Existence of SARS-CoV-2 RNA on ambient particulate matter samples: A nationwide study in Turkey

Coronavirus disease 2019 (COVID-19) is caused by the SARS-CoV-2 virus and has been affecting the world since the end of 2019. The disease led to significant mortality and morbidity in Turkey, since the first case was reported on March 11th, 2020. Studies suggest a positive association between air pollution and SARS-CoV-2 infection. The aim of the present study was to investigate the role of ambient particulate matters (PM), as potential carriers for SARS-CoV-2. Ambient PM samples in various size ranges were collected from 13 sites including urban and urban-background locations and hospital gardens in 10 cities across Turkey between 13th of May and 14th of June 2020 to investigate the possible presence of SARS-CoV-2 RNA on ambient PM. A total of 203 daily samples (TSP, n = 80; PM_2.5, n = 33; PM_2.5-10, n = 23; PM₁₀μm, n = 19; and 6 size segregated PM, n = 48) were collected using various samplers. The N1 gene and RdRP gene expressions were analyzed for the presence of SARS-CoV-2, as suggested by the Centers for Disease Control and Prevention (CDC). According to real time (RT)-PCR and three-dimensional (3D) digital (d) PCR analysis, dual RdRP and N1 gene positivity were detected in 20 (9.8%) samples. Ambient PM-bound SARS-CoV-2 was analyzed quantitatively and the air concentrations of the virus ranged from 0.1 copies/m³ to 23 copies/m³. The highest percentages of virus detection on PM samples were from hospital gardens in Tekirdağ, Zonguldak, and Istanbul, especially in PM_2.5 mode. Findings of this study have suggested that SARS-CoV-2 may be transported by ambient particles, especially at sites close to the infection hot-spots. However, whether this has an impact on the spread of the virus infection remains to be determined.

P1101Is there any link between vitamin D deficiency and vasovagal syncope?

Background

This study aimed to investigate serum 25[OH]D levels between patients with vasovagal syncope(VVS) diagnosed by head-up tilt table test (HUTT) and patients who do not develop syncope during the test.

Methods

Sixty-eight consecutive patients [mean age 33.2 ± 14.5 years, 49 females (72.1%)] were categorized based on their HUTT results (positive vs. negative, n = 40 vs. 28).25[OH]D levels were measured by chemiluminescent microparticle immunoassay method in all patients.

Results

There was no difference between the two groups in terms of blood tests, Body Mass Index, gender, echocardiographic findings(p > 0.05).Mean 25[OH]D level was lower in HUTT positive patients when compared to the HUTT negative group(p < 0.05).25[OH]D levels were significantly lower between patients over the age 25 in two groups (mean level 17.9 ± 7.3 vs 26.3 ± 8.5, respectively,p < 0.005).(Table 1) 

Conclusion

We found that patients diagnosed VVS by HUTT test had lower 25[OH]D levels.Measurement of vitamin D level may be an important factor in VVS patients.

Table 1 Head-up Tilt Testing positive (n = 40) negative (n = 28) p value Age (years) 33.2 ± 13.7 33.3 ± 15.9 0.973 Female gender (%) 31 (77.5) 18(64.3) 0.232 BMI (kg/m2) 23.4 ± 3.1 23.0 ± 2.6 0,596 EF (%) 59.2 ± 1.6 59.1 ± 1.3 0.357 LA (mm) 34 ± 2.4 33 ± 2.7 0.715 RA (mm) 32 ± 2.5 31 ± 2.7 0.141 Vitamin D (ng/mL) 16.5 ± 6.6 23.9 ± 9.5 0.001 Vitamin B12 (pg/mL) 355.1 ± 124.6 378 ± 87.0 0.367 TSH (mIU/L) 1.8 ± 0.8 1.7 ± 0.9 0.367 Glucose (mg/dL) 87.0 ± 7.4 90.5 ± 8.1 0.076 Creatinine (mg/dL) 0.6 ± 0.1 0.7 ± 0.1 0..55 Sodium (mmol/L) 139.8 ± 2.0 139.7 ± 2.5 0.931 Potassium (mmol/L) 4.1 ± 0.3 4.1 ± 0.2 0.674 Calcium (mg/dL) 8.9 ± 0.9 8.9 ± 1.1 0.476 Wbc (x103/uL) 7.3 ± 1.6 6.9 ± 1.6 0.339 Hb (g/dL) 13.3 ± 1.3 13.5 ± 1.8 0.664 Age (years) Vitamin D level Vitamin D level 0.132 ≤ 25 (n = 31) 14.8 ± 5.5 21.2 ± 10.2 0.057 > 25 (n = 37) 17.9 ± 7.3 26.3 ± 8.5 0.005 Patients characteristics of Head-up Tilt Testing positive and negative group

P667 Protein supplementation improves left ventricular systolic functions in athletes by 2D speckle tracking echocardiography

Funding Acknowledgements

none

Background

Exercise induced left ventricular remodelling is known for many years. Left ventricular enlargement, hypertrophy, left atrial dilatation are adaptive responsive mechanisms of myocardial tissue to increased physiological demand by exercise. In recent years, strain and strain rate have been used for the assessment of myocardial adaptation in athletes’. In literature, left ventricular and right ventricular deformation is decreased in athletes’, compared to normal healthy individuals. Also left atrial reservoir and contractile functions, which can be measured by speckle tracking echocardiography, decrease in endurance athletes with atrial fibrillation. Athletes have been using protein supplementation frequently in recent years however cardiac effects are largely unknown. There is limited data in the literature about cardiac effects of protein supplementation.

Purpose

In our study, we aim to evaluate the effects of protein supplementation on cardiac functions in athletes with 2D speckle tracking echocardiography. This is the first study in the literature evaluating the effects of protein supplements on echocardiographic parameters.

Methods

Eighty-three athletes (mean age = 29.7 ± 7.9) without history of cardiac disease or other chronic diseases such as hypertension, diabetes mellitus, kidney failure were prospectively included in our study. 73.5% (n = 61) of them were male. Participants were divided into two groups; participants who use protein supplementation regularly was defined as group 1 (n = 33); did not use protein supplementation was defined as group 2 (n = 50). In addition to Standard 2D echocardiographic measurements, left ventricle global longitidunal strain (LvGLS), right ventricle global longitidunal strain (RvGLS), right ventricle free wall strain (RvFWS), left atrium strain and strain rate were analyzed with Vivid E9, offline using a customized software package (Echo Pac for PC, GE Vingmed) (Figure 1).

Results

Diameter of interventricular wall was higher in group 1 (10.1 ± 1.0 vs 9.5 ± 1.2, p = 0.022). Systolic peak ejection velocity of the mitral valve medial annulus is higher in group 1 than group 2 (0.09 ± 0.1 vs 0.08 ± 0.1, p < 0.001). Late diastolic velocity of the mitral valve medial annulus is higher in the group 1 (0.09 ± 0.02 vs 0.08 ± 0.02, p = 0.015). LvGLS which was the indicator of left ventricular deformation was significantly higher in the group 1 (-19.49 ± 1.9 vs -18.45 ± 2.2, p = 0.030). Although RvGLS was higher in the group 1, there was no statistically significant difference (-22.93 ± 4.52 vs -21.07 ± 5.02, p = 0.083).

Conclusion

In recent years protein supplementation usage increases in young adults and athletes. In our study, although there was no statistically significant difference with left ventricular ejection fraction, LvGLS which is the early indicator of LV systolic functions better in the athletes who used protein supplementation. Further studies are needed to evaluate the long term effects of protein supplements on the heart.

P777 Effects of chronic cigarette smoking on left ventricle, left atrium and right ventricle strain parameters with 2D speckle tracking echocardiography

Funding Acknowledgements

None

Background

Cigarette smoking effects myocardium with several mechanisms such as sympathetic nervous system activation, oxidative stress and endothelial dysfunction. Chronic smokers have an increased risk of morbidity and mortality associated with adverse cardiac events. Echocardiography is the well-established non-invasive diagnostic tool for the assessment of cardiac systolic and diastolic functions. 2D speckle tracking echocardiography (STE) has been widely used for this purpose in recent years.

Purpose

The aim of this study is to compare the left ventricle, left atrium and right ventricle systolic functions with 2D speckle tracking echocardiography in chronic smokers and non-smoker healthy population.

Method

40 healthy participant (mean age 33.4 ± 10.0) without smoking history, 42 healthy participant (mean age 33.9 ± 9.2) who had smoking history at least 3 years without history of cardiac disease or any other chronic diseases such as hypertension, diabetes mellitus, kidney failure were prospectively included. In addition to Standard 2D echocardiographic measurements, left ventricular global longitidunal strain (LvGLS), right ventricular global longitidunal strain (RvGLS), left atrial strain and strain rate were analyzed with Vivid E9, offline using a customized software package.

Results

Smokers had lower peak early diastolic velocity (E) and E/A (late diastolic velocity) ratio in mitral inflow (0.70 ± 0.13 vs 0.77 ± 0.13, p = 0.023; 1.47 ± 0.44 vs 1.73 ± 0.44, p = 0.011; respectively). Peak early diastolic velocity of mitral valve medial annulus and E’/A’ ratio (0.11 ± 0.02 vs 0.12 ± 0.02, p = 0.023; 1.20 ± 0.37 vs 1.40 ± 0.46, p = 0.039; respectively) was lower in smokers. LvGLS and RvGLS were significantly impaired in smokers (-17.65 ± 3.01 vs -19.21 ± 2.52, p = 0.013; -18.96 ± 4.47 vs -21.06 ± 4.58, p = 0.039; respectively). Although εs, reservoir phase strain of left atrium; εe, conduit phase strain of left atrium; εa, contractile phase strain of left atrium were similar between two groups, εe/εa was significantly lower in smokers than non-smokers (1.32 ± 0.59, 1.63 ± 0.63, p = 0.026).

Conclusion

Impaired RV deformation was found in chronic cigarette smokers. Besides standardized diastolic dysfunction parameters εe/εa might be used for the early indicator of diastolic dysfunction. Although there was no statistically significant difference with left ventricular ejection fraction between smokers and non-smokers, LvGLS which is the early indicator of LV systolic dysfunction in chronic smokers might be used for the early assesment of LV systolic impairment.

Abstract P777 figure 1

Melanoma arising in chronic ulceration associated with lymphoedema

Chronic ulceration can be complicated by development of a malignancy. The most frequent associated malignances are squamous cell carcinoma and basal cell carcinoma, although melanoma, leiomyosarcoma and adenocarcinoma are less commonly seen. Chronic lymphoedema may also predispose to development of some malignancies, including lymphangiosarcoma, squamous cell carcinoma and Kaposi's sarcoma. Here, we report the case of a 77-year-old man with primary lymphoedema, who developed melanoma in a chronic foot ulcer of 60 years' duration. The patient underwent wide excision for the melanoma, and remains free from metastases at 1-year follow up.