Cardiopulmonary disease as sequelae of long-term COVID-19: Current perspectives and challenges

COVID-19 infection primarily targets the lungs, which in severe cases progresses to cytokine storm, acute respiratory distress syndrome, multiorgan dysfunction, and shock. Survivors are now presenting evidence of cardiopulmonary sequelae such as persistent right ventricular dysfunction, chronic thrombosis, lung fibrosis, and pulmonary hypertension. This review will summarize the current knowledge on long-term cardiopulmonary sequelae of COVID-19 and provide a framework for approaching the diagnosis and management of these entities. We will also identify research priorities to address areas of uncertainty and improve the quality of care provided to these patients.

Effects of Flooring Types on Growth Performance, Behaviour and Health of Dairy Calves

In this study, perforated rubber mats (PRM), concrete floor bedded with long wheat straw (CLS and concrete floor bedded with wheat straw (CS) were compared as flooring types for dairy calves. Growth, feed efficiency ratio, gains in body measurements, some behavioural activities as well as faecal scores, bedding scores and calf’s cleanliness scores of the dairy calves were evaluated for 6 months. Overall growth rate differed significantly due to types of floor, and total weight gains of the dairy calves in PRM group was 7.0% and 16.0% higher than those of calves in CLS and CS groups respectively. However, differences with regard to the amount of dry matter of milk, concentrate as well as total dry matter of the feeds consumed per kg of weight gain during pre-weaning and post-weaning periods among the PRM, CS and CLS groups were not statistically significant. When, gains in linear body measurements were evaluated, total gains in height at withers, body length, chest depth and heart girth of the calves in PRM group were superior to those in CLS and CS groups. The calves in PRM group had high growth rate along with high percentage of time spent for lying behaviour which is one the most significant activities among the behaviours of the calves. The calves kept on PRM group exhibited 52.6% and 45.5% higher percentage of time spent for lying behaviour than those in CS and CLS groups respectively. Data regarding the bedding scores and calf's cleanliness scores also revealed that the PRM flooring was the cleanest and driest one compared to the other flooring types, and the calves in the PRM group were cleaner than those in CLS and CS groups. Calves in PRM group exhibited significantly (P<0.01) lover faecal consistency scores than those in CLS and CS groups. In conclusion, based upon growth rate, feed efficiency ratio, behavioural parameters as well as the bedding scores, calf's cleanliness scores and faecal consistency scores, PRM is preferable to CLS and CS floorings for individual dairy calves' pens.

Burden of atrial fibrillation in patients with rheumatic diseases

BACKGROUND

Studies have suggested that atrial fibrillation (AF) in patients with rheumatic diseases (RD) may be due to inflammation.

AIM

To determine the highest association of AF among hospitalized RD patients and to determine morbidity and mortality associated with AF in hospitalized patients with RD.

METHODS

The National inpatient sample database from October 2015 to December 2017 was analyzed to identify hospitalized patients with RD with and without AF. A subgroup analysis was performed comparing outcomes of AF among different RD.

RESULTS

The prevalence of AF was 23.9% among all patients with RD (n = 3949203). Among the RD subgroup, the prevalence of AF was highest in polymyalgia rheumatica (33.2%), gout (30.2%), and pseudogout (27.1%). After adjusting for comorbidities, the odds of having AF were increased with gout (1.25), vasculitis (1.19), polymyalgia rheumatica (1.15), dermatopolymyositis (1.14), psoriatic arthropathy (1.12), lupus (1.09), rheumatoid arthritis (1.05) and pseudogout (1.04). In contrast, enteropathic arthropathy (0.44), scleroderma (0.96), ankylosing spondylitis (0.96), and Sjorgen’s syndrome (0.94) had a decreased association of AF. The mortality, length of stay, and hospitalization costs were higher in patients with RD having AF vs without AF. Among the RD subgroup, the highest mortality was found with scleroderma (4.8%), followed by vasculitis (4%) and dermatopolymyositis (3.5%).

CONCLUSION

A highest association of AF was found with gout followed by vasculitis, and polymyalgia rheumatica when compared to other RD. Mortality was two-fold higher in patients with RD with AF.

Potential specific therapies in COVID-19

COVID-19 has grown into a global pandemic that has strained healthcare throughout the world. There is a sense of urgency in finding a cure for this deadly virus. In this study, we reviewed the empiric options used in common practice for COVID-19, based on the literature available online, with an emphasis on human experiences with these treatments on severe acute respiratory syndrome-associated coronavirus (SARS-COV-1) and other viruses. Convalescent blood products are the most promising potential treatment for use in COVID-19. The use of chloroquine or hydroxychloroquine (HCQ), remdesivir, and tocilizumab are some of the other promising potential therapies; however, they are yet to be tested in randomized clinical trials (RCTs). The use of lopinavir-ritonavir did not prove beneficial in a large RCT. The use of corticosteroids should be avoided in COVID-19 pneumonia unless used for other indications, based on the suggestion of harm in patients with SARS-COV-1 and Middle Eastern Respiratory Syndrome (MERS) infection. The reviews of this paper are available via the supplemental material section.