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Abstract
INTRODUCTION Since the end of 2019, a new disease outbreak has been spreading worldwide, after starting from Wuhan, China. The viral pathogen responsible for the disease was named as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), and for the illness the acronym COVID-19 was coined (COronaVIrus Disease 2019). Viral pathogenesis, epidemiology, and clinics are still somewhat obscure, when occurring during childhood the most. The aim of this study was to evaluate the features of liver involvement and damage in course of COVID-19. EVIDENCE ACQUISITION An insight into what is known as to COVID-19 and hepatic damage in adulthood as well as pediatric age was given. All the most relevant papers up to 15/10/2020 were identified and discussed. An extensive search strategy was carried out to identify all paper published from December 1st, 2019, to September 5, 2020, combining the key words "coronavirus," "coronavirus infection," "SARS-CoV-2," "COVID-19," "liver," "liver injury," "hepatic injury," "children," "pediatric" in key electronic bibliographic databases (PubMed, Google Scholar), following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. EVIDENCE SYNTHESIS Establishing whether liver damage is due to a direct viral action or host immune system inflammatory reaction or consequence of the administered drugs or secondary to another organ failure (for example the heart) is difficult. What is sure is the fact that liver function should be checked at the time of admission to hospital and during hospitalization. CONCLUSIONS In conclusion, liver involvement during COVID-19 is likely due to a multifactorial origin. An aberrant immune system reaction to SARS-CoV-2 is probably the most important underlying trigger, though more extended studies are needed for a definitive confirmation. The markers of liver injury should be carefully in each patient admitted for COVID-19: in fact, in case of altered hepatic markers, a specific therapy to protect liver is needed.
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Affiliation(s)
- Simone Mameli
- Graduate School in Pediatrics, University of Cagliari, Cagliari, Italy
| | - Maria A Marcialis
- Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
| | - Pier P Bassareo
- Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, University College of Dublin, Dublin, Ireland -
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
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Scuotto C, Ilardi CR, Maggi G, Ilardi A, Gamboz N, Staiano M, Borrelli G, La Marra M, Perrella R. What makes us more susceptible to false memories in the era of COVID-19? A focus on vaccines and Green Pass. Brain Behav 2023; 13:e2815. [PMID: 36448933 PMCID: PMC9847604 DOI: 10.1002/brb3.2815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/15/2022] [Accepted: 10/27/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic was accompanied by an overabundance of fake news increasing the risk of developing false memories (FMs). Previous studies have shown that the relationship between fake news and FMs could be mediated by some individual variables, including attitudinal biases. We explored the role of these variables in true memories (TMs) and FMs formation, with special emphasis on vaccine- and Green Pass (GP)-related topics. METHOD We set up a large online survey exploring several constructs including media usage, attitude toward vaccines and GP, perceived (PK) and objective knowledge (OK) about COVID-19-related information, fear of the disease, depression and anxiety symptoms, coping mechanisms, and reasoning skills. Then, we asked participants whether they remembered certain news (true or fake), providing confidence ratings. RESULTS Data from 289 respondents (198 females) from the general population were analyzed. Participants with positive attitude reported a greater fear that their loved ones contracted the COVID-19, a more frequent use of traditional media, and a higher PK when compared with respondents with negative attitude. On the whole sample, participants reported higher confidence levels when required to judge their memory of true than fake news; however, participants with positive attitude reported a higher confidence for both true and fake news. The relationship between attitude and TM confidence was mediated by the PK, whereas the relationship between attitude and FM confidence was probably affected by OK. CONCLUSION Attitude can modulate individual behaviors in the context of health issues. The PK and OK may interact with attitude in the memory formation.
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Affiliation(s)
- Chiara Scuotto
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ciro Rosario Ilardi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Alfonso Ilardi
- Inmates Ward, Department of Internal Medicine, Antonio Cardarelli Hospital, Naples, Italy
| | - Nadia Gamboz
- Laboratory of Experimental Psychology, Suor Orsola Benincasa University, Naples, Italy
| | - Maria Staiano
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Borrelli
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Marco La Marra
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Raffaella Perrella
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
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Piras A, Melis G, Cugusi L, Bassareo PP. Myopericarditis in a Male Adolescent Following the Second Shot of COVID-19 Pfizer m-RNA Vaccine: Typical Example and Analysis of 110 Single Case Reports. Pediatr Rep 2022; 14:401-409. [PMID: 36278552 PMCID: PMC9589994 DOI: 10.3390/pediatric14040048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
One of the most powerful weapons against COVID-19 is vaccines. After the worldwide spread of the disease, m-RNA vaccines were authorized not only in adult patients, but also in children and adolescents aged 12-18. Since then, alarming reports of cases of myocarditis and/or pericarditis have been noted, primarily involving males after the second vaccine shot. A typical example of myopericarditis occurring in an adolescent a few days after the second shot of an m-RNA vaccine is described here. An in-depth review of all 110 single case reports published up to July 2022 with related features and outcomes is also presented. This is the first extensive analysis focused solely on a significant number of single case reports, which have usually been excluded from systematic reviews and meta-analyses carried out in the field. The analysis presented here confirms that most cases occurred in males after the second injection of an m-RNA vaccine. Cases were mild and responsive to the usual medical treatment. What is newly reported is that not only adolescents, but also older people, especially females, were affected by this adverse event.
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Affiliation(s)
- Alessandra Piras
- Struttura Complessa di Cardiologia-UTIC-Emodinamica, Azienda Ospedaliero-Universitaria di Cagliari, 09042 Monserrato, Cagliari, Italy
| | - Giada Melis
- Pronto Soccorso ed OBI, Azienda Ospedaliero-Universitaria di Cagliari, 09042 Monserrato, Cagliari, Italy
| | - Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Sardinia, Italy
| | - Pier Paolo Bassareo
- School of Medicine, University College of Dublin, D04 V1W8 Dublin, Ireland
- Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland
- Correspondence:
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Ostrowska M, Kasprzak M, Stolarek W, Grzelakowska K, Kryś J, Kubica A, Adamski P, Podhajski P, Navarese EP, Anielska-Michalak E, Matuszewska-Brycht O, Curzytek A, Dudek A, Gromadziński L, Grzelakowski P, Kamiński L, Kleinrok A, Kostkiewicz M, Koziński M, Król P, Kulawik T, Minczew G, Mindykowski M, Pawlak A, Prokopczuk J, Skonieczny G, Sobkowicz B, Sowiński S, Stankala S, Szymański P, Wester A, Wilczewski P, Bartuś S, Budaj A, Gajda R, Gąsior M, Gruchała M, Droźdź J, Jaguszewski M, Jankowski P, Legutko J, Lesiak M, Leszek P, Mitkowski P, Nessler J, Tomaszuk-Kazberuk A, Tycińska A, Zdrojewski T, Kaźmierczak J, Kubica J. Longer Hospitalizations and Higher In-Hospital Mortality for Acute Heart Failure during the COVID-19 Pandemic in Larger vs. Smaller Cardiology Departments: Subanalysis of the COV-HF-SIRIO 6 Multicenter Study. Rev Cardiovasc Med 2022; 23:292. [PMID: 39077718 PMCID: PMC11262386 DOI: 10.31083/j.rcm2309292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/27/2022] [Accepted: 08/04/2022] [Indexed: 07/31/2024] Open
Abstract
Background The coronavirus disease-2019 (COVID-19) pandemic is surging across Poland, leading to many direct deaths and underestimated collateral damage. We aimed to compare the influence of the COVID-19 pandemic on hospital admissions and in-hospital mortality in larger vs. smaller cardiology departments (i.e., with ≥ 2000 vs. < 2000 hospitalizations per year in 2019). Methods We performed a subanalysis of the COV-HF-SIRIO 6 multicenter retrospective study including all patients hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, focusing on patients with acute heart failure (AHF) and COVID-19. Results Total number of hospitalizations was reduced by 29.2% in larger cardiology departments and by 27.3% in smaller cardiology departments in 2020 vs. 2019. While hospitalizations for AHF were reduced by 21.8% and 25.1%, respectively. The length of hospital stay due to AHF in 2020 was 9.6 days in larger cardiology departments and 6.6 days in smaller departments (p < 0.001). In-hospital mortality for AHF during the COVID-19 pandemic was significantly higher in larger vs. smaller cardiology departments (10.7% vs. 3.2%; p < 0.001). In-hospital mortality for concomitant AHF and COVID-19 was extremely high in larger and smaller cardiology departments accounting for 31.3% vs. 31.6%, respectively. Conclusions During the COVID-19 pandemic longer hospitalizations and higher in-hospital mortality for AHF were observed in larger vs. smaller cardiology departments. Reduced hospital admissions and extremely high in-hospital mortality for concomitant AHF and COVID-19 were noted regardless of department size.
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Affiliation(s)
| | - Michał Kasprzak
- Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
| | - Wioleta Stolarek
- Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
| | | | - Jacek Kryś
- Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
| | - Aldona Kubica
- Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
| | - Piotr Adamski
- Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
| | | | | | - Edyta Anielska-Michalak
- Department of Cardiology, Marian Zyndram-Kościałkowski Ministry of Interior and Administration Hospital, 15-471 Białystok, Poland
| | - Oliwia Matuszewska-Brycht
- Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, 92-213 łódź, Poland
| | - Andrzej Curzytek
- Department of Cardiology, Hospital of the Ministry of Interior and Administration, 35-111 Rzeszów, Poland
| | - Aneta Dudek
- 1st Department of Cardiology, Collegium Medicum, Jan Kochanowski University, 25-736 Kielce, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 11-041 Olsztyn, Poland
| | - Paweł Grzelakowski
- Department of Cardiology and Cardiac Surgery, 10th Military Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Leszek Kamiński
- Department of Cardiology Independent Public Healthcare in Przeworsk, 37-200 Przeworsk, Poland
| | - Andrzej Kleinrok
- Institute of Humanities and Medicine, Academy of Zamosc, 22-400 Zamość, Poland
| | | | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 81-519 Gdynia, Poland
| | - Paweł Król
- Department of Cardiology, Tertiary Care Hospital, 06-400 Ciechanów, Poland
| | - Tomasz Kulawik
- Department of Cardiology, Masovian Rehabilitation Center “STOCER”, Dr Włodzimierz Roefler Hospital, 05-800 Pruszków, Poland
| | - Gleb Minczew
- Department of Cardiology, District Hospital, 89-500 Tuchola, Poland
| | - Marcin Mindykowski
- Department of Cardiology, Dr. Emil Warmiński Tertiary Care Municipal Hospital, 85-808 Bydgoszcz, Poland
| | - Agnieszka Pawlak
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland
- Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Janusz Prokopczuk
- Department of Cardiology, Polish Hospitals, 47-200 Kędzierzyn-Koźle, Poland
| | - Grzegorz Skonieczny
- Department of Cardiology and Intensive Cardiac Care Unit, District Polyclinic Hospital, 87-100 Toruń, Poland
| | - Bożena Sobkowicz
- Department of Cardiology, Medical University of Białystok, 15-276 Białystok, Poland
| | - Sergiusz Sowiński
- Department of Cardiology and Cardiac Intensive Care, Tertiary Care Municipal Hospital, 87-100 Toruń, Poland
| | - Sebastian Stankala
- Cardiology Subdivision of Heart Failure. St. Elizabeth Hospital, 48-210 Biała, Poland
| | - Paweł Szymański
- Department of Cardiology, Interventional Cardiology and Electrophysiology with Cardiac Intensive Care Unit, Tertiary Care Hospital, 86-300 Grudziądz, Poland
| | - Andrzej Wester
- 1st Department of Physiology, Institute of Medical Sciences, University of Opole 2, Cardiology Center of Kluczbork SCANMED SA, 46-203 Kluczbork, Poland
| | | | - Stanisław Bartuś
- 2nd Department of Cardiology, Collegium Medicum, Jagiellonian University, 30-688 Cracow, Poland
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, 04-073 Warsaw, Poland
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland
- Gajda-Med District Hospital in Pultusk, 06-100 Pułtusk, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medicine in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdansk, 80-952 Gdańsk, Poland
| | - Jarosław Droźdź
- Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, 92-213 łódź, Poland
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, 80-952 Gdańsk, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital in Krakow, 31-202 Cracow, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantology, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Przemysław Mitkowski
- Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| | - Jadwiga Nessler
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, 31-202 Cracow, Poland
| | | | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Białystok, 15-276 Białystok, Poland
| | - Tomasz Zdrojewski
- Department of Arterial Hypertension and Diabetology, Medical University of Gdansk, 80-952 Gdańsk, Poland
| | - Jarosław Kaźmierczak
- Department of Cardiology, Pomeranian Medical University, 71-899 Szczecin, Poland
| | - Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
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Calcaterra G, Bassareo PP, Barilla' F, Romeo F, Mehta JL. Concerning the unexpected prothrombotic state following some coronavirus disease 2019 vaccines. J Cardiovasc Med (Hagerstown) 2022; 23:71-74. [PMID: 34366403 DOI: 10.2459/jcm.0000000000001232] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Currently, the world is coping with the COVID-19 pandemic with a few vaccines. So far, the European Medicine Agency has approved four of them. However, following widespread vaccination with the recombinant adenoviral vector-based Oxford-AstraZeneca vaccine, available only in the United Kingdom and Europe, many concerns have emerged, especially the report of several cases of the otherwise rare cerebral sinus vein thrombosis and splanchnic vein thrombosis. The onset of thrombosis particularly at these unusual sites, about 5--14 days after vaccination, along with thrombocytopenia and other specific blood test abnormalities, are the main features of the vaccine side effects. The acronym vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) has been coined to name this new condition, with the aim of highlighting the difference from the classic heparin-induced thrombocytopenia (HIT). VIPIT seems to primarily affect young to middle-aged women. For this reason, the vaccine administration has been stopped or limited in a few European countries. Coagulopathy induced by the Oxford-AstraZeneca vaccine (and probably by Janssen/Johnson & Johnson vaccine as well in the USA) is likely related to the use of recombinant vector DNA adenovirus, as experimentally proven in animal models. Conversely, Pfizer and Moderna vaccines use mRNA vectors. All vaccine-induced thrombotic events should be treated with a nonheparin anticoagulant. As the condition has some similarities with HIT, patients should not receive any heparin or platelet transfusion, as these treatments may potentially worsen the clinical course. Aspirin has limited rational use in this setting and is not currently recommended. Intravenous immunoglobulins may represent another potential treatment, but, most importantly, clinicians need to be aware of this new unusual postvaccination syndrome.
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Affiliation(s)
| | - Pier Paolo Bassareo
- University College of Dublin, Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | | | | | - Jawahar L Mehta
- University of Arkansas for Medical Sciences and the VA Medical Center, Little Rock, Arkansas, USA
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Calcaterra G, Bassareo PP, De Gregorio C, Barilla F, Romeo F, Mehta JL. COVID-19 Vaccine-Induced Pro-thrombotic Immune Thrombocytopenia (VIPIT): State of the Art. Curr Cardiol Rev 2022; 18:11-17. [PMID: 35319381 PMCID: PMC9896421 DOI: 10.2174/1573403x18666220321105909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/03/2021] [Accepted: 01/07/2022] [Indexed: 11/22/2022] Open
Abstract
In 2020, as the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic spread rapidly throughout the world, scientists worked relentlessly to develop and test the safety and effectiveness of potential vaccines. Usually, the vaccine development process involves years of investigation and testing prior to gaining approval for use in practice. A pathogenic PF4-dependent syndrome, unrelated to the use of heparin therapy, may be manifested following the administration of viral vector vaccines. It leads to severe clot formation at unusual sites approximately in 1 out of 110.000 vaccinated persons. This side effect, although rare, represents a newly devastating clotting phenomenon manifested in otherwise healthy young adults, who are often female. An in-depth description of the specific biological mechanisms implicated in the syndrome is here summarized.
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Affiliation(s)
| | - Pier Paolo Bassareo
- Address correspondence to this author at the University College of Dublin, School of Medicine, Mater Misericordiae University Hospital, Dublin, Republic of Ireland; E-mail:
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Kubica J, Ostrowska M, Stolarek W, Kasprzak M, Grzelakowska K, Kryś J, Kubica A, Adamski P, Podhajski P, Navarese EP, Anielska-Michalak E, Brycht O, Curzytek A, Dudek A, Gromadziński L, Grzelakowski P, Kamiński L, Kleinrok A, Kostkiewicz M, Koziński M, Król P, Kulawik T, Minczew G, Mindykowski M, Pawlak A, Prokopczuk J, Skonieczny G, Sobkowicz B, Sowiński S, Stankala S, Szymański P, Wester A, Wilczewski P, Bartuś S, Budaj A, Gąsior M, Gruchała M, Drożdż J, Jaguszewski M, Jankowski P, Legutko J, Lesiak M, Leszek P, Mitkowski P, Nessler J, Tomaszuk-Kazberuk A, Tycińska A, Zdrojewski T, Kaźmierczak J. Impact of COVID-19 pandemic on acute heart failure admissions and mortality: a multicentre study (COV-HF-SIRIO 6 study). ESC Heart Fail 2021; 9:721-728. [PMID: 34786869 PMCID: PMC8652676 DOI: 10.1002/ehf2.13680] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 12/15/2022] Open
Abstract
Aims The coronavirus disease‐2019 (COVID‐19) pandemic has changed the landscape of medical care delivery worldwide. We aimed to assess the influence of COVID‐19 pandemic on hospital admissions and in‐hospital mortality rate in patients with acute heart failure (AHF) in a retrospective, multicentre study. Methods and results From 1 January 2019 to 31 December 2020, a total of 101 433 patients were hospitalized in 24 Cardiology Departments in Poland. The number of patients admitted due to AHF decreased by 23.4% from 9853 in 2019 to 7546 in 2020 (P < 0.001). We noted a significant reduction of self‐referrals in the times of COVID‐19 pandemic accounting 27.8% (P < 0.001), with increased number of AHF patients brought by an ambulance by 15.9% (P < 0.001). The length of hospital stay was overall similar (7.7 ± 2.8 vs. 8.2 ± 3.7 days; P = not significant). The in‐hospital all‐cause mortality in AHF patients was 444 (5.2%) in 2019 vs. 406 (6.5%) in 2020 (P < 0.001). A total number of AHF patients with concomitant COVID‐19 was 239 (3.2% of AHF patients hospitalized in 2020). The rate of in‐hospital deaths in AHF patients with COVID‐19 was extremely high accounting 31.4%, reaching up to 44.1% in the peak of the pandemic in November 2020. Conclusions Our study indicates that the COVID‐19 pandemic led to (i) reduced hospital admissions for AHF; (ii) decreased number of self‐referred AHF patients and increased number of AHF patients brought by an ambulance; and (iii) increased in‐hospital mortality for AHF with very high mortality rate for concomitant AHF and COVID‐19.
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Affiliation(s)
- Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Małgorzata Ostrowska
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Wioleta Stolarek
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Klaudyna Grzelakowska
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Jacek Kryś
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Aldona Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Piotr Adamski
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Przemysław Podhajski
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Eliano Pio Navarese
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Skłodowskiej-Curie Street, Bydgoszcz, 85-094, Poland
| | - Edyta Anielska-Michalak
- Department of Cardiology, Marian Zyndram-Kościałkowski Ministry of Interior and Administration Hospital, Białystok, Poland
| | - Oliwia Brycht
- II Department of Cardiology, Chair of Cardiology, Cardiac Surgery and Vascular Diseases, Medical University of Lodz, Lodz, Poland
| | - Andrzej Curzytek
- Department of Cardiology, Hospital of the Ministry of Interior and Administration, Rzeszów, Poland
| | - Aneta Dudek
- 1st Department of Cardiology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Paweł Grzelakowski
- Department of Cardiology and Cardiac Surgery, 10th Military Hospital and Polyclinic, Bydgoszcz, Poland
| | - Leszek Kamiński
- Department of Cardiology Independent Public Healthcare in Przeworsk, Przeworsk, Poland
| | - Andrzej Kleinrok
- Cardiology Department, Pope John Paul II District Hospital in Zamość, Zamosc, Poland
| | | | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Paweł Król
- Department of Cardiology, Tertiary Care Hospital, Ciechanów, Poland
| | - Tomasz Kulawik
- Department of Cardiology, Masovian Rehabilitation Center "STOCER", Dr. Włodzimierz Roefler Hospital, Pruszków, Poland
| | - Gleb Minczew
- Department of Cardiology, District Hospital, Tuchola, Poland
| | - Marcin Mindykowski
- Department of Cardiology, Dr. Emil Warmiński Tertiary Care Municipal Hospital, Bydgoszcz, Poland
| | - Agnieszka Pawlak
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.,Mossakowski Medical Research Centre Polish Academy of Science, Warsaw, Poland
| | - Janusz Prokopczuk
- Department of Cardiology, Polish Hospitals, Kędzierzyn-Koźle, Poland
| | - Grzegorz Skonieczny
- Department of Cardiology and Intensive Cardiac Care Unit, District Polyclinic Hospital, Toruń, Poland
| | - Bożena Sobkowicz
- Department of Cardiology, Medical University in Białystok, Białystok, Poland
| | - Sergiusz Sowiński
- Department of Cardiology and Cardiac Intensive Care, Tertiary Care Municipal Hospital, Toruń, Poland
| | - Sebastian Stankala
- Cardiology Subdivision of Heart Failure, St. Elizabeth Hospital, Biała, Poland
| | - Paweł Szymański
- Department of Cardiology, Interventional Cardiology and Electrophysiology with Cardiac Intensive Care Unit, Tertiary Care Hospital, Grudziądz, Poland
| | - Andrzej Wester
- 1st Department of Physiology, Institute of Medical Sciences, University of Opole, Cardiology Center of Kluczbork SCANMED SA, Opole, Poland
| | | | - Stanisław Bartuś
- 2nd Department of Cardiology, Collegium Medicum, Jagiellonian University, Cracow, Poland
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Jarosław Drożdż
- II Department of Cardiology, Chair of Cardiology, Cardiac Surgery and Vascular Diseases, Medical University of Lodz, Lodz, Poland
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Jankowski
- 1st Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantology, National Institute of Cardiology, Warsaw, Poland
| | | | - Jadwiga Nessler
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Agnieszka Tycińska
- Department of Cardiology, Medical University in Białystok, Białystok, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
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8
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Gaspardone A, Versaci F, Tomai F, Biondi-Zoccai G, Sgueglia GA, Gioffré G, Romagnoli E, Mancone M, Calcagno S, Proietti I, Sciahbasi A, DI Pietro R, Tanzilli G, Mariano E, Romeo F. Reduction in emergency access for acute myocardial infarction during the COVID-19 pandemic: a survey from the greater area of Rome, Italy. Minerva Cardiol Angiol 2021; 70:421-427. [PMID: 33823575 DOI: 10.23736/s2724-5683.21.05516-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND On March 9, 2020, the Italian government imposed a national lockdown to tackle the COronaVIrus Disease 19 (COVID-19) pandemic, including stay at home recommendations. The precise impact of COVID-19 scare and lockdown on emergency access for acute myocardial infarction (MI) is still subject to debate. METHODS Data on all patients undergoing invasive coronary angiography at 9 hospitals in the greater area of Rome, Italy, between February 19, 2020 and March 29, 2020, 9, 2020, were retrospectively collected. Incidence of ST-elevation MI (STEMI), and non-ST-elevation MI (NSTEMI), as well as corresponding percutaneous coronary intervention (PCI), was compared distinguishing two different 20-day time periods (before vs on or after March 10, 2020). RESULTS During the study period, 1,068 patients underwent coronary angiography, 142 (13%) with STEMI and 169 (16%) with NSTEMI. The average daily number of STEMI decreased from 4.3 before the lockdown to 2.9 after the lockdown (p=0.021). Similarly, the average daily number of NSTEMI changed from 5.0 to 3.5 (p=0.028). The average daily number of primary PCI changed from 4.2 to 2.9 (p=0.030), while the average daily number of PCI for NSTEMI changed from 3.5 to 2.5 (p=0.087). For STEMI patients, the time from symptom onset to hospital arrival (onset-to-door time less than three hours) showed a significant increase after the lockdown (p=0.018), whereas door-to-balloon time did not change significantly from before to after the lockdown (p=0.609). CONCLUSIONS The present study, originally reporting on the trends in STEMI and NSTEMI in the Rome area, highlights that significant decreases in the incidence of both acute coronary syndromes occurred between February 19, 2020 and March 29, 2020, together with increases in time from symptom onset to hospital arrival, luckily without changes in door-to-balloon time.
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Affiliation(s)
| | - Francesco Versaci
- Division of Cardiology, Ospedale Santa Maria Goretti, Latina, Italy -
| | | | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | | | | | - Enrico Romagnoli
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Simone Calcagno
- Division of Cardiology, Ospedale Santa Maria Goretti, Latina, Italy
| | - Igino Proietti
- Division of Cardiology, Ospedale M.G. Vannini, Rome, Italy
| | | | | | - Gaetano Tanzilli
- Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mariano
- Division of Cardiology, Department of Medical Sciences, Università Tor Vergata, Rome, Italy
| | - Francesco Romeo
- Division of Cardiology, Department of Medical Sciences, Università Tor Vergata, Rome, Italy
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9
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Pinna G, Sanfilippo L, Bassareo PP, Fanos V, Marcialis MA. COVID-19 and Comorbidities: Is Inflammation the Underlying Condition in Children? A Narrative Review. Curr Pediatr Rev 2021; 17:38-44. [PMID: 33183207 DOI: 10.2174/1573396316666201112093920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023]
Abstract
This paper examines the potential link between COVID-19 and the presence of comorbidities and assesses the role of inflammation in this correlation. In COVID-19 patients, the most frequently associated diseases share a pathogenic inflammatory basis and apparently act as a risk factor in the onset of a more severe form of the disease, particularly in adulthood. However, in children, the understanding of the underlying pathogenic mechanisms is often complicated by the milder symptoms presented. A series of theories have, therefore, been put forward with a view of providing a better understanding of the role played by inflammation in this dramatic setting. All evidence available to date on this topic is discussed in this review.
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Affiliation(s)
- Giulia Pinna
- Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
| | | | - Pier Paolo Bassareo
- University College of Dublin, Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
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10
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Calcaterra G, Mehta JL, Fanos V, Bassareo PP. Insights on Kawasaki disease and multisystem inflammatory syndrome: relationship with COVID-19 infection. Minerva Pediatr (Torino) 2020; 73:203-208. [PMID: 33305919 DOI: 10.23736/s2724-5276.20.06140-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Jawahar L Mehta
- Division of Cardiology, VA Medical Center, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, University Hospital of Cagliari, University of Cagliari, Monserrato, Cagliari, Italy
| | - Pier P Bassareo
- Mater Misericordiae University Hospital, University College of Dublin, Dublin, Ireland -
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11
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Colombi D, Villani GD, Maffi G, Risoli C, Bodini FC, Petrini M, Morelli N, Anselmi P, Milanese G, Silva M, Sverzellati N, Michieletti E. Qualitative and quantitative chest CT parameters as predictors of specific mortality in COVID-19 patients. Emerg Radiol 2020; 27:701-710. [PMID: 33119835 PMCID: PMC7594966 DOI: 10.1007/s10140-020-01867-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/23/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To test the association between death and both qualitative and quantitative CT parameters obtained visually and by software in coronavirus disease (COVID-19) early outbreak. METHODS The study analyzed retrospectively patients underwent chest CT at hospital admission for COVID-19 pneumonia suspicion, between February 21 and March 6, 2020. CT was performed in case of hypoxemia or moderate-to-severe dyspnea. CT scans were analyzed for quantitative and qualitative features obtained visually and by software. Cox proportional hazards regression analysis examined the association between variables and overall survival (OS). Three models were built for stratification of mortality risk: clinical, clinical/visual CT evaluation, and clinical/software-based CT assessment. AUC for each model was used to assess performance in predicting death. RESULTS The study included 248 patients (70% males, median age 68 years). Death occurred in 78/248 (32%) patients. Visual pneumonia extent > 40% (HR 2.15, 95% CI 1.2-3.85, P = 0.01), %high attenuation area - 700 HU > 35% (HR 2.17, 95% CI 1.2-3.94, P = 0.01), exudative consolidations (HR 2.85-2.93, 95% CI 1.61-5.05/1.66-5.16, P < 0.001), visual CAC score > 1 (HR 2.76-3.32, 95% CI 1.4-5.45/1.71-6.46, P < 0.01/P < 0.001), and CT classified as COVID-19 and other disease (HR 1.92-2.03, 95% CI 1.01-3.67/1.06-3.9, P = 0.04/P = 0.03) were significantly associated with shorter OS. Models including CT parameters (AUC 0.911-0.913, 95% CI 0.873-0.95/0.875-0.952) were better predictors of death as compared to clinical model (AUC 0.869, 95% CI 0.816-0.922; P = 0.04 for both models). CONCLUSIONS In COVID-19 patients, qualitative and quantitative chest CT parameters obtained visually or by software are predictors of mortality. Predictive models including CT metrics were better predictors of death in comparison to clinical model.
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Affiliation(s)
- Davide Colombi
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy.
| | - Gabriele D Villani
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Gabriele Maffi
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Camilla Risoli
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Flavio C Bodini
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Marcello Petrini
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Nicola Morelli
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Pietro Anselmi
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Gianluca Milanese
- Department of Medicine and Surgery (DiMeC), Unit "Scienze Radiologiche", University of Parma, Padiglione Barbieri, V. Gramsci 14, Parma, Italy
| | - Mario Silva
- Department of Medicine and Surgery (DiMeC), Unit "Scienze Radiologiche", University of Parma, Padiglione Barbieri, V. Gramsci 14, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery (DiMeC), Unit "Scienze Radiologiche", University of Parma, Padiglione Barbieri, V. Gramsci 14, Parma, Italy
| | - Emanuele Michieletti
- Department of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Via Taverna 49, 29121, Piacenza, Italy
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