustralia
| | - Aye Moa
- Biosecurity Program, The Kirby Institute, University of New South Wales (UNSW), 2052, SydneyAustralia
| | - Timothy C Tan
- Department of Cardiology, Blacktown Hospital, University of Western Sydney, 2148, Blacktown, NSW, Australia
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, 2052, Sydney, NSW, Australia
- Department of Cardiology, Westmead Hospital, Sydney University, 2145, Westmead, NSW, Australia
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11
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Raisi-Estabragh Z, Harvey NC, Petersen SE. Response to: Correspondence on 'Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank' by Jolobe. Heart 2023; 109:heartjnl-2022-322124. [PMID: 36593100 DOI: 10.1136/heartjnl-2022-322124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
- Health Data Research UK, London, UK
- Alan Turing Institute, London, UK
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12
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Roy R, McDonaugh B, O'Gallagher K. COVID-19 and the heart. Br Med Bull 2022; 144:4-11. [PMID: 36155748 PMCID: PMC9619476 DOI: 10.1093/bmb/ldac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is evidence for a bi-directional relationship between COVID-19 and the cardiovascular (CV) system. SOURCE OF DATA Published literature. AREAS OF AGREEMENT Pre-existing heart failure (HF) increases the risk of mortality with COVID-19. CV complications are recognized, including increased rates of acute coronary syndromes, HF, arrhythmia and myocarditis. Drugs targeting the angiotensin system are safe and may provide prognostic benefit. AREAS OF CONTROVERSY Vaccination as a cause of myocarditis remains a key area of contention. GROWING POINTS As the pandemic progresses, we are gaining more data about the long-term effects of COVID-19 on the CV system: long COVID, and medium-to-long-term increases in CV risk. AREAS TIMELY FOR DEVELOPING RESEARCH Large-scale longitudinal studies will shed light on long-term CV outcomes with COVID-19. Furthermore, the differential effects of COVID-19 variants on the CV system must be investigated.
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Affiliation(s)
- Roman Roy
- Cardiovascular Department, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | | | - Kevin O'Gallagher
- Cardiovascular Department, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.,British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London SE5 9NU, UK
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