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Hussain MS, Sharma G. The Burden of Cardiovascular Diseases Due to COVID-19 Pandemic. Thorac Cardiovasc Surg 2024; 72:40-50. [PMID: 35987194 DOI: 10.1055/s-0042-1755205] [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: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) is an infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that produces respiratory symptoms and has serious consequences for people's cardiovascular systems (CVS). It is a severe issue and a major task not only for health care experts but also for governments to contain this pandemic. SARS-CoV-2 is the seventh member of the human coronavirus family to be implicated in this zoonotic outbreak. COVID-19's CV interactions are comparable to those of SARS-CoV, Middle East respiratory syndrome (MERS-CoV), and influenza. Those who have COVID-19 and underlying cardiovascular diseases (CVDs) are at a higher risk of serious illness and mortality, and disease has been linked to several direct and indirect CV consequences. COVID-19 causes CVDs such as arrhythmias, cardiac arrest, cardiogenic shock, myocarditis, stress-cardiomyopathy, and acute myocardial damage (AMD) as a consequence of acute coronary syndrome. The provision of CV care may expose health care professionals to risk as they become hosts or vectors of viral transmission. It binds to the angiotensin-converting enzyme receptor, causing constitutional and pulmonary signs in the beginning, and then as the infection advances, it affects other organs such as the gastrointestinal tract, CVS, neurological system, and so on. COVID-19 mortality is increased by underlying CVDs comorbidities.
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Affiliation(s)
- Md Sadique Hussain
- Department of Pharmaceutical Sciences, Jaipur National University, Jagatpura, Jaipur, Rajasthan, India
| | - Ganesh Sharma
- Department of Pharmaceutical Sciences, Jaipur National University, Jagatpura, Jaipur, Rajasthan, India
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Fatuyi M, Amoah J, Egbuchiem H, Antia A, Akinti S, Mararenko A, Alzamara M, Bhatia A. Impact of COVID-19 Infection on Clinical Outcomes Among Patients With Acute Decompensated Heart Failure: A Nationwide Analysis. Curr Probl Cardiol 2023; 48:101908. [PMID: 37399856 DOI: 10.1016/j.cpcardiol.2023.101908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
Heart Failure (HF) is a common comorbidity in the United state. COVID-19 infection has shown worse clinical outcomes among heart failure patients; however, there is limited evidence on the impact of COVID-19 infection on the subset of HF. Hence, we aimed to investigate the clinical outcomes in patients hospitalized with COVID-19 infection without HF vs concomitant COVID-19 infection with Acute Decompensated Heart Failure with Preserved Ejection Fraction (AD-HFpEF) vs concomitant COVID-19 Infection with Acute Decompensated Heart Failure with Reduced Ejection Fraction (AD-HFrEF) using a large dataset illustrating a real word analysis. A retrospective study design of hospitalizations using the National Inpatient Sample (NIS) database registry 2020 with a principal diagnosis of adult patients (≥18 years) hospitalized with COVID-19 infection as principal diagnosis using ICD-10 codes stratified to COVID-19 infection without HF vs COVID-19 infection with AD-HFpEF vs COVID-19 infection with AD-HFrEF. The primary outcome was in-hospital mortality. Multivariate logistic, linear, poisson, and Cox regression models were used for analysis. A P-value < 0.05 was considered statistically significant. A total of 1,050,045 COVID-19 infection cases were included in this study, out of which 1,007,860 (98.98%) had only COVID-19 infection without HF, while 20,550 (1.96%) had COVID-19 infection with Acute Decompensated HFpEF, and 21,675 (2.06%) had COVID-19 infection with Acute Decompensated HFrEF. Our study shows that patients with COVID-19 infection and AD-HFrEF had the highest in-hospital mortality rate (25.4%). Using COVID-19 infection without HF with a mortality of 10.6% as a reference, COVID-19 infection with AD-HFpEF with a 22.5% mortality rate (95% CI 2.3-2.6, aOR; 2.4) and COVID-19 infection with AD-HFrEF with 25.4% mortality rate (95% CI 2.7-3.1, aOR; 2.9). Acute Decompensated HF with concurrent COVID-19 infection is associated with higher in-hospital mortality, with higher in-hospital mortality outcome observed among COVID 19 infection with concurrent AD-HFrEF.
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Affiliation(s)
- Michael Fatuyi
- Department of Medicine, TriHealth Good Samaritan Hospital Program, Cincinnati, OH.
| | - Joseph Amoah
- Department of Medicine, Case Western Reserve University Hospital, Cleveland, OH
| | - Henry Egbuchiem
- Department of Medicine, Case Western Reserve University Hospital, Cleveland, OH
| | - Akanimo Antia
- Department of Medicine, Lincoln Medical Center, Bronx, NY
| | - Segun Akinti
- Department of Medicine, Brookdale University Hospital, medical center, Queens, NY
| | - Anton Mararenko
- Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ
| | - Muayad Alzamara
- Department of Medicine, TriHealth Good Samaritan Hospital Program, Cincinnati, OH
| | - Ankit Bhatia
- Department of Cardiology, Heart and Vascular Institute, The Christ Hospital Health Network,Cincinnati, OH
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Beydoun HA, Ng TKS, Beydoun MA, Shadyab AH, Jung SY, Costanian C, Saquib N, Ikramuddin FS, Pan K, Zonderman AB, Manson JE. Biomarkers of glucose homeostasis as mediators of the relationship of body mass index and waist circumference with COVID-19 outcomes among postmenopausal women: The Women's Health Initiative. Clin Nutr 2023; 42:1690-1700. [PMID: 37523800 PMCID: PMC10529929 DOI: 10.1016/j.clnu.2023.07.004] [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: 09/13/2022] [Revised: 05/01/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND & AIMS Systematic reviews, meta-analyses and Mendelian randomization studies suggest that cardiometabolic diseases may be associated with COVID-19 risk and prognosis, with evidence implicating insulin resistance (IR) as a common biological mechanism. As driving factors for IR, we examined body mass index (BMI) and waist circumference (WC) among postmenopausal women in association with COVID-19 outcomes (positivity and hospitalization), and the role of glucose homeostasis as a mediator of this relationship. METHODS Associations of BMI and WC at baseline (1993-1998) with COVID-19 outcomes collected at Survey 1 (June-December, 2020) and/or Survey 2 (September-December, 2021) were evaluated among 42,770 Women's Health Initiative (WHI) participants (baseline age: 59.36 years) of whom 16,526 self-reported having taken ≥1 COVID-19 test, with 1242 reporting ≥1 positive COVID-19 test and 362 reporting ≥1 COVID-19 hospitalization. We applied logistic regression and causal mediation analyses to sub-samples with available fasting biomarkers of glucose homeostasis (glucose, insulin, Homeostatic Model Assessment for Insulin Resistance, Homeostasis Model Assessment for β-cell function, Quantitative Insulin-sensitivity Check Index, Triglyceride-Glucose index (TyG)) at baseline, whereby 57 of 759 reported COVID-19 test positivity and 23 of 1896 reported COVID-19 hospitalization. RESULTS In fully adjusted models, higher BMI, WC and TyG were associated with COVID-19 test positivity and hospitalization. Glucose concentrations mediated associations of BMI and WC with COVID-19 positivity, whereas TyG mediated BMI and WC's associations with COVID-19 hospitalization. CONCLUSIONS Obesity and central obesity markers collected an average of 24 years prior were associated with COVID-19 outcomes among postmenopausal women. Glucose concentration and TyG partly mediated these associations.
