1
|
Kimata M, Hashimoto K, Harada N, Kawamura Y, Kimizuka Y, Fujikura Y, Kaneko M, Kiriu N, Sekine Y, Iwabuchi N, Kiyozumi T, Kawana A, Matsukuma S, Tanaka Y. Noninvasive Ambulatory Electrocardiographic Markers from Patients with COVID-19 Pneumonia: A Report of Three Cases. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:655. [PMID: 38674301 PMCID: PMC11052239 DOI: 10.3390/medicina60040655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/05/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
Coronavirus disease 2019 (COVID-19) has affected medical practice. More than 7,000,000 patients died worldwide after being infected with COVID-19; however, no specific laboratory markers have yet been established to predict death related to this disease. In contrast, electrocardiographic changes due to COVID-19 include QT prolongation and ST-T changes; however, there have not been studies on the ambulatory electrocardiographic markers of COVID-19. We encountered three patients diagnosed as having COVID-19 who did not have a prior history of significant structural heart diseases. All patients had abnormalities in ambulatory echocardiogram parameters detected by high-resolution 24 h electrocardiogram monitoring: positive late potentials (LPs) and T-wave alternans (TWA), abnormal heart rate variability (HRV), and heart rate turbulence (HRT). Case 1 involved a 78-year-old woman with a history of chronic kidney disease, Case 2 involved a 76-year-old man with hypertension and diabetes, and Case 3 involved a 67-year-old man with renal cancer, lung cancer, and diabetes. None of them had a prior history of significant structural heart disease. Although no significant consistent increases in clinical markers were observed, all three patients died, mainly because of respiratory failure with mild heart failure. The LP, TWA, HRV, and HRT were positive in all three cases with no significant structural cardiac disease at the initial phase of admission. The further accumulation of data regarding ambulatory electrocardiographic markers in patients with COVID-19 is needed. Depending on the accumulation of data, the LP, TWA, HRV, and HRT could be identified as potential risk factors for COVID-19 pneumonia in the early phase of admission.
Collapse
Affiliation(s)
- Motohiro Kimata
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.H.); (Y.T.)
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.H.); (Y.T.)
| | - Naomi Harada
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.H.); (Y.T.)
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.H.); (Y.T.)
- Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan
| | - Yoshifumi Kimizuka
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (Y.K.); (Y.F.); (A.K.)
| | - Yuji Fujikura
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (Y.K.); (Y.F.); (A.K.)
| | - Mayuko Kaneko
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.K.); (Y.S.); (T.K.)
| | - Nobuaki Kiriu
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.K.); (Y.S.); (T.K.)
| | - Yasumasa Sekine
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.K.); (Y.S.); (T.K.)
| | - Natsumi Iwabuchi
- Department of Laboratory Medicine, National Defense Medical College Hospital, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (N.I.); (S.M.)
| | - Tetsuro Kiyozumi
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.K.); (Y.S.); (T.K.)
- Department of Defense Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (Y.K.); (Y.F.); (A.K.)
| | - Susumu Matsukuma
- Department of Laboratory Medicine, National Defense Medical College Hospital, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (N.I.); (S.M.)
- Department of Pathology and Laboratory Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa 359-8513, Saitama, Japan; (M.K.); (N.H.); (Y.T.)
| |
Collapse
|
2
|
Cersosimo A, Di Pasquale M, Arabia G, Metra M, Vizzardi E. COVID myocarditis: a review of the literature. Monaldi Arch Chest Dis 2023. [PMID: 37930657 DOI: 10.4081/monaldi.2023.2784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023] Open
Abstract
Myocarditis is a potentially fatal complication of coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. COVID-19 myocarditis appears to have distinct inflammatory characteristics that distinguish it from other viral etiologies. COVID-19 myocarditis can present with symptoms ranging from dyspnea and chest pain to acute heart failure and death. It is critical to detect any cases of myocarditis, especially fulminant myocarditis, which can be characterized by signs of heart failure and arrhythmias. Serial troponins, echocardiography, and electrocardiograms should be performed as part of the initial workup for suspected myocarditis. The second step in detecting myocarditis is cardiac magnetic resonance imaging and endomyocardial biopsy. Treatment for COVID-19 myocarditis is still debatable; however, combining intravenous immunoglobulins and corticosteroids may be effective, especially in cases of fulminant myocarditis. Overall, more research is needed to determine the incidence of COVID-19 myocarditis , and the use of intravenous immunoglobulins and corticosteroids in combination requires large randomized controlled trials to determine efficacy. The purpose of this review is to summarize current evidence on the subject. This review aims to summarise current evidence on this topic.
