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Elamragy A, Samir A, Maher A, Rizk H, Meshaal M. Infective endocarditis presentations during the COVID-19 pandemic: have they paid an untold toll? Glob Cardiol Sci Pract 2024; 2024:e202411. [PMID: 38746068 PMCID: PMC11090171 DOI: 10.21542/gcsp.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 05/16/2024] Open
Abstract
Background: COVID-19 caused restrictions and re-allocation of medical resources among all healthcare services. During the peak of the pandemic, several unrelated-yet critical-conditions had silently taken their toll. Infective endocarditis (IE), owing to its non-specific clinical presentation, may have been largely mislabeled as COVID-19 in a number of cases. Results: This retrospective observational study reviewed all IE presentations at an IE unit in a university hospital during the peak of COVID-19. Patient characteristics, courses, and outcomes were compared with historical controls from our IE database published before the COVID era. We identified 30 IE cases [Group A] during the COVID-19 peak in our region (June 2021 to June 2022), with a 25% decrease compared to the usual annual rate. This is in contrast to the expected surge during the pandemic. Compared with group B (398 published IE cases from our database), group A had significantly longer symptoms-to-presentation intervals (60 [31-92] vs. 28 [14-72] days, p = 0.01). Male sex dominated both groups, but group A had significantly less pre-existing structural heart disease. Despite the more liberal use of empirical antibiotics in the COVID-era, group-A had lower rates of culture-negative IE. Compared to group B, group A demonstrated a better response to medical therapy, fewer arterial embolizations, fewer indications for surgery, and fewer overall complications, except for increased acute kidney injury. This can be explained by the abundant use of non-steroidal anti-inflammatory drugs. The data analysis strongly suggests that there might have been a natural selection or selection bias of IE patients with favorable profiles to survive the pandemic to the appropriate diagnosis. Conclusions: The diagnosis of IE and commencing the appropriate workup were significantly undermined during the COVID-19 pandemic. The inexplicable decline in IE referral rate and the favorable outcomes witnessed during the pandemic strongly suggest a referral bias and natural selection of those who survived the pandemic to the appropriate IE diagnosis.
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Affiliation(s)
- Ahmed Elamragy
- Kasralainy Medical School, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmad Samir
- Kasralainy Medical School, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Maher
- Kasralainy Medical School, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hussein Rizk
- Kasralainy Medical School, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Meshaal
- Kasralainy Medical School, Faculty of Medicine, Cairo University, Cairo, Egypt
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2
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Maselli F, Storari L, Mourad F, Barbari V, Signorini M, Signorelli F. Headache, Loss of Smell, and Visual Disturbances: Symptoms of SARS-CoV-2 Infection? A Case Report. Phys Ther 2023; 103:7044658. [PMID: 37116462 DOI: 10.1093/ptj/pzad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/24/2022] [Accepted: 12/26/2022] [Indexed: 04/30/2023]
Abstract
OBJECTIVE The purpose of this case report is to describe the main components of the history and physical examination that led to idiopathic intracranial hypertension differential diagnosis, which initially was investigated as COVID-19. METHODS (CASE DESCRIPTION) A 28-year-old woman complaining of constant headache and loss of smell and taste was suspected as SARS-CoV-2 infection by her general practitioner. She underwent 3 molecular swab tests, all negative, then decided to seek her physical therapist for relieving headache. RESULTS The full cranial nerve examination revealed impaired olfactory (CNI), abducens (CN VI), and facial (CN VII) nerves, leading the physical therapist to refer the patient to a neurosurgeon for a suspected central nervous system involvement. The neurosurgeon prescribed a detailed MRI and an ophthalmologic examination, which allowed for the final diagnosis of idiopathic intracranial hypertension. CONCLUSION An urgent lumbo-peritoneal shunting surgery resolved the patient's symptoms and saved her sight. Despite the ongoing COVID-19 pandemic, health care professionals must pay attention to properly investigating patients' signs and symptoms using comprehensive clinical reasoning, considering the screening for referral to specialist medical attention. IMPACT A thorough physical examination is required for every patient even if patients' signs and symptoms are in line with apparent common and widespread pathologies. Cranial nerve evaluation is an essential component of the physical therapist assessment and decision-making process. The ongoing pandemic highlighted the fundamental assistance of physical therapists toward physicians in the screening and management of musculoskeletal diseases.
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Affiliation(s)
- Filippo Maselli
- Human Neurosciences Department, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Storari
- Human Neurosciences Department, Sapienza University of Rome, Rome, Italy
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health and Sport Sciences Research Institute A.s.b.l., Differdange, Luxembourg
| | - Valerio Barbari
- Human Neurosciences Department, Sapienza University of Rome, Rome, Italy
| | - Manuel Signorini
- Department of Radiology, ULSS 9 Scaligera, Mater Salutis Hospital, Legnago, Italy
| | - Francesco Signorelli
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Division of Neurosurgery, University "Aldo Moro" of Bari, Bari, Italy
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Freund O, Azolai L, Sror N, Zeeman I, Kozlovsky T, Greenberg SA, Epstein Weiss T, Bornstein G, Tchebiner JZ, Frydman S. Diagnostic delays among COVID-19 patients with a second concurrent diagnosis. J Hosp Med 2023; 18:321-328. [PMID: 36779316 DOI: 10.1002/jhm.13063] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/22/2023] [Accepted: 02/02/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND Little is known about the effect of a new pandemic on diagnostic errors. OBJECTIVE We aimed to identify delayed second diagnoses among patients presenting to the emergency department (ED) with COVID-19. DESIGNS An observational cohort Study. SETTINGS AND PARTICIPANTS Consecutive hospitalized adult patients presenting to the ED of a tertiary referral center with COVID-19 during the Delta and Omicron variant surges. Included patients had evidence of a second diagnosis during their ED stay. MAIN OUTCOME AND MEASURES The primary outcome was delayed diagnosis (without documentation or treatment in the ED). Contributing factors were assessed using two logistic regression models. RