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Kanuri SH, Jayesh Sirrkay P, Ulucay AS. COVID-19 HEART unveiling as atrial fibrillation: pathophysiology, management and future directions for research. Egypt Heart J 2023; 75:36. [PMID: 37120772 PMCID: PMC10149046 DOI: 10.1186/s43044-023-00359-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/22/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND COVID-19 infections are known to cause numerous systemic complications including cardiovascular disorders. In this regard, clinicians recently noticed that patients recovering from COVID-19 infections presented with diverse set of cardiovascular disorders in addition to those admitted to ICU (intensive care unit). COVID-19 heart has multifaceted presentation ranging from dysrhythmias, myocarditis, stroke, coronary artery disease, thromboembolism to heart failure. Atrial fibrillation is the most common cardiac arrhythmia among COVID-19 patients. In the background section, we briefly discussed epidemiology and spectrum of cardiac arrhythmias in COVID-19 patients. MAIN BODY In this state-of-the-art review we present here, we present the information regarding COVID-19-induced A-fib in sections, namely mechanism of action, clinical presentation, diagnosis and treatment. Unfortunately, its occurrence significantly increases the mortality and morbidity with a potential risk of complications such as cardiac arrest and sudden death. We included separate sections on complications including thromboembolism and ventricular arrhythmias. Since its mechanism is currently a gray area, we included a separate section on basic science research studies that are warranted in the future to comprehend its underlying pathogenic mechanisms. CONCLUSIONS Taken together, this review builds upon the current literature of COVID-19-induced A-fib, including pathophysiology, clinical presentation, treatment and complications. Furthermore, it provides recommendations for future research moving forward that can open avenues for developing novel remedies that can prevent as well as hasten clinical recovery of atrial fibrillation in COVID-19 patients.
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Kumar NR, Patel S, Norwood B. Subacute Cardiac Tamponade in a COVID-19 Patient Despite Negative Testing. Cureus 2022; 14:e29090. [PMID: 36249624 PMCID: PMC9556279 DOI: 10.7759/cureus.29090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
COVID-19 infection has been documented to cause a wide range of symptoms including cardiac complications. We present a case of subacute cardiac tamponade in a patient infected with COVID-19 in the absence of respiratory symptoms; we also review the current literature on this rare sequela. Our patient is a 67-year-old man who presented to the hospital due to intermittent chest pain for three weeks. COVID-19 polymerase chain reaction (PCR) testing was negative two times. He had an outpatient echocardiogram that showed a moderate pericardial effusion about a week prior to the hospital presentation. On admission, a repeat echocardiogram showed a large pericardial effusion with tamponade physiology. Pericardiocentesis did not reveal a clear etiology of the hemorrhagic effusion but four days later, the patient was found to be positive for COVID-19 infection without any clear respiratory illness. Given the absence of other etiology and negative workup, cardiac tamponade was attributed to pericardial inflammation from this virus and our patient improved with colchicine and steroids. We, therefore, advise providers to consider COVID-19 as a cause of hemorrhagic, cryptogenic cardiac tamponade despite negative COVID-19 testing. We also review 42 additional reported cases of cardiac tamponade in patients infected with COVID-19. COVID-19 can cause cardiac tamponade even in the absence of pulmonary disease. This case and literature review highlight tamponade as a rare complication of COVID-19 and should be considered in the differential of any acute deterioration in this patient population.
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Schnaubelt S, Eibensteiner F, Merrelaar M, Tihanyi D, Strassl R, Clodi C, Domanovits H, Losert H, Holzer M. Adult Respiratory Syncytial Virus Infection and Hypoxic Cardiac Arrest—Coexistent or Causal? A Hypothesis-Generating Case Report. Medicina (B Aires) 2022; 58:medicina58081121. [PMID: 36013588 PMCID: PMC9416440 DOI: 10.3390/medicina58081121] [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: 07/08/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a well-known pathogen in paediatric patients. However, it also causes substantial morbidity and mortality in adults, posing a major healthcare problem. We present a patient with chronic pulmonary conditions and an acute RSV infection, thus leading to cardiac arrest (CA). We speculate that RSV as the causative agent for CA should be considered in post-resuscitation care. From a wider public health perspective, immuno-naivety for RSV caused by the coronavirus disease 2019 pandemic may induce a severe rise in cases, morbidity, and mortality in the future.