Collapse
Affiliation(s)
- Angelica Cersosimo
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia.
| | - Mattia Di Pasquale
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia.
| | - Gianmarco Arabia
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia.
| | - Marco Metra
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia.
| | - Enrico Vizzardi
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia.
| |
Collapse
|
3
|
Baek YS, Jo Y, Lee SC, Choi W, Kim DH. Artificial intelligence-enhanced electrocardiography for early assessment of coronavirus disease 2019 severity. Sci Rep 2023; 13:15187. [PMID: 37704692 PMCID: PMC10499801 DOI: 10.1038/s41598-023-42252-5] [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: 01/31/2023] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
Despite challenges in severity scoring systems, artificial intelligence-enhanced electrocardiography (AI-ECG) could assist in early coronavirus disease 2019 (COVID-19) severity prediction. Between March 2020 and June 2022, we enrolled 1453 COVID-19 patients (mean age: 59.7 ± 20.1 years; 54.2% male) who underwent ECGs at our emergency department before severity classification. The AI-ECG algorithm was evaluated for severity assessment during admission, compared to the Early Warning Scores (EWSs) using the area under the curve (AUC) of the receiver operating characteristic curve, precision, recall, and F1 score. During the internal and external validation, the AI algorithm demonstrated reasonable outcomes in predicting COVID-19 severity with AUCs of 0.735 (95% CI: 0.662-0.807) and 0.734 (95% CI: 0.688-0.781). Combined with EWSs, it showed reliable performance with an AUC of 0.833 (95% CI: 0.830-0.835), precision of 0.764 (95% CI: 0.757-0.771), recall of 0.747 (95% CI: 0.741-0.753), and F1 score of 0.747 (95% CI: 0.741-0.753). In Cox proportional hazards models, the AI-ECG revealed a significantly higher hazard ratio (HR, 2.019; 95% CI: 1.156-3.525, p = 0.014) for mortality, even after adjusting for relevant parameters. Therefore, application of AI-ECG has the potential to assist in early COVID-19 severity prediction, leading to improved patient management.
Collapse
Affiliation(s)
- Yong-Soo Baek
- Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea.
- School of Computer Science, University of Birmingham, Birmingham, B15 2TT, UK.
- DeepCardio Inc., 100 Inha-ro, Incheon, 22212, Republic of Korea.
| | - Yoonsu Jo
- DeepCardio Inc., 100 Inha-ro, Incheon, 22212, Republic of Korea
| | - Sang-Chul Lee
- DeepCardio Inc., 100 Inha-ro, Incheon, 22212, Republic of Korea
- Department of Computer Engineering, Inha University, 100 Inha-ro, Incheon, 22212, Republic of Korea
| | - Wonik Choi
- DeepCardio Inc., 100 Inha-ro, Incheon, 22212, Republic of Korea.
- Department of Information and Communication Engineering, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.
| | - Dae-Hyeok Kim
- Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea
- DeepCardio Inc., 100 Inha-ro, Incheon, 22212, Republic of Korea
| |
Collapse
|
4
|
Mahmoud EO, Elsabagh YA, Abd El Ghaffar N, Fawzy MW, Hussein MA. Atherosclerosis Associated With COVID-19: Acute, Tends to Severely Involve Peripheral Arteries, and May be Reversible. Angiology 2023:33197231198253. [PMID: 37611951 DOI: 10.1177/00033197231198253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atherosclerosis in COVID-19 directly through duplex ultrasound measurements and their relation to co-morbidities, clinical and laboratory severity markers, and serum interleukin (IL) 6 and 17. Serum IL 6 and 17, average carotid intima-media thickness (cIMT), diameter and peak systolic velocities (PSV) of tibial, ulnar, radial arteries, and ankle brachial index (ABI) were measured in 44 COVID-19 patients and 44 healthy controls. Serum IL6, IL17, PSV, and cIMT were higher while diameter was lower (P ≤ .01) in cases. Clinical severity index correlated positively with age, co-morbidities, ferritin, IL6, IL17, cIMT, and PSV (P ≤ .04) and negatively with diameter and ABI (P = .04). Patients with severe lymphopenia had higher PSV, IL6, and IL17 and lower diameter (P < .00001). Ferritin positively correlated with PSV and negatively with diameter and ABI (P ≤ .01). Those who received an IL6 inhibitor (tocilizumab) showed lower PSV and higher diameter (P ≤ .01). In multiple regression analysis, IL17 and (age, co-morbidities) were related to (PSV, diameter) and cIMT (P ≤ .001, ≤0.02), respectively. COVID-19 may be associated with subclinical acute and may be reversible atherosclerosis severely involving peripheral arteries.
Collapse
Affiliation(s)
- Eman O Mahmoud
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| | - Yumn A Elsabagh
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| | | | - Mary Wadie Fawzy
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| | - Mohamed A Hussein
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| |
Collapse
|
5
|
Sharma YP, Gawalkar AA, Batta A, Shrimanth YS, Revaiah PC, Karki P, Chaudhary V, Kasinadhuni G, Santosh K, Bootla D, Kumar S, Patel NKJ, Sambyal BS, Panda P. Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome. J Family Med Prim Care 2023; 12:962-966. [PMID: 37448943 DOI: 10.4103/jfmpc.jfmpc_1629_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
|
6
|
De A, Bansal M. Clinical profile and the extent of residual myocardial dysfunction among patients with previous coronavirus disease 2019. Int J Cardiovasc Imaging 2023; 39:887-894. [PMID: 36607468 PMCID: PMC9816519 DOI: 10.1007/s10554-022-02787-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/24/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Many patients who have recovered from their coronavirus disease 2019 (COVID-19) episode continue to remain symptomatic and seek medical opinion. The clinical characteristics and echocardiography findings of such subjects have not been adequately studied. METHODS The study included 472 subjects (age 54.0 ± 13.4 years, 57% men) with previous COVID-19 (median duration since COVID-19 12.0 weeks, interquartile range 9.0-26.0 weeks) and 100 controls (age 53.9 ± 13.6 years, 53% men). All subjects underwent detailed clinical assessment and echocardiography, including measurement of left ventricular (LV) ejection fraction (EF) and global longitudinal strain (GLS). RESULTS Less than third (29.2%) of the post-COVID subjects had needed hospitalization for their initial infection. Exertional dyspnea or breathing difficulty at rest were the commonest reasons for post-COVID presentation. As compared to controls, the post-COVID subjects had impaired LV systolic (LVEF 63.2 ± 2.2 vs. 61.9 ± 4.6, P = 0.007; GLS - 19.9 ± 2.6% vs. -17.6 ± 3.4%, P < 0.001) and diastolic function. Majority of those with reduced LV GLS had preserved LVEF. The patients presenting before 12 weeks were more likely to be symptomatic, but LV GLS did not differ. The patients needing hospitalization had higher burden of co-morbidities and significantly reduced LV GLS as compared to those who had received domiciliary treatment. The patients in the lowest GLS tertile were older, had higher burden of co-morbidities, and had had more severe initial infection with greater need for hospitalization, oxygen therapy and steroids. The need for hospitalization was independently associated with lower GLS at the time of current presentation. CONCLUSION This study shows that impairment of LV systolic and diastolic function is common among subjects recovering from previous COVID-19 episode. The patients with more severe initial infection have more marked impairment of LV function and this impairment persists even after several months of recovery from the initial infection. Routine measurement of GLS may be helpful since LV systolic dysfunction in these patients is mostly subclinical.
Collapse
Affiliation(s)
- Aniruddha De
- Suraksha Diagnostics Private Limited, Kolkata, India ,Dept. of Non-invasive Cardiology, Apollo Multispecialty Hospitals, Kolkata, India
| | - Manish Bansal
- Clinical and Preventive Cardiology, Medanta Heart Institute, Medanta- The Medicity, 122001 Gurgaon, Haryana India
| |
Collapse
|
7
|
Menon A, R. D. Use of peripheral perfusion index (PI) as a predictor of cardiovascular complications in hospitalised Covid 19 patients - A pilot study. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i5.1846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction and Aim: Cardiovascular complications have been associated with fatality in Covid-19 patients. Reduced peripheral perfusion is a marker for cardiovascular dysfunction. Peripheral Perfusion Index (PI) is a non-invasive measure of microvascular perfusion with regards to pulsatile arterial blood flow. The study was aimed at finding the utility of PI as a hemodynamic marker in Covid-19.
Materials and Methods: Observational study done on 58 hospitalised adult Covid-19 patients over a span of 6 days. Each day the hemodynamic parameters such as pulse rate, SpO2 and Peripheral Perfusion Index (PI) were measured using a finger pulse oximeter. Peripheral Blood pressure was measured using automated BP apparatus. Mean Arterial Pressure (MAP) and pulse pressure (PP) was calculated.