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Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
| | - Ted K S Ng
- Department of Internal Medicine & Rush Institute of Healthy Aging, Rush University Medical Center, Chicago, IL, USA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Christy Costanian
- Center for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, ON, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia
| | - Farha S Ikramuddin
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Kathy Pan
- School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Hong K, Kisiju T, Kim J, Chun BC. Cardio-cerebrovascular complications in COVID-19 patients: A retrospective cohort study. Front Med (Lausanne) 2022; 9:1045274. [PMID: 36619633 PMCID: PMC9813409 DOI: 10.3389/fmed.2022.1045274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Background Recent studies have highlighted the cardio-cerebrovascular manifestations of coronavirus disease 2019 (COVID-19). Objective This study aimed to analyze the likelihood of cardiovascular and cerebrovascular manifestations among patients with COVID-19-positive individuals in South Korea. Methods A cohort database for COVID-19 from the National Health Insurance Service was used which included patients diagnosed with COVID-19 between January 1 and June 4, 2020. Individuals who tested COVID-19 positive, notwithstanding the severity of the disease, were designated as cases. COVID-19- negative individuals were used as controls for the study. The exclusion criteria included people who had a history of cardiovascular and cerebrovascular diseases between 2015 and 2019. A new diagnosis of cardiovascular and cerebrovascular complications was considered the primary endpoint. The adjusted incidence rate ratio (IRR) of development of complications was estimated using log-link Poisson regression. The model was adjusted at two levels, the first one included age and sex while the second included age, sex, residence area, and level of income. The hazard ratio (HR) was estimated using Cox-proportional hazard regression analysis while adjusting for all demographic variables and covariates. Results Significant results were obtained for acute conditions, such as ischemic heart disease and cerebral hemorrhage. The IRR of COVID-19- positive individuals compared with that of controls for the diagnosis of ischemic heart disease was 1.78 (1.57-2.02; 95% confidence interval [CI]) when adjusted for age and sex. HR was calculated as 3.02 (2.19-4.17; 95% CI) after adjusting for the covariates. In case of cerebral hemorrhage, the adjusted IRR was 2.06 (1.25-3.40; 95% CI) and the adjusted HR was 4.08 (0.90-19.19; 95% CI). Conclusion The findings of our study suggest that COVID-19 infection can be a significant risk factor for acute cardiovascular complications, such as ischemic heart disease and acute cerebrovascular complications, such as cerebral infarction, after properly adjusting for covariates.
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Affiliation(s)
- Kwan Hong
- Department of Public Health, Korea University Graduate School, Seoul, Republic of Korea,Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Trishna Kisiju
- Department of Public Health, Korea University Graduate School, Seoul, Republic of Korea,Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeehyun Kim
- Department of Public Health, Korea University Graduate School, Seoul, Republic of Korea,Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea,Department of Healthcare Sciences, Graduate School, Transdisciplinary Major in Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Byung Chul Chun
- Department of Public Health, Korea University Graduate School, Seoul, Republic of Korea,Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea,Department of Healthcare Sciences, Graduate School, Transdisciplinary Major in Learning Health Systems, Korea University, Seoul, Republic of Korea,*Correspondence: Byung Chul Chun,
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Umesh M, Singaravelu V, Daulatabad V, Kamble P, Singhal A, John NA, John J. An overview of prognostic value of neurologic and cardiac biomarkers in patients with COVID-19 sequelae. Horm Mol Biol Clin Investig 2022; 43:475-484. [PMID: 35728088 DOI: 10.1515/hmbci-2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/08/2022] [Indexed: 01/08/2023]
Abstract
Many studies conducted after the pandemic period revealed that, while COVID-19 primarily injured the lungs, it also affects other organs in the form of cardiovascular complications, metabolic derangements, renal damage, and so on. Although we know that inflammatory cascades, complement activation, and pro-inflammatory cytokines are all involved in vasculitic processes that cause organ damage, we do not know the exact mechanism of complications such as acute respiratory distress syndrome (ARDS), cardiovascular ischemia, deep vein thrombosis, pulmonary thromboembolism, and brain injuries (embolism) that are frequently observed in COVID 19. The currently available biomarkers do not predict the severity of the aforementioned complications. As a result, more specific biomarkers such as serum calcium binding protein (S100B), glial fibrillary acid protein (GFAP), myelin basic protein (MBP), neuron-specific enolase (NSE), hs-TNI, (highly sensitive cardiac troponin) - HBDH, (Hydroxybutyrate Dehydrogenase), CK-MB (creatine kinase myocardial band), ST2 (suppression of tumorigenicity 2) are in need for early detection & improved clinical outcome.
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Affiliation(s)
- Madhusudhan Umesh
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Vidya Singaravelu
- Department of Pediatrics, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Prafull Kamble
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Anish Singhal
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Nitin Ashok John
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Jyoti John
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
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Akinrinmade AO, Obitulata-Ugwu VO, Obijiofor NB, Victor F, Chive M, Marwizi FM, Odion-Omonhimin LO, Obasi NB. COVID-19 and Acute Coronary Syndrome: A Literature Review. Cureus 2022; 14:e29747. [PMID: 36324350 PMCID: PMC9617587 DOI: 10.7759/cureus.29747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019, also known as the COVID-19 pandemic has had a deleterious impact on daily living, with health and socioeconomic effects of a global magnitude. Acute coronary syndrome (ACS), an important cardiovascular disease with significant morbidity and mortality rates, has been frequently reported in patients with this novel virus. This review aims to discuss the potential associations between COVID-19 and ACS with the use of multiple databases, including but not limited to; PubMed, ScienceDirect, World Health Organization, and American Heart Association. We have explored the pathophysiology of ACS, focusing on COVID-19 in particular with the use of various works of literature that highlights the pattern of viral entry and replication via the angiotensin-converting enzyme II. The review has also discussed the impact of the pandemic on hospital admissions, diagnosis, and management of ACS patients, as well as briefly highlighted a possible link between the widely available COVID-19 vaccines and possible cardiovascular complications. The association between COVID-19 and ACS needs more in-depth studies to help establish whether there exists a direct causal and or inciting correlation between them. Understanding this association might lead to new research and treatment options for ACS patients.
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Lemos MM, Cavalini GR, Pugliese Henrique CR, Perli VAS, de Moraes Marchiori G, Marchiori LLDM, Sordi AF, Franzói de Moraes SM, de Paula Ramos S, Valdés-Badilla P, Mota J, Magnani Branco BH. Body composition and cardiorespiratory fitness in overweight or obese people post COVID-19: A comparative study. Front Physiol 2022; 13:949351. [PMID: 36213222 PMCID: PMC9532828 DOI: 10.3389/fphys.2022.949351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
The present study aimed to evaluate the body composition and cardiorespiratory fitness of overweight or obese people after COVID-19. 171 volunteers of both sexes (men, n = 93 and women, n = 78) between 19 and 65 years old were allocated into three groups according to the severity of their symptoms of COVID-19: non-hospitalized people/mild symptoms (n = 61), hospitalized (n = 58), and hospitalized in an intensive care unit-ICU (n = 52). Two laboratory visits were carried out 24 h apart. First, a medical consultation was carried out, with subsequent measurement of body weight and height (calculation of body mass index) and body composition assessment via electrical bioimpedance. After 24 h, a cardiorespiratory test was performed using the Bruce protocol, with a direct gas exchange analysis. Hospitalized individuals had significantly higher values for fat mass and body fat percentage than non-hospitalized individuals (p < 0.05). Significantly higher values were found for heart rate (HR) and peak oxygen consumption (VO2peak) for individuals who were not hospitalized when compared to those hospitalized in the ICU (p < 0.05). Significantly higher values for distance, ventilation, and the relationship between respiratory quotient were found for non-hospitalized individuals compared to hospitalized individuals and those in the ICU (p < 0.05). After the cardiorespiratory test, higher values for peripheral oxygen saturation (SpO2) were observed for non-hospitalized individuals than for all hospitalized individuals (p < 0.05). Diastolic blood pressure was significantly higher at the tenth and fifteenth minute post-Bruce test in hospitalized than in non-hospitalized participants (p < 0.05). Based on these results, proposals for cardiopulmonary rehabilitation are indispensable for hospitalized groups considering the responses of blood pressure. Monitoring HR, SpO2, and blood pressure are necessary during rehabilitation to avoid possible physical complications. Volume and intensity of exercise prescription should respect the physiologic adaptation. Given lower physical conditioning among all the groups, proposals for recovering from health conditions are urgent and indispensable for COVID-19 survivors.
