Case of COVID-19 infection and polycythaemia presenting with massive acute pulmonary embolism

Cardiovascular implications of the COVID-19: Management of complications and drug safety concerns

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has rapidly spread worldwide and has been infected more than 219 million individuals with 4.55 million deaths worldwide as of September 2021, causing a pandemic. Preexisting cardiovascular (CV) comorbidities such as hypertension, diabetes, and coronary artery disease seem to be associated with greater severity of infection, worse prognosis, and higher mortality. Moreover, COVID-19 can contribute to CV complications, including acute myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism, emphasizing the importance of precocious detection and implementation of optimal therapeutic strategies. This review provides an overview of evidence-based data of CV complications of COVID-19, focusing on their management strategies, as well as potential cardiac adverse effects and drug interactions, due to off-label and investigational drugs used for the treatment of COVID-19.

Prognosis of COVID-19 in the middle eastern population, knowns and unknowns

Since its emergence in China in 2019, the SARS-CoV-2 virus has affected all countries worldwide. The virus is easily transmitted from one person to another via infected aerosols or contaminated surfaces. Unlike its counterparts, the prognosis of COVID-19 ranges from asymptomatic to critical disease or death. Several factors play a role in determining the severity of the disease in infected patients. Among others, is the pre-existence of an underlying medical condition such as diabetes, cancer, and others. Furthermore, although children are less prone to the severe form of the COVID-19 disease, they require attention due to the report of many atypical presentations of the infection, post-asymptomatic exposure. In the Middle East, little is known about the prognosis of the SARS-CoV-2 infection in high-risk categories, notably patients with diabetes, cancer, and pregnant women. The aim of this review is to summarize the current knowledge about this group of population in the middle eastern region as well as to highlight the gap in the literature. We have found that the majority of the papers were from the Gulf countries. Although, few studies were conducted; high-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts. Higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were also observed. Children are often asymptomatic or present with atypical presentations. More studies should be conducted to determine the clinical biomarkers of COVID-19 in high-risk categories to help in patient risk stratification and management in the middle eastern population.

U shape association of hemoglobin level with in-hospital mortality for COVID-19 patients

Our hypothesis was that high hemoglobin (Hb) level might be associated with hypercoagulable state and death due to COVID-19. Of the 9467 hospitalized COVID-19 patients, patients were subdivided into 5 groups based on the level of Hb; Hb < 10 g/dL, 10 g/dL ≤ Hb < 12 g/dL, 12 g/dL ≤ Hb < 14 g/dL, 14 g/dL ≤ Hb < 16 g/dL, and Hb ≥ 16 g/dL. Compared to patients with 12 g/dL ≤ Hb < 14 g/dL, patients with Hb ≥ 16 g/dL had significantly higher adjusted in-hospital mortality (OR [95% CI] 1.62 [1.15–2.27], P = 0.005).

The effect of three-dimensional nursing management on the respiratory exercise compliance and nursing efficiency in post-thoracotomy patients with acute pulmonary embolisms

OBJECTIVE

To study the effect of the three-dimensional nursing management mode on compliance with respiratory function exercises and on the nursing efficiency in post-thoracotomy, acute pulmonary embolism (PE) patients.

METHODS

A cohort of 20 post-thoracotomy patients with acute PE were equally and randomly divided into two groups. The patients in the experimental group underwent the three-dimensional nursing management mode, and the patients in the control group underwent ordinary nursing. The compliance with respiratory function exercises during the hospital stay and within 3 months after discharge was observed, and the efficiency of the three-dimensional nursing management mode was determined according to the patient recovery.

RESULTS

The overall recovery effect in the experimental group was good, the respiratory function exercise effect was significant, and just one patient still had dyspnea after one week of nursing. There were 5 patients with chest tightness and chest pain and 7 patients with dyspnea in the control group. One patient died after a recurrence of the disease (P < 0.05). The total nursing efficiency was 90% in the experimental group and 30% in the control group (P < 0.05). Three months after discharge, the patients in the two groups were followed up, and a survey was conducted. In the experimental group, 14 patients and their families were very satisfied with the nursing. In the control group, 2 patients and their families were dissatisfied with the nursing, and the difference was statistically significant (P < 0.05).

CONCLUSIONS

Three-dimensional nursing management with post-thoracotomy, acute pulmonary embolism patients contributes to improving the patients' compliance with respiratory function exercises and to the nursing efficiency. It can greatly improve the nursing efficiency, relieve patients' post-surgical pain, and can promote the formation of a good doctor-patient relationship to a certain extent.