Results: Correlation between PI and other parameters checked using Pearson’s test. There was significant positive correlation between PI and PP in day wise analysis during first 2 days with linear regression showing PP can be predicted as a dependant function from PI. This shows the association between PI and systemic cardiovascular function.
Conclusion: PI is a useful measure of peripheral microvascular perfusion and relates to systemic PP. It can be predicted from the results that PI can act as a reliable guide to predict the cardiovascular condition of the patient. As PI is measured from finger pulse oximeter, it is a non-invasive and easy-to-record method, which can be used by untrained personnel in Covid-19 patients.
Collapse
|
8
|
Ali M, Shiwani HA, Elfaki MY, Hamid M, Pharithi R, Kamgang R, Egom CB, Oyono JLE, Egom EEA. COVID-19 and myocarditis: a review of literature. Egypt Heart J 2022; 74:23. [PMID: 35380300 PMCID: PMC8980789 DOI: 10.1186/s43044-022-00260-2] [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: 02/08/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
Myocarditis has been discovered to be a significant complication of coronavirus disease 2019 (COVID-19), a condition caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. COVID-19 myocarditis seems to have distinct inflammatory characteristics, which make it unique to other viral etiologies. The incidence of COVID-19 myocarditis is still not clear as a wide range of figures have been quoted in the literature; however, it seems that the risk of developing myocarditis increases with more severe infection. Furthermore, the administration of the mRNA COVID-19 vaccine has been associated with the development of myocarditis, particularly after the second dose. COVID-19 myocarditis has a wide variety of presentations, ranging from dyspnea and chest pain to acute heart failure and possibly death. It is important to catch any cases of myocarditis, particularly those presenting with fulminant myocarditis which can be characterized by signs of heart failure and arrythmias. Initial work up for suspected myocarditis should include serial troponins and electrocardiograms. If myocardial damage is detected in these tests, further screening should be carried out. Cardiac magnetic resonance imagining and endomyocardial biopsy are the most useful tests for myocarditis. Treatment for COVID-19 myocarditis is still controversial; however, the use of intravenous immunoglobulins and corticosteroids in combination may be effective, particularly in cases of fulminant myocarditis. Overall, the incidence of COVID-19 myocarditis requires further research, while the use of intravenous immunoglobulins and corticosteroids in conjunction requires large randomized controlled trials to determine their efficacy.
Collapse
Affiliation(s)
- Mohammed Ali
- School of Medicine, The University of Manchester, Stopford Building, 99 Oxford Road, Manchester, M13 9PG, UK.
| | | | | | - Moaz Hamid
- Birmingham Midland Eye Centre, Birmingham, UK
| | | | - Rene Kamgang
- St Vincent's University Hospital, Dublin, Ireland
| | | | - Jean Louis Essame Oyono
- Laboratory of Endocrinology and Radioisotopes, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Emmanuel Eroume-A Egom
- Laboratory of Endocrinology and Radioisotopes, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
- Institut du Savoir Montfort (ISM), Hôpital Montfort, 713 Montreal Rd, Ottawa, ON, K1K 0T2, Canada
| |
Collapse
|
9
|
Jahan N, Brahma A, Kumar MS, Bagepally BS, Ponnaiah M, Bhatnagar T, Murhekar MV. Seroprevalence of IgG antibodies against SARS-CoV-2 in India, March 2020 to August 2021: a systematic review and meta-analysis. Int J Infect Dis 2022; 116:59-67. [PMID: 34968773 PMCID: PMC8712428 DOI: 10.1016/j.ijid.2021.12.353] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION India experienced 2 waves of COVID-19 pandemic caused by SARS-CoV-2 and reported the second highest caseload globally. Seroepidemiologic studies were done to track the course of the pandemic. We systematically reviewed and synthesized the seroprevalence of SARS-CoV-2 in the Indian population. METHODS We included studies reporting seroprevalence of IgG antibodies against SARS-CoV-2 from March 1, 2020 to August 11, 2021 and excluded studies done only among patients with COVID-19 and vaccinated individuals. We searched published databases, preprint servers, and government documents using a combination of keywords and medical subheading (MeSH) terms of "Seroprevalence AND SARS-CoV-2 AND India". We assessed risk of bias using the Newcastle-Ottawa scale, the appraisal tool for cross-sectional studies (AXIS), the Joanna Briggs Institute (JBI) critical appraisal tool, and WHO's statement on the Reporting of Seroepidemiological Studies for SARS-CoV-2 (ROSES-S). We calculated pooled seroprevalence along with 95% Confidence Intervals (CI) during the first (March 2020 to February 2021) and second wave (March to August 2021). We also estimated seroprevalence by selected demographic characteristics. RESULTS We identified 3821 studies and included 53 studies with 905379 participants after excluding duplicates, screening of titles and abstracts and full-text screening. Of the 53, 20 studies were of good quality. Some of the reviewed studies did not report adequate information on study methods (sampling = 24% (13/53); laboratory = 83% [44/53]). Studies of 'poor' quality had more than one of the following issues: unjustified sample size, nonrepresentative sample, nonclassification of nonrespondents, results unadjusted for demographics and methods insufficiently explained to enable replication. Overall pooled seroprevalence was 20.7% in the first (95% CI = 16.1 to 25.3) and 69.2% (95% CI = 64.5 to 73.8) in the second wave. Seroprevalence did not differ by age in first wave, whereas in the second, it increased with age. Seroprevalence was slightly higher among women in the second wave. In both the waves, the estimate was higher in urban than in rural areas. CONCLUSION Seroprevalence increased by 3-fold between the 2 waves of the pandemic in India. Our review highlights the need for designing and reporting studies using standard protocols.
Collapse
Affiliation(s)
- Nuzrath Jahan
- ICMR-National Institute of Epidemiology, Chennai, India
| | - Adarsha Brahma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | | | | | | | | |
Collapse
|
10
|
Jandial A, Gupta A, Malviya A, Agastam S, Kumar D. Coagulation abnormalities & thromboprophylaxis in COVID-19. Indian J Med Res 2021; 153:606-618. [PMID: 34643567 PMCID: PMC8555598 DOI: 10.4103/ijmr.ijmr_3841_20] [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] [Indexed: 01/08/2023] Open
Abstract
The ongoing pandemic of novel coronavirus 2019 is rapidly evolving, and newer organ- and system-specific manifestations are being observed. Thrombotic complications and coagulopathy are frequent manifestations of the disease, especially in sick patients, which appear to be unique and distinct from sepsis-induced coagulopathy, disseminated intravascular coagulation and other viral infection-induced coagulation abnormalities. Elevated D-dimers and fibrinogen in the early stage of the disease with minimally deranged prothrombin time and platelet counts are prominent and distinguishing features. Venous and arterial thromboses, as opposed to bleeding events, are the major clinical correlates. There is much to be known about the pathogenesis of COVID-associated coagulopathy; however, the mechanisms overlap with thrombotic microangiopathy, haemophagocytic syndrome and antiphospholipid syndrome compounded by the diffuse endothelial damage. The recommendations regarding the treatment are still evolving, but antithrombotic therapy has a definite role in positive outcomes of sick patients.
Collapse
Affiliation(s)
- Aditya Jandial
- Department of Hematology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Anunay Gupta
- Department of Cardiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Amit Malviya
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | - Sourabh Agastam
- Department of Cardiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Dilip Kumar
- Department of Cardiology, Cardiac Catheterization Laboratory, Medical Institute of Cardiovascular Sciences, Kolkata, West Bengal, India
| |
Collapse
|
11
|
Sharif MH, Khan AW, Khaleeque M, Haffar A, Jaiswal V, Song D, Abdelghffar M, Ahmad S, Almas T, Hanif M. Complete heart block in patients infected with SARS-CoV-2: A case series from a developing country. Ann Med Surg (Lond) 2021; 69:102828. [PMID: 34512966 PMCID: PMC8420262 DOI: 10.1016/j.amsu.2021.102828] [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: 08/17/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 01/19/2023] Open
Abstract
Coronavirus Disease 19 (COVID-19) has led to a global pandemic and has been the center of attention across the entire medical community. This novel virus was initially thought to affect primarily the respiratory system, but now it is evident that it has a multitude of effects on the human body. Our point of interest is to establish the effect of COVID-19 infection on the conducting system of the heart. We present a case series of four patients who developed complete heart block (CHB) shortly after being infected with COVID-19 without any previous known risk factors of complete heart block. There have only been a few previous case reports on the occurrence of CHB in COVID-19 patients highlighting the importance and the need of our case series to the literature of cardiovascular outcomes in COVID-19 patients. Our case series highlight that COVID-19 can indeed affect the conduction system of the heart and cause CHB in patients who then recovered spontaneously further elucidating the transient nature of cardiovascular effects caused by the novel virus.
Collapse
Affiliation(s)
| | | | | | | | | | - David Song
- Icahn School of Medicine at Mount Sinai, NY, USA
| | | | - Saad Ahmad
- Icahn School of Medicine at Mount Sinai, NY, USA
| | - Talal Almas
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | |
Collapse
|