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Affiliation(s)
- Maurício Medeiros Lemos
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Postgraduate Program in Health Promotion, Cesumar University, Paraná, Brazil
| | - Gustavo Rocha Cavalini
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
| | - Carlos Renato Pugliese Henrique
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
| | - Victor Augusto Santos Perli
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
| | | | | | - Ana Flávia Sordi
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
| | | | | | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, Chile
| | - Jorge Mota
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sports; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Postgraduate Program in Health Promotion, Cesumar University, Paraná, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sports; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Physiology and Nutrition Department, Clinisport Prime, Maringa, Brazil
- *Correspondence: Braulio Henrique Magnani Branco,
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Predictors of Long COVID in Patients without Comorbidities: Data from the Polish Long-COVID Cardiovascular (PoLoCOV-CVD) Study. J Clin Med 2022; 11:jcm11174980. [PMID: 36078910 PMCID: PMC9456773 DOI: 10.3390/jcm11174980] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background: The SARS-CoV-2 pandemic has become an enormous worldwide challenge over the last two years. However, little is still known about the risk of Long COVID (LC) in patients without comorbidities. Thus, we aimed to assess the predictors of LC in patients without comorbidities. Methods: Patients’ information, the course of the disease with symptoms, and post-COVID-19 complaints were collected within 4−12 weeks after COVID-19 recovery. Next, the patients were followed for at least 3 months. ECG, 24-h ECG monitoring, 24-h blood pressure (BP) monitoring, echocardiography, and selected biochemical tests were performed. LC was recognized based on the WHO definition. Results: We identified 701 consecutive patients, 488 of whom completed a 3-month follow-up (63% women). Comparisons were made between the LC group (n = 218) and patients without any symptoms after SARS-CoV-2 recovery (non-LC group) (n = 270). Patients with a severe course of acute-phase COVID-19 developed LC complications more often (34% vs. 19%, p < 0.0001). The persistent symptoms were observed in 45% of LC patients. The LC group also had significantly more symptoms during the acute phase of COVID-19, and they suffered significantly more often from dyspnoea (48 vs. 33%), fatigue (72 vs. 63%), chest pain (50 vs. 36%), leg muscle pain (41 vs. 32%), headache (66 vs. 52%), arthralgia (44 vs. 25%), and chills (34 vs. 25%). In LC patients, significant differences regarding sex and body mass index were observed—woman: 69% vs. 56% (p = 0.003), and BMI: 28 [24−31] vs. 26 kg/m2 [23−30] (p < 0.001), respectively. The number of symptoms in the acute phase was significantly greater in the LC group than in the control group (5 [2−8] vs. 2 [1−5], p = 0.0001). The LC group also had a higher 24-h heart rate (77 [72−83] vs. 75 [70−81], p = 0.021) at admission to the outpatient clinic. Multivariate regression analysis showed that LC patients had a higher BMI (odds ratio (OR): 1.06, 95% confidence intervals [CI]: 1.02−1.10, p = 0.007), almost twice as often had a severe course of COVID-19 (OR: 1.74, CI: 1.07−2.81, p = 0.025), and presented with joint pain in the acute phase (OR: 1.90, CI: 1.23−2.95, p = 0.004). Conclusions: A severe course of COVID-19, BMI, and arthralgia are independently associated with the risk of Long COVID in healthy individuals.
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Norris T, Razieh C, Zaccardi F, Yates T, Islam N, Gillies CL, Chudasama YV, Rowlands AV, Davies MJ, McCann GP, Banerjee A, Lam CSP, Docherty AB, Openshaw PJ, Baillie JK, Semple MG, Lawson CA, Khunti K. Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19. Heart 2022; 108:1200-1208. [PMID: 34911741 PMCID: PMC8678560 DOI: 10.1136/heartjnl-2021-320047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death. METHODS A multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death. RESULTS Of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication. CONCLUSIONS In hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity.
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Affiliation(s)
- Tom Norris
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
| | - Cameron Razieh
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Francesco Zaccardi
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Nazrul Islam
- Big Data Institute, University of Oxford, Oxford, Oxfordshire, UK
| | - Clare L Gillies
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Yogini V Chudasama
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Amitava Banerjee
- Farr Institute of Health Informatics Research, University College London, London, UK
| | - Carolyn S P Lam
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Annemarie B Docherty
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Edinburgh, UK
| | | | - J Kenneth Baillie
- The Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | | | - Claire Alexandra Lawson
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
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Dmytriw AA, Ghozy S, Sweid A, Piotin M, Bekelis K, Sourour N, Raz E, Vela-Duarte D, Linfante I, Dabus G, Kole M, Martínez-Galdámez M, Nimjee SM, Lopes DK, Hassan AE, Kan P, Ghorbani M, Levitt MR, Escalard S, Missios S, Shapiro M, Clarençon F, Elhorany M, Tahir RA, Youssef PP, Pandey AS, Starke RM, El Naamani K, Abbas R, Mansour OY, Galvan J, Billingsley JT, Mortazavi A, Walker M, Dibas M, Settecase F, Heran MKS, Kuhn AL, Puri AS, Menon BK, Sivakumar S, Mowla A, D'Amato S, Zha AM, Cooke D, Vranic JE, Regenhardt RW, Rabinov JD, Stapleton CJ, Goyal M, Wu H, Cohen J, Turkel-Parella D, Xavier A, Waqas M, Tutino V, Siddiqui A, Gupta G, Nanda A, Khandelwal P, Tiu C, Portela PC, Perez de la Ossa N, Urra X, de Lera M, Arenillas JF, Ribo M, Requena M, Piano M, Pero G, De Sousa K, Al-Mufti F, Hashim Z, Nayak S, Renieri L, Du R, Aziz-Sultan MA, Liebeskind D, Nogueira RG, Abdalkader M, Nguyen TN, Vigilante N, Siegler JE, Grossberg JA, Saad H, Gooch MR, Herial NA, Rosenwasser RH, Tjoumakaris S, Patel AB, Tiwari A, Jabbour P. International Controlled Study of Revascularization and Outcomes Following COVID-Positive Mechanical Thrombectomy. Eur J Neurol 2022; 29:3273-3287. [PMID: 35818781 PMCID: PMC9349405 DOI: 10.1111/ene.15493] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022]
Abstract
Background and purpose Previous studies suggest that mechanisms and outcomes in patients with COVID‐19‐associated stroke differ from those in patients with non‐COVID‐19‐associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID‐19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors. Methods A cross‐sectional, international multicenter retrospective study was conducted in consecutively admitted COVID‐19 patients with concomitant acute LVO, compared to a control group without COVID‐19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable‐adjusted analysis was conducted. Results In this cohort of 697 patients with acute LVO, 302 had COVID‐19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID‐19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID‐19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23–0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12–0.77; p = 0.012). Moreover, endovascular complications, in‐hospital mortality, and length of hospital stay were significantly higher among COVID‐19 patients (p < 0.001). Conclusion COVID‐19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID‐19 patients with LVO were more often younger and had higher morbidity/mortality rates.
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Affiliation(s)
- Adam A Dmytriw
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA.,Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sherief Ghozy
- Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ahmad Sweid
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Michel Piotin
- Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Kimon Bekelis
- Department of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, New York, USA
| | - Nader Sourour
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Eytan Raz
- Department of Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Daniel Vela-Duarte
- Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Florida, USA
| | - Italo Linfante
- Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Florida, USA
| | - Guilherme Dabus
- Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Florida, USA
| | - Max Kole
- Department of Neurosurgery, Henry Ford Hospital, Michigan, USA
| | - Mario Martínez-Galdámez
- Department of Interventional Neuroradiology, Hospital Clinico Universitario de Valladolid, Spain
| | - Shahid M Nimjee
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Demetrius K Lopes
- Department of Neurosurgery, Advocate Aurora Health, Chicago, Illinois, USA
| | - Ameer E Hassan
- Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Peter Kan
- Department of Neurosurgery, UTMB, Houston, Texas, USA
| | | | - Michael R Levitt
- Departments of Neurological Surgery, Radiology, Mechanical Engineering, and Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA
| | - Simon Escalard
- Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Symeon Missios
- Department of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, New York, USA
| | - Maksim Shapiro
- Department of Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Fréderic Clarençon
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Mahmoud Elhorany
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Rizwan A Tahir
- Department of Neurosurgery, Henry Ford Hospital, Michigan, USA
| | - Patrick P Youssef
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Aditya S Pandey
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert M Starke
- Department of Neurosurgery & Neuroradiology, University of Miami & Jackson Memorial Hospital, Miami, Florida, USA
| | - Kareem El Naamani
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Rawad Abbas
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | | | - Jorge Galvan
- Department of Interventional Neuroradiology, Hospital Clinico Universitario de Valladolid, Spain
| | | | - Abolghasem Mortazavi
- Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Melanie Walker
- Departments of Neurological Surgery, Radiology, Mechanical Engineering, and Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA
| | - Mahmoud Dibas
- Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Fabio Settecase
- Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Manraj K S Heran
- Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna L Kuhn
- Division of Neurointerventional Radiology, Department of Radiology, UMass Memorial Medical Center, Worcester, Massachusetts, USA
| | - Ajit S Puri
- Division of Neurointerventional Radiology, Department of Radiology, UMass Memorial Medical Center, Worcester, Massachusetts, USA
| | - Bijoy K Menon
- Calgary Stroke Program, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Sanjeev Sivakumar
- Department of Medicine (Neurology), Prisma Health Upstate, USC, Greenville, South Carolina, USA
| | - Ashkan Mowla
- Department of Neurological Surgery, University of Southern California, Los Angeles, California, USA
| | - Salvatore D'Amato
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA
| | - Alicia M Zha
- Department of Neurology, UT Health Science Center, Houston, Texas, USA
| | - Daniel Cooke
- Department of Neurointerventional Radiology, San Francisco General Hospital, San Francisco, California, USA
| | - Justin E Vranic
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA
| | - Robert W Regenhardt
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA
| | - James D Rabinov
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA
| | - Christopher J Stapleton
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA
| | - Mayank Goyal
- Calgary Stroke Program, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Hannah Wu
- Department of Neurology, Brookdale University Hospital, Brooklyn, New York, USA.,Department of Neurology, Jamaica Medical Center, Richmond Hill, New York, USA.,Department of Neurology, NYU Lutheran Hospital, Brooklyn, New York, USA
| | - Jake Cohen
- Department of Neurology, Brookdale University Hospital, Brooklyn, New York, USA.,Department of Neurology, Jamaica Medical Center, Richmond Hill, New York, USA.,Department of Neurology, NYU Lutheran Hospital, Brooklyn, New York, USA
| | - David Turkel-Parella
- Department of Neurology, Brookdale University Hospital, Brooklyn, New York, USA.,Department of Neurology, Jamaica Medical Center, Richmond Hill, New York, USA.,Department of Neurology, NYU Lutheran Hospital, Brooklyn, New York, USA
| | - Andrew Xavier
- Department of Neurology, Sinai Grace Hospital, Detroit, Michigan, USA.,Department of Neurology, St. Joseph Mercy Health, Ann Arbor, Michigan, USA
| | - Muhammad Waqas
- Department of Neurosurgery, University of New York at Buffalo, Buffalo, New York, USA
| | - Vincent Tutino
- Department of Neurosurgery, University of New York at Buffalo, Buffalo, New York, USA
| | - Adnan Siddiqui
- Department of Neurosurgery, University of New York at Buffalo, Buffalo, New York, USA
| | - Gaurav Gupta
- Department of Neurology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | - Anil Nanda
- Department of Neurology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | - Priyank Khandelwal
- Department of Neurology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
| | - Cristina Tiu
- Department of Neurology, University Emergency Hospital Bucharest, Bucharest, Romania; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Pere C Portela
- Department of Neurology, Hospital Universitari, Bellvitge, Barcelona, Spain
| | - Natalia Perez de la Ossa
- Stroke Unit, Neuroscience Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Xabier Urra
- Department of Neurology, Hospital Clínic, Barcelona, Spain
| | - Mercedes de Lera
- Department of Neurology, Hospital Clínico Universitario, Valladolid, Spain
| | - Juan F Arenillas
- Department of Neurology, Hospital Clínico Universitario, Valladolid, Spain
| | - Marc Ribo
- Stroke Unit, Department of Neurology, Vall d'Hebron Research Institute, Barcelona, Spain; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Manuel Requena
- Stroke Unit, Department of Neurology, Vall d'Hebron Research Institute, Barcelona, Spain; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Mariangela Piano
- Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Guglielmo Pero
- Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Keith De Sousa
- Department of Neurology, Eastern Region, Northwell Health, Long Island, New York, New York, USA
| | - Fawaz Al-Mufti
- Department of Neurology, Radiology, and Neurosurgery, Westchester Medical Center at NY Medical College, Valhalla, New York, USA
| | - Zafar Hashim
- Department of Radiology, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom
| | - Sanjeev Nayak
- Department of Radiology, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom
| | - Leonardo Renieri
- Department of Radiology, Neurovascular Unit, Careggi University Hospital, Florence, Italy
| | - Rose Du
- Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mohamed A Aziz-Sultan
- Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David Liebeskind
- Department of Neurology, Ronald Reagan UCLA Medical Center, Los Angeles, USA
| | - Raul G Nogueira
- Department of Neurology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Mohamad Abdalkader
- Departments of Neurology and Radiology, Boston Medical Center, Boston University School of Medicine, Massachusetts, USA
| | - Thanh N Nguyen
- Departments of Neurology and Radiology, Boston Medical Center, Boston University School of Medicine, Massachusetts, USA
| | - Nicholas Vigilante
- Cooper Neurological Institute, Cooper University Hospital, Camden, New Jersey, USA
| | - James E Siegler
- Cooper Neurological Institute, Cooper University Hospital, Camden, New Jersey, USA
| | | | - Hassan Saad
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Michael R Gooch
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Nabeel A Herial
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Robert H Rosenwasser
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Stavropoula Tjoumakaris
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Aman B Patel
- Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, MA, USA
| | - Ambooj Tiwari
- Department of Neurology, Brookdale University Hospital, Brooklyn, New York, USA.,Department of Neurology, Jamaica Medical Center, Richmond Hill, New York, USA.,Department of Neurology, NYU Lutheran Hospital, Brooklyn, New York, USA
| | - Pascal Jabbour
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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11
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Norris T, Razieh C, Yates T, Zaccardi F, Gillies CL, Chudasama YV, Rowlands A, Davies MJ, McCann GP, Banerjee A, Docherty AB, Openshaw PJ, Baillie JK, Semple MG, Lawson CA, Khunti K. Admission Blood Glucose Level and Its Association With Cardiovascular and Renal Complications in Patients Hospitalized With COVID-19. Diabetes Care 2022; 45:1132-1140. [PMID: 35275994 PMCID: PMC9174963 DOI: 10.2337/dc21-1709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/30/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association between admission blood glucose levels and risk of in-hospital cardiovascular and renal complications. RESEARCH DESIGN AND METHODS In this multicenter prospective study of 36,269 adults hospitalized with COVID-19 between 6 February 2020 and 16 March 2021 (N = 143,266), logistic regression models were used to explore associations between admission glucose level (mmol/L and mg/dL) and odds of in-hospital complications, including heart failure, arrhythmia, cardiac ischemia, cardiac arrest, coagulation complications, stroke, and renal injury. Nonlinearity was investigated using restricted cubic splines. Interaction models explored whether associations between glucose levels and complications were modified by clinically relevant factors. RESULTS Cardiovascular and renal complications occurred in 10,421 (28.7%) patients; median admission glucose level was 6.7 mmol/L (interquartile range 5.8-8.7) (120.6 mg/dL [104.4-156.6]). While accounting for confounders, for all complications except cardiac ischemia and stroke, there was a nonlinear association between glucose and cardiovascular and renal complications. For example, odds of heart failure, arrhythmia, coagulation complications, and renal injury decreased to a nadir at 6.4 mmol/L (115 mg/dL), 4.9 mmol/L (88.2 mg/dL), 4.7 mmol/L (84.6 mg/dL), and 5.8 mmol/L (104.4 mg/dL), respectively, and increased thereafter until 26.0 mmol/L (468 mg/dL), 50.0 mmol/L (900 mg/dL), 8.5 mmol/L (153 mg/dL), and 32.4 mmol/L (583.2 mg/dL). Compared with 5 mmol/L (90 mg/dL), odds ratios at these glucose levels were 1.28 (95% CI 0.96, 1.69) for heart failure, 2.23 (1.03, 4.81) for arrhythmia, 1.59 (1.36, 1.86) for coagulation complications, and 2.42 (2.01, 2.92) for renal injury. For most complications, a modifying effect of age was observed, with higher odds of complications at higher glucose levels for patients age <69 years. Preexisting diabetes status had a similar modifying effect on odds of complications, but evidence was strongest for renal injury, cardiac ischemia, and any cardiovascular/renal complication. CONCLUSIONS Increased odds of cardiovascular or renal complications were observed for admission glucose levels indicative of both hypo- and hyperglycemia. Admission glucose could be used as a marker for risk stratification of high-risk patients. Further research should evaluate interventions to optimize admission glucose on improving COVID-19 outcomes.