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Affiliation(s)
- Sebastian Schnaubelt
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence:
| | - Felix Eibensteiner
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Marieke Merrelaar
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Daniel Tihanyi
- Department of Pulmonology, Clinic Penzing, Vienna Healthcare Group, 1140 Vienna, Austria
| | - Robert Strassl
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Hans Domanovits
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria
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Cheng CH, Wong KL, Chin JW, Chan TT, So RHY. Deep Learning Methods for Remote Heart Rate Measurement: A Review and Future Research Agenda. SENSORS (BASEL, SWITZERLAND) 2021; 21:6296. [PMID: 34577503 PMCID: PMC8473186 DOI: 10.3390/s21186296] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 01/05/2023]
Abstract
Heart rate (HR) is one of the essential vital signs used to indicate the physiological health of the human body. While traditional HR monitors usually require contact with skin, remote photoplethysmography (rPPG) enables contactless HR monitoring by capturing subtle light changes of skin through a video camera. Given the vast potential of this technology in the future of digital healthcare, remote monitoring of physiological signals has gained significant traction in the research community. In recent years, the success of deep learning (DL) methods for image and video analysis has inspired researchers to apply such techniques to various parts of the remote physiological signal extraction pipeline. In this paper, we discuss several recent advances of DL-based methods specifically for remote HR measurement, categorizing them based on model architecture and application. We further detail relevant real-world applications of remote physiological monitoring and summarize various common resources used to accelerate related research progress. Lastly, we analyze the implications of research findings and discuss research gaps to guide future explorations.
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Affiliation(s)
- Chun-Hong Cheng
- Department of Computer Science, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China;
- PanopticAI, Hong Kong Science and Technology Parks, New Territories, Hong Kong, China; (J.-W.C.); (T.-T.C.); (R.H.Y.S.)
| | - Kwan-Long Wong
- PanopticAI, Hong Kong Science and Technology Parks, New Territories, Hong Kong, China; (J.-W.C.); (T.-T.C.); (R.H.Y.S.)
- Department of Bioengineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
| | - Jing-Wei Chin
- PanopticAI, Hong Kong Science and Technology Parks, New Territories, Hong Kong, China; (J.-W.C.); (T.-T.C.); (R.H.Y.S.)
- Department of Industrial Engineering and Decision Analytics, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
| | - Tsz-Tai Chan
- PanopticAI, Hong Kong Science and Technology Parks, New Territories, Hong Kong, China; (J.-W.C.); (T.-T.C.); (R.H.Y.S.)
- Department of Industrial Engineering and Decision Analytics, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
| | - Richard H. Y. So
- PanopticAI, Hong Kong Science and Technology Parks, New Territories, Hong Kong, China; (J.-W.C.); (T.-T.C.); (R.H.Y.S.)
- Department of Industrial Engineering and Decision Analytics, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
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Multiple drugs. REACTIONS WEEKLY 2021. [PMCID: PMC8256981 DOI: 10.1007/s40278-021-98437-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mulia EPB, Maghfirah I, Rachmi DA, Julario R. Atrial arrhythmia and its association with COVID-19 outcome: a pooled analysis. ACTA ACUST UNITED AC 2021; 8:532-535. [PMID: 33470951 DOI: 10.1515/dx-2020-0155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/05/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Eka Prasetya Budi Mulia
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Irma Maghfirah
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Dita Aulia Rachmi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Rerdin Julario
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
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Schnaubelt S, Domanovits H, Niederdoeckl J, Schuetz N, Cacioppo F, Oppenauer J, Spiel AO, Laggner AN. The Impact of the COVID-19 Pandemic on Incidences of Atrial Fibrillation and Electrical Cardioversion at a Tertiary Care Emergency Department: An Inter- and Intra-year Analysis. Front Med (Lausanne) 2020; 7:595881. [PMID: 33344481 PMCID: PMC7746864 DOI: 10.3389/fmed.2020.595881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/13/2020] [Indexed: 01/17/2023] Open
Abstract
Background: National authorities have introduced measures as lockdowns against spreading of COVID-19 and documented incidences of multiple non-COVID-19 diseases have dropped. Yet, data on workload dynamics concerning atrial fibrillation and electrical cardioversion whilst a national lockdown are scarce and may assist in future planning. Methods: Documented cases of atrial fibrillation and respective electrical cardioversion episodes at the Emergency Department of the Medical University of Vienna, Austria, from 01/01/2020 to 31/05/2020 were assessed. As reference groups, those incidences were calculated for the years 2017, 2018, and 2019. Inter- and intra-year analyses were conducted through Chi-square test and Poisson regression. Results: A total of 2,310 atrial fibrillation-, and 511 electrical cardioversion episodes were included. We found no significant incidence differences in inter-year analyses of the time periods from January to May, or of the weeks pre- and post the national lockdown due to the COVID-19 pandemic. However, the intra-year analysis of the year 2020 showed a trend toward decreased atrial fibrillation incidences (rate-ratio 0.982, CI 0.964–1.001, p = 0.060), and significantly increased electrical cardioversion incidences in the post-lockdown period (rate ratio 1.051, CI 1.008–10.96, p = 0.020). Conclusion: The decreased atrial fibrillation incidences are in line with international data. However, an increased demand of electrical cardioversions during the lockdown period was observed. A higher threshold to seek medical attention may produce a selected group with potentially more severe clinical courses. In addition, lifestyle modifications during isolation and a higher stress level may promote atrial fibrillation episodes to be refractory to other therapeutic approaches than electrical cardioversion.
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Affiliation(s)
| | - Hans Domanovits
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Jan Niederdoeckl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Nikola Schuetz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Filippo Cacioppo
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Julia Oppenauer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexander O Spiel
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.,Vienna Health Care Group, Department of Emergency Medicine, Clinic Ottakring, Vienna, Austria
| | - Anton N Laggner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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Shabbir A, Camm CF, Elkington A, Tilling L, Stirrup J, Chan A, Bull S. Myopericarditis and myositis in a patient with COVID-19: a case report. Eur Heart J Case Rep 2020; 4:1-6. [PMID: 33442587 PMCID: PMC7665419 DOI: 10.1093/ehjcr/ytaa370] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/02/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Concurrent myopericarditis and myositis can present in patients with pre-existing systemic inflammatory diseases. Here we present a case of myopericarditis and myositis associated with COVID-19, in the absence of respiratory symptoms. CASE SUMMARY We present a middle-aged female with a history of hypertension and previous myopericarditis. The patient was admitted with symptoms of central chest pain, and ECG and echocardiographic features of myopericarditis. Her symptoms did not improve, and CT thorax suggested possible SARS-CoV-2 infection for which she tested positive, despite no respiratory symptoms. Whilst on the ward, she developed bilateral leg weakness and a raised creatine kinase (CK), and magnetic resonance imaging (MRI) of her thighs confirmed myositis. A cardiac MRI confirmed myopericarditis. She was treated with colchicine 500 μg twice daily, ibuprofen 400 mg three times day, and prednisolone 30 mg per day, and her symptoms and weakness improved. DISCUSSION We describe the first reported case of concurrent myopericarditis, and myositis associated with COVID-19. Conventional therapy with colchicine, non-steroidal anti-inflammatory drugs, and glucocorticoids improved her symptoms, and reduced biochemical markers of myocardial and skeletal muscle inflammation.
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Affiliation(s)
- Asad Shabbir
- The Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
| | | | | | - Lindsey Tilling
- The Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
| | - James Stirrup
- The Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
| | - Antoni Chan
- The Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
| | - Sacha Bull
- The Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
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Camm CF, Camm AJ. The cardiac effects of SARS-CoV2: COVID-19 special issue. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-2. [PMID: 33094216 PMCID: PMC7566449 DOI: 10.1093/ehjcr/ytaa351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- C Fielder Camm
- Cardiology Department, Royal Berkshire Hospital, Reading, UK.,University of Oxford, Oxford, UK
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