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Affiliation(s)
- Tom Norris
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Cameron Razieh
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
| | - Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Clare L. Gillies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Yogini V. Chudasama
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Alex Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
| | - Melanie J. Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
| | - Gerry P. McCann
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
- Cardiovascular Sciences Department, University of Leicester, Leicester, U.K
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, U.K
| | - Annemarie B. Docherty
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, U.K
- Intensive Care Unit, Royal Infirmary Edinburgh, Edinburgh, U.K
| | | | | | - Malcolm G. Semple
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, U.K
- Respiratory Medicine, Alder Hey Children’s Hospital, Liverpool, U.K
| | - Claire A. Lawson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research Applied Research Collaboration–East Midlands, Leicester General Hospital, Leicester, U.K
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12
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Guerrero Orriach JL, Quesada Muñoz G. Clevidipine and COVID 19: From Hypertension to Inflammatory Response. J Inflamm Res 2022; 15:2383-2386. [PMID: 35444451 PMCID: PMC9013712 DOI: 10.2147/jir.s350822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
Globally, more than 4 million have died from COVID-19, World Health Organization (WHO) to declare COVID-19 a pandemic. The COVID 19 pathology, produced by SARS-COV2, a virus from the coronavirus family, emerged at the end of 2019. The majority of cases usually have a mild or moderate form, characterized by fever, cough, intense asthenia and multiple symptoms derived from the initial replicative effect and subsequent hyperimmune effect. Severe cases present with Acute Respiratory Distress Syndrome (ARDS), due to pneumonia with bilateral involvement, which lead to hospital admission of patients and the need for admission to intensive care units (ICU) of approximately 10‒20%. According to the different series; the mortality of the condition once the patient is admitted to the ICU is close to 35‒45%. Currently, more than 4 million people have died in the world due to this pathology. The volume of infections generated the declaration by the World Health Organization (WHO) of the pandemic situation. Factors associated with a higher risk of progression into severe disease include age and comorbidities, especially systemic arterial hypertension due to its high incidence in the general population. Clevidipine can be rapidly and effectively adjusted to the clinical status of the patient, since it can be withdrawn and its effects reversed in just a few minutes, and contains high concentrations of lipids, and it could reduce the inflammatory response induced by SARS-COV2, which is key to progression into severe disease. However, its application in pro-inflammatory settings has not yet been explored, although it must play a key role in inflammation as a scavenger molecule.
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Affiliation(s)
- Jose Luis Guerrero Orriach
- Institute of Biomedical Research in Malaga, Malaga, Spain
- Department of Anesthesiology, Virgen de la Victoria University Hospital, Malaga, Spain
- Department of Pharmacology and Pediatrics, School of Medicine, University of Malaga, Malaga, Spain
- Correspondence: Jose Luis Guerrero Orriach, Institute of Biomedical Research in Malaga, Malaga, Spain, Email
| | - Guillermo Quesada Muñoz
- Institute of Biomedical Research in Malaga, Malaga, Spain
- Department of Anesthesiology, Virgen de la Victoria University Hospital, Malaga, Spain
- Department of Pharmacology and Pediatrics, School of Medicine, University of Malaga, Malaga, Spain
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13
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Bianconi V, Mannarino MR, Figorilli F, Cosentini E, Batori G, Marini E, Banach M, Sahebkar A, Pirro M. The detrimental impact of elevated Ferritin to Iron ratio on in-hospital prognosis of patients with COVID-19. Expert Rev Mol Diagn 2022; 22:469-478. [PMID: 35260036 PMCID: PMC8935458 DOI: 10.1080/14737159.2022.2052047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 03/08/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Acute viral infections, including coronavirus disease 2019 (COVID-19), are characterized by the dysregulation of iron metabolism, resulting in high serum ferritin and low iron levels. RESEARCH DESIGN AND METHODS This study aimed to evaluate the prospective impact of iron metabolism dysregulation, as expressed by serum Ferritin-to-Iron Ratio (FIR), on the in-hospital prognosis of patients with COVID-19. Serum levels of ferritin and iron, as well as other iron metabolism markers and recognized prognostic indicators of COVID-19 severity, were measured in 362 patients consecutively hospitalized for COVID-19. The prospective relationship between FIR and the risk of the composite outcome of intensive care unit (ICU) admission/in-hospital death was analyzed. RESULTS In the population examined (mean age 74 ± 15 years, males 55%), the rates of radiographic signs of pneumonia, respiratory distress, and the need for noninvasive ventilation were higher in patients with high FIR (≥29.2, the 75th percentile) than in those with low FIR (<29.2, the 75th percentile) (p < 0.05 for all comparisons). High FIR was associated with a 1.7-fold (HR 1.709, 95% CI 1.017-2.871, p = 0.043) higher risk of ICU admission/in-hospital death. CONCLUSIONS Increasing FIR values significantly and independently predicts worse in-hospital prognosis in hospitalized patients with COVID-19.
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Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Massimo R. Mannarino
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Filippo Figorilli
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Cosentini
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giuseppe Batori
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ettore Marini
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Maciej Banach
- Department of Hypertension, Wam University Hospital, Medical University of Lodz, Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mothers Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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14
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Gupta A, Marzook H, Ahmad F. Comorbidities and clinical complications associated with SARS-CoV-2 infection: an overview. Clin Exp Med 2022; 23:313-331. [PMID: 35362771 PMCID: PMC8972750 DOI: 10.1007/s10238-022-00821-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes major challenges to the healthcare system. SARS-CoV-2 infection leads to millions of deaths worldwide and the mortality rate is found to be greatly associated with pre-existing clinical conditions. The existing dataset strongly suggests that cardiometabolic diseases including hypertension, coronary artery disease, diabetes and obesity serve as strong comorbidities in coronavirus disease (COVID-19). Studies have also shown the poor outcome of COVID-19 in patients associated with angiotensin-converting enzyme-2 polymorphism, cancer chemotherapy, chronic kidney disease, thyroid disorder, or coagulation dysfunction. A severe complication of COVID-19 is mostly seen in people with compromised medical history. SARS-CoV-2 appears to attack the respiratory system causing pneumonia, acute respiratory distress syndrome, which lead to induction of severe systemic inflammation, multi-organ dysfunction, and death mostly in the patients who are associated with pre-existing comorbidity factors. In this article, we highlighted the key comorbidities and a variety of clinical complications associated with COVID-19 for a better understanding of the etiopathogenesis of COVID-19.
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Affiliation(s)
- Anamika Gupta
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Hezlin Marzook
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Firdos Ahmad
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE. .,Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, UAE.
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15
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Babajani A, Moeinabadi-Bidgoli K, Niknejad F, Rismanchi H, Shafiee S, Shariatzadeh S, Jamshidi E, Farjoo MH, Niknejad H. Human placenta-derived amniotic epithelial cells as a new therapeutic hope for COVID-19-associated acute respiratory distress syndrome (ARDS) and systemic inflammation. Stem Cell Res Ther 2022; 13:126. [PMID: 35337387 PMCID: PMC8949831 DOI: 10.1186/s13287-022-02794-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/25/2022] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has become in the spotlight regarding the serious early and late complications, including acute respiratory distress syndrome (ARDS), systemic inflammation, multi-organ failure and death. Although many preventive and therapeutic approaches have been suggested for ameliorating complications of COVID-19, emerging new resistant viral variants has called the efficacy of current therapeutic approaches into question. Besides, recent reports on the late and chronic complications of COVID-19, including organ fibrosis, emphasize a need for a multi-aspect therapeutic method that could control various COVID-19 consequences. Human amniotic epithelial cells (hAECs), a group of placenta-derived amniotic membrane resident stem cells, possess considerable therapeutic features that bring them up as a proposed therapeutic option for COVID-19. These cells display immunomodulatory effects in different organs that could reduce the adverse consequences of immune system hyper-reaction against SARS-CoV-2. Besides, hAECs would participate in alveolar fluid clearance, renin–angiotensin–aldosterone system regulation, and regeneration of damaged organs. hAECs could also prevent thrombotic events, which is a serious complication of COVID-19. This review focuses on the proposed early and late therapeutic mechanisms of hAECs and their exosomes to the injured organs. It also discusses the possible application of preconditioned and genetically modified hAECs as well as their promising role as a drug delivery system in COVID-19. Moreover, the recent advances in the pre-clinical and clinical application of hAECs and their exosomes as an optimistic therapeutic hope in COVID-19 have been reviewed.
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Affiliation(s)
- Amirhesam Babajani
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kasra Moeinabadi-Bidgoli
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Rismanchi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepehr Shafiee
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siavash Shariatzadeh
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Jamshidi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Farjoo
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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16
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Beydoun HA, Beydoun MA, Weiss J, Gautam RS, Hossain S, Alemu BT, Zonderman AB. Predictors of Covid-19 level of concern among older adults from the health and retirement study. Sci Rep 2022; 12:4396. [PMID: 35292672 PMCID: PMC8921703 DOI: 10.1038/s41598-022-08332-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/07/2022] [Indexed: 11/28/2022] Open
Abstract
The purpose of this longitudinal study is to construct a prediction model for Covid-19 level of concern using established Covid-19 socio-demographic, lifestyle and health risk characteristics and to examine specific contributions of obesity-related cardiometabolic health characteristics as predictors of Covid-19 level of concern among a representative sample of U.S. older adults. We performed secondary analyses of existing data on 2872 2006–2020 Health and Retirement Study participants and examined 19 characteristics in relation to the outcome of interest using logistic regression and machine learning algorithms. In mixed-effects ordinal logistic regression models, a history of diabetes, stroke as well as 1–2 cardiometabolic risk factors and/or chronic conditions were associated with greater Covid-19 level of concern, after controlling for confounders. Female sex, birth cohort, minority race, Hispanic ethnicity and total wealth as well as depressive symptoms were associated with higher level of Covid-19 concern, and education was associated with lower level of Covid-19 concern in fully adjusted mixed-effects ordinal logistic regression models. The selected socio-demographic, lifestyle and health characteristics accounted for < 70% of the variability in Covid-19 level of concern based on machine learning algorithms. Independent risk factors for Covid-19 level of concern among U.S. older adults include socio-demographic characteristics and depressive symptoms. Advanced research is needed to identify relevant predictors and elucidate underlying mechanisms of observed relationships.
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Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA, 22060, USA.
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, 21225, USA
| | - Jordan Weiss
- Department of Demography, UC Berkeley, Berkeley, CA, 94720, USA
| | - Rana S Gautam
- Department of Sociology and Human Services, University of North Georgia, Dahlonega, GA, 30597, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, 21225, USA
| | - Brook T Alemu
- Health Sciences Program, School of Health Sciences, Western Carolina University, Cullowhee, NC, 28723, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, 21225, USA
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17
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Mortality Predictors in Severe COVID-19 Patients from an East European Tertiary Center: A Never-Ending Challenge for a No Happy Ending Pandemic. J Clin Med 2021; 11:jcm11010058. [PMID: 35011795 PMCID: PMC8745635 DOI: 10.3390/jcm11010058] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 01/08/2023] Open
Abstract
(1) Background: There are limited clinical data in patients from the Eastern European regions hospitalized for a severe form of Coronavirus disease 2019 (COVID-19). This study aims to identify risk factors associated with intra-hospital mortality in patients with COVID-19 severe pneumonia admitted to a tertiary center in Iasi, Romania. (2) Methods: The study is of a unicentric retrospective observational type and includes 150 patients with severe COVID-19 pneumonia divided into two subgroups, survivors and non-survivors. Demographic and clinical parameters, as well as comorbidities, laboratory and imaging investigations upon admission, treatments, and evolution during hospitalization were recorded. First, we sought to identify the risk factors associated with intra-hospital mortality using logistic regression. Secondly, we assessed the correlations between D-Dimer and C-reactive protein and predictors of poor prognosis. (3) Results: The predictors of in-hospital mortality identified in the study are D-dimers >0.5 mg/L (p = 0.002), C-reactive protein >5 mg/L (p = 0.001), and heart rate above 100 beats per minute (p = 0.001). The biomarkers were also significantly correlated the need for mechanical ventilation, admission to intensive care unit, or multiple organ dysfunction syndrome. By area under the curve (AUC) analysis, we noticed that both D-Dimer (AUC 0.741) and C-reactive protein (AUC 0.707) exhibit adequate performance in predicting a poor prognosis in patients with severe viral infection. (4) Conclusions: COVID-19's outcome is significantly influenced by several laboratory and clinical factors. As mortality induced by severe COVID-19 pneumonia is considerable, the identification of risk factors associated with negative outcome coupled with an early therapeutic approach are of paramount importance, as they may significantly improve the outcome and survival rates.
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18
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Wajekar AS, Solanki SL, Divatia JV. Pre-Anesthesia Re-Evaluation in Post COVID-19 Patients Posted for Elective Surgeries: an Online, Cross-Sectional Survey. Indian J Surg Oncol 2021; 12:234-239. [PMID: 34025062 PMCID: PMC8128089 DOI: 10.1007/s13193-021-01347-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/11/2021] [Indexed: 02/07/2023] Open
Abstract
Multiple studies have reported the increased risk of pulmonary complications and mortality in patients undergoing surgery with perioperative COVID-19 infection. With several reports of long-term sequelae in patients recovered from COVID-19 infection, this survey was conducted to collect the opinions of anesthesiologists regarding modifications to pre-anesthesia checkup (PAC) when COVID-19 survivors are posted for elective surgeries. We designed, validated and distributed a detailed online questionnaire, about various modifications in PAC in different patient populations like asymptomatic patients, patients with mild, moderate or severe hypoxia, significant cardiac complaints during COVID-19 and also geriatric, pediatric and pregnant patients with a history of COVID-19. We received 154 responses. Majority of responders agree that 0-2 weeks from the date of negative for SARS-CoV-2, is the ideal duration for all elective surgeries. Greater than 50% responders agree that a fresh PAC evaluation should be done for such patients which should include documentation of current functional status, fresh chest X-ray, electrocardiogram and coagulation profile. All patients who had hypoxia or cardiac symptoms during COVID-19 infection and even recovered asymptomatic geriatric patients should undergo cardiorespiratory evaluation with investigations such as HRCT chest, ABG, PFT, echocardiography and troponin I levels. Patients' PAC should be individualized, factoring in the severity of COVID-19 infection, post recovery functional status, associated co-morbidities and the urgency as well as the risk of surgical intervention. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13193-021-01347-z.
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Affiliation(s)
- Anjana S Wajekar
- Department of Anaesthesiology, critical care and pain, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra India
| | - Sohan L Solanki
- Department of Anaesthesiology, critical care and pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra India
| | - Jigeeshu V Divatia
- Department of Anaesthesiology, critical care and pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra India
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19
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Cardiovascular complications after COVID-19 in chronic kidney disease, dialysis and kidney transplant patients. Int Urol Nephrol 2021; 54:1551-1563. [PMID: 34811606 PMCID: PMC8608362 DOI: 10.1007/s11255-021-03059-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 11/11/2021] [Indexed: 02/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) is associated with increased mortality in patients with chronic kidney disease (CKD), dialysis patients and kidney transplant recipients (KTR). Cardiovascular complications, such as sudden arrhythmias, thromboembolic events, coronary events, cardiomyopathies and heart failure, may present in about 10–20% of patients with COVID-19. Patients with CKD, dialysis patients and KTR are all at increased cardiovascular risk and present with more cardiovascular complications after COVID-19 compared to the general population. During the pandemic, health care giving has rapidly changed by reducing elective outpatient reviews, which may refrain these high-risk patients from the appropriate management of their medical conditions, further increasing cardiovascular risk. Importantly, acute kidney injury (AKI) is another common complication of severe COVID-19 and associates with increased mortality. A large proportion of the AKI patients need renal replacement treatment, while 30% of them may not present renal function recovery and remain dialysis-dependent after discharge, thereby having potentially increased future cardiovascular risk. This review summarizes current knowledge regarding the cardiovascular events and mortality in patients with CKD or undergoing hemodialysis and in KTR.
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20
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Assante R, D'Antonio A, Mannarino T, Gaudieri V, Zampella E, Mainolfi CG, Cantoni V, Green R, Caiazzo E, Nappi C, Criscuolo E, Bologna R, Zumbo G, Petretta M, Cuocolo A, Acampa W. Impact of COVID-19 infection on short-term outcome in patients referred to stress myocardial perfusion imaging. Eur J Nucl Med Mol Imaging 2021; 49:1544-1552. [PMID: 34773166 PMCID: PMC8589632 DOI: 10.1007/s00259-021-05619-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/05/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE We assessed the impact of COVID-19 infection on cardiovascular events in patients with suspected or known coronary artery disease (CAD) referred to stress single-photon emission computed tomography myocardial perfusion imaging (MPS). METHODS A total of 960 consecutive patients with suspected or known CAD were submitted by referring physicians to stress MPS for assessment of myocardial ischemia between January 2018 and June 2019. All patients underwent stress-optional rest MPS. Perfusion defects were quantitated as % of LV myocardium and expressed as total perfusion defect (TPD), representing the defect extent and severity. A TPD ≥ 5% was considered abnormal. RESULTS During a mean follow-up of 27 months (range 4-38) 31 events occurred. Moreover, 55 (6%) patients had a COVID-19 infection. The median time from index MPS to COVID-19 infection was 16 months (range 6-24). At Cox multivariable analysis, abnormal MPS and COVID-19 infection resulted as independent predictors of events. There were no significant differences in annualized event rate in COVID-19 patients with or without abnormal MPS (p = 0.56). Differently, in patients without COVID-19, the presence of abnormal MPS was associated with higher event rate (p < .001). Patients with infection compared to those without had a higher event rate in the presence of both normal and abnormal TPD. CONCLUSION In patients with suspected or known CAD, the presence of COVID-19 infection during a short-term follow-up was associated with a higher rate of cardiovascular events.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emanuele Criscuolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Roberto Bologna
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giulia Zumbo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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21
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Martha JW. COVID-19 and Cardiovascular Complications: An Updated Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has become a global pandemic. Patients with pre-existing comorbidities such as hypertension, diabetes, and cardiovascular disease (CVD) are associated with greater severity and higher mortality. COVID-19 can cause cardiovascular complications, including myocardial injury, myocarditis, heart failure, acute coronary syndrome, and coagulation abnormalities. Possible pathophysiology and molecular pathways driving these disease processes are cytokine release syndrome, RAAS system dysregulation, plaque destabilization and coagulation disorders Myocarditis is one concern among persons who received mRNA-Based COVID-19 vaccines. There are several cardiovascular complications that are possibly caused by COVID-19 treatments, such as QT interval prolongation, arrhythmia, and hypotension. Due to increasingly recognized CVD damage in COVID-19, we need to understand about COVID-19 related to cardiovascular complications and treatment strategies.
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22
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Larijani B, Foroughi-Heravani N, Abedi M, Tayanloo-Beik A, Rezaei-Tavirani M, Adibi H, Arjmand B. Recent Advances of COVID-19 Modeling Based on Regenerative Medicine. Front Cell Dev Biol 2021; 9:683619. [PMID: 34760882 PMCID: PMC8573217 DOI: 10.3389/fcell.2021.683619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has caused a pandemic since December 2019 that originated in Wuhan, China. Soon after that, the world health organization declared Coronavirus disease-2019 a global health concern. SARS-CoV-2 is responsible for a lethal respiratory infection as well as the involvement of other organs due to its large tropism spectrum such as neurologic, cardiovascular, endocrine, gastrointestinal, and renal systems. Since the behavior of the virus is not fully understood, a new manifestation of the infection is revealed every day. In order to be able to design more efficient drugs and vaccines to treat the infection, finding out the exact mechanism of pathogenicity would be necessary. Although there have been some big steps toward understanding the relevant process, there are still some deficiencies in this field. Accordingly, regenerative medicine (RM), can offer promising opportunities in discovering the exact mechanisms and specific treatments. For instance, since it is not always possible to catch the pathophysiology mechanisms in human beings, several modeling methods have been introduced in this field that can be studied in three main groups: stem cell-based models, organoids, and animal models. Regarding stem cell-based models, induced pluripotent stem cells are the major study subjects, which are generated by reprogramming the somatic stem cells and then directing them into different adult cell populations to study their behavior toward the infection. In organoid models, different cell lines can be guided to produce a 3D structure including liver, heart, and brain-like platforms. Among animal models, mice are the most common species in this field. However, in order for mice models to be permissive to the virus, angiotensin-converting enzyme 2 receptors, the main receptor involved in the pathogenicity of the virus, should be introduced to the host cells through different methods. Here, the current known mechanism of SARS-CoV-2 infection, different suggested models, the specific response toward different manipulation as well as challenges and shortcomings in each case have been reviewed. Finally, we have tried to provide a quick summary of the present available RM-based models for SARS-CoV-2 infection, as an essential part of developing drugs, for future therapeutic goals.
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Affiliation(s)
- Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran
| | - Najmeh Foroughi-Heravani
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Abedi
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Tayanloo-Beik
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hossein Adibi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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23
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Marziliano N, Medoro A, Mignogna D, Saccon G, Folzani S, Reverberi C, Russo C, Intrieri M. Sudden Cardiac Death Caused by a Fatal Association of Hypertrophic Cardiomyopathy ( MYH7, p.Arg719Trp), Heterozygous Familial Hypercholesterolemia ( LDLR, p.Gly343Lys) and SARS-CoV-2 B.1.1.7 Infection. Diagnostics (Basel) 2021; 11:1229. [PMID: 34359312 PMCID: PMC8307649 DOI: 10.3390/diagnostics11071229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 01/31/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) and heterozygous familial hypercholesterolemia (HeFH), two of the most common genetic cardiovascular disorders, can lead to sudden cardiac death. These conditions could be complicated by concomitant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as in the case herein described. A young amateur soccer player died in late October 2020 after a fatal arrhythmia and the autopsy revealed the presence of HCM with diffuse non-obstructive coronary disease. The molecular autopsy revealed a compound condition with a first mutation in the MYH7 gene (p.Arg719Trp) and a second mutation in the LDLR gene (p.Gly343Cys): both have already been described as associated with HCM and HeFH, respectively. In addition, molecular analyses showed the presence of SARS-CoV-2 lineage B.1.1.7 (UK variant with high titer in the myocardium. Co-segregation analysis within the family (n = 19) showed that heterozygous LDLR mutation was maternally inherited, while the heterozygous MYH7 genetic lesion was de novo. All family member carriers of the LDLR mutation (n = 13) had systematic higher LDL plasma concentrations and positive records of cardiac and vascular ischemic events at young age. Considering that HCM mutations are in themselves involved in the predisposition to malignant arrhythmogenicity and HeFH could cause higher risk of cardiac complications in SARS-CoV-2 infection, this case could represent an example of a potential SARS-CoV-2 infection role in triggering or unmasking inherited cardiovascular disease, whose combination might represent the cause of fatal arrhythmia at such a young age. Additionally, it can provide clues in dating the presence of the SARS-CoV-2 lineage B.1.1.7 in Northern Italy in the early phases of the second pandemic wave.
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Affiliation(s)
- Nicola Marziliano
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (D.M.); (G.S.); (C.R.); (M.I.)
- Clinical Pathology Laboratory, ASST Rhodense, Rho, 20017 Milan, Italy
| | - Alessandro Medoro
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (D.M.); (G.S.); (C.R.); (M.I.)
| | - Donatella Mignogna
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (D.M.); (G.S.); (C.R.); (M.I.)
| | - Giovanni Saccon
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (D.M.); (G.S.); (C.R.); (M.I.)
| | - Stefano Folzani
- Poliambulatorio Città di Collecchio, Collecchio, 43044 Parma, Italy; (S.F.); (C.R.)
| | - Claudio Reverberi
- Poliambulatorio Città di Collecchio, Collecchio, 43044 Parma, Italy; (S.F.); (C.R.)
| | - Claudio Russo
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (D.M.); (G.S.); (C.R.); (M.I.)
| | - Mariano Intrieri
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (D.M.); (G.S.); (C.R.); (M.I.)
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24
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Marfella R, Paolisso P, Sardu C, Palomba L, D'Onofrio N, Cesaro A, Barbieri M, Rizzo MR, Sasso FC, Scisciola L, Turriziani F, Galdiero M, Pignataro D, Minicucci F, Trotta MC, D'Amico M, Mauro C, Calabrò P, Balestrieri ML, Signioriello G, Barbato E, Galdiero M, Paolisso G. SARS-COV-2 colonizes coronary thrombus and impairs heart microcirculation bed in asymptomatic SARS-CoV-2 positive subjects with acute myocardial infarction. Crit Care 2021; 25:217. [PMID: 34167575 PMCID: PMC8222703 DOI: 10.1186/s13054-021-03643-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The viral load of asymptomatic SAR-COV-2 positive (ASAP) persons has been equal to that of symptomatic patients. On the other hand, there are no reports of ST-elevation myocardial infarction (STEMI) outcomes in ASAP patients. Therefore, we evaluated thrombus burden and thrombus viral load and their impact on microvascular bed perfusion in the infarct area (myocardial blush grade, MBG) in ASAP compared to SARS-COV-2 negative (SANE) STEMI patients. METHODS This was an observational study of 46 ASAP, and 130 SANE patients admitted with confirmed STEMI treated with primary percutaneous coronary intervention and thrombus aspiration. The primary endpoints were thrombus dimension + thrombus viral load effects on MBG after PPCI. The secondary endpoints during hospitalization were major adverse cardiovascular events (MACEs). MACEs are defined as a composite of cardiovascular death, nonfatal acute AMI, and heart failure during hospitalization. RESULTS In the study population, ASAP vs. SANE showed a significant greater use of GP IIb/IIIa inhibitors and of heparin (p < 0.05), and a higher thrombus grade 5 and thrombus dimensions (p < 0.05). Interestingly, ASAP vs. SANE patients had lower MBG and left ventricular function (p < 0.001), and 39 (84.9%) of ASAP patients had thrombus specimens positive for SARS-COV-2. After PPCI, a MBG 2-3 was present in only 26.1% of ASAP vs. 97.7% of SANE STEMI patients (p < 0.001). Notably, death and nonfatal AMI were higher in ASAP vs. SANE patients (p < 0.05). Finally, in ASAP STEMI patients the thrombus viral load was a significant determinant of thrombus dimension independently of risk factors (p < 0.005). Thus, multiple logistic regression analyses evidenced that thrombus SARS-CoV-2 infection and dimension were significant predictors of poorer MBG in STEMI patients. Intriguingly, in ASAP patients the female vs. male had higher thrombus viral load (15.53 ± 4.5 vs. 30.25 ± 5.51 CT; p < 0.001), and thrombus dimension (4.62 ± 0.44 vs 4.00 ± 1.28 mm2; p < 0.001). ASAP vs. SANE patients had a significantly lower in-hospital survival for MACE following PPCI (p < 0.001). CONCLUSIONS In ASAP patients presenting with STEMI, there is strong evidence towards higher thrombus viral load, dimension, and poorer MBG. These data support the need to reconsider ASAP status as a risk factor that may worsen STEMI outcomes.
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Affiliation(s)
- Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy.
- Mediterranea Cardiocentro, Naples, Italy.
| | - Pasquale Paolisso
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
- Cardiovascular Center Aalst, Aalst, Belgium
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
| | - Luciana Palomba
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nunzia D'Onofrio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli" Naples, Naples, Italy
| | - Arturo Cesaro
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
| | - Lucia Scisciola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
| | - Fabrizio Turriziani
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Danilo Pignataro
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Minicucci
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele D'Amico
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ciro Mauro
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Paolo Calabrò
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Luisa Balestrieri
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli" Naples, Naples, Italy
| | - Giuseppe Signioriello
- Department of Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Emanuele Barbato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
- Cardiovascular Center Aalst, Aalst, Belgium
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Naples, Piazza Miraglia, 2, 80138, Naples, Italy
- Mediterranea Cardiocentro, Naples, Italy
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Guglielmi V, Colangeli L, D’Adamo M, Sbraccia P. Susceptibility and Severity of Viral Infections in Obesity: Lessons from Influenza to COVID-19. Does Leptin Play a Role? Int J Mol Sci 2021; 22:ijms22063183. [PMID: 33804765 PMCID: PMC8003928 DOI: 10.3390/ijms22063183] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 12/13/2022] Open
Abstract
The recent pandemic Sars-CoV2 infection and studies on previous influenza epidemic have drawn attention to the association between the obesity and infectious diseases susceptibility and worse outcome. Metabolic complications, nutritional aspects, physical inactivity, and a chronic unbalance in the hormonal and adipocytokine microenvironment are major determinants in the severity of viral infections in obesity. By these pleiotropic mechanisms obesity impairs immune surveillance and the higher leptin concentrations produced by adipose tissue and that characterize obesity substantially contribute to such immune response dysregulation. Indeed, leptin not only controls energy balance and body weight, but also plays a regulatory role in the interplay between energy metabolism and immune system. Since leptin receptor is expressed throughout the immune system, leptin may exert effects on cells of both innate and adaptive immune system. Chronic inflammatory states due to metabolic (i.e., obesity) as well as infectious diseases increase leptin concentrations and consequently lead to leptin resistance further fueling inflammation. Multiple factors, including inflammation and ER stress, contribute to leptin resistance. Thus, if leptin is recognized as one of the adipokines responsible for the low grade inflammation found in obesity, on the other hand, impairments of leptin signaling due to leptin resistance appear to blunt the immunologic effects of leptin and possibly contribute to impaired vaccine-induced immune responses. However, many aspects concerning leptin interactions with inflammation and immune system as well as the therapeutical approaches to overcome leptin resistance and reduced vaccine effectiveness in obesity remain a challenge for future research.
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Lewek J, Jatczak-Pawlik I, Maciejewski M, Jankowski P, Banach M. COVID-19 and cardiovascular complications - preliminary results of the LATE-COVID study. Arch Med Sci 2021; 17:818-822. [PMID: 34025853 PMCID: PMC8130484 DOI: 10.5114/aoms/134211] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) may affect many organs and may be responsible for numerous complications including cardiovascular problems. METHODS We analysed consecutive patients (n = 51) admitted to the cardiology department between 1st October 2020 and 31st January 2021 due to symptoms which might have reflected cardiovascular complications following COVID-19. We collected data concerning clinical characteristics, results of laboratory tests, echocardiography and 24-hour ambulatory ECG recording. RESULTS The post-COVID-19 complications appeared 1-4 months after disease recovery. Severe cardiovascular complications were observed in 27.5% of hospitalized patients. In comparison to those with mild complications, patients with severe complications had significantly higher prevalence of diabetes (36 vs. 8%; p = 0.01), decrease in ejection fraction (36% vs. 0%, p < 0.001), higher resting heart rate at admission (85 vs. 72 bpm; p < 0.001), and higher levels of C-reactive protein (p = 0.02) and troponin T (17.9 vs. 4.2 pg/ml; p = 0.01). Dyspnoea and exercise intolerance were also more frequent in patients with severe complications. CONCLUSIONS Diabetes, elevated level of CRP and troponin, heart rate variability parameters and worsening of left ventricular ejection fraction are related to the severity of cardiovascular complications following COVID-19 infection.
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Affiliation(s)
- Joanna Lewek
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Izabela Jatczak-Pawlik
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Marek Maciejewski
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Piotr Jankowski
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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Vahedian-Azimi A, Mohammadi SM, Heidari Beni F, Banach M, Guest PC, Jamialahmadi T, Sahebkar A. Improved COVID-19 ICU admission and mortality outcomes following treatment with statins: a systematic review and meta-analysis. Arch Med Sci 2021; 17:579-595. [PMID: 34025827 PMCID: PMC8130467 DOI: 10.5114/aoms/132950] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Approximately 1% of the world population has now been infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). With cases still rising and vaccines just beginning to rollout, we are still several months away from seeing reductions in daily case numbers, hospitalisations, and mortality. Therefore, there is a still an urgent need to control the disease spread by repurposing existing therapeutics. Owing to antiviral, anti-inflammatory, immunomodulatory, and cardioprotective actions, statin therapy has been considered as a plausible approach to improve COVID-19 outcomes. MATERIAL AND METHODS We carried out a meta-analysis to investigate the effect of statins on 3 COVID-19 outcomes: intensive care unit (ICU) admission, tracheal intubation, and death. We systematically searched the PubMed, Web of Science, Scopus, and ProQuest databases using keywords related to our aims up to November 2, 2020. All published observational studies and randomised clinical trials on COVID-19 and statins were retrieved. Statistical analysis with random effects modelling was performed using STATA16 software. RESULTS The final selected studies (n = 24 studies; 32,715 patients) showed significant reductions in ICU admission (OR = 0.78, 95% CI: 0.58-1.06; n = 10; I 2 = 58.5%) and death (OR = 0.70, 95% CI: 0.55-0.88; n = 21; I 2 = 82.5%) outcomes, with no significant effect on tracheal intubation (OR = 0.79; 95% CI: 0.57-1.11; n = 7; I 2= 89.0%). Furthermore, subgroup analysis suggested that death was reduced further by in-hospital application of stains (OR = 0.40, 95% CI: 0.22-0.73, n = 3; I 2 = 82.5%), compared with pre-hospital use (OR = 0.77, 95% CI: 0.60-0.98, n = 18; I 2 = 81.8%). CONCLUSIONS These findings call attention to the need for systematic clinical studies to assess both pre- and in-hospital use of statins as a potential means of reducing COVID-19 disease severity, particularly in terms of reduction of ICU admission and total mortality reduction.
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Affiliation(s)
- Amir Vahedian-Azimi
- Trauma Research Centre, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyede Momeneh Mohammadi
- Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Farshad Heidari Beni
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Paul C. Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Centre, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Biomedical Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Lipiński PF, Zaborniak J, Garnuszek P, Szurmak P. Virtual screening for small molecular non-covalent binders of the SARS-CoV-2 main protease. Arch Med Sci 2021; 17:838-842. [PMID: 34025857 PMCID: PMC8130460 DOI: 10.5114/aoms/133122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/07/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | - Piotr Garnuszek
- Radioisotope Centre POLATOM, National Centre for Nuclear Research, Poland
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Yuvanc E, Tuglu D, Ozan T, Kisa U, Balci M, Batislam E, Yilmaz E. Evaluation of pheniramine maleate and zofenopril in reducing renal damage induced by unilateral ureter obstruction. An experimental study. Arch Med Sci 2021; 17:812-817. [PMID: 34025852 PMCID: PMC8130462 DOI: 10.5114/aoms.2019.88320] [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: 12/28/2017] [Accepted: 03/14/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Obstruction of the ureter may occur due to congenital, iatrogenic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction. MATERIAL AND METHODS Twenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically. RESULTS An increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01). CONCLUSIONS In our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruction.
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Affiliation(s)
- Ercan Yuvanc
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Devrim Tuglu
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Tunc Ozan
- Department of Urology, Firat University School of Medicine, Elazig, Turkey
| | - Ucler Kisa
- Department of Biochemistry, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Mahi Balci
- Department of Pathology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Ertan Batislam
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Erdal Yilmaz
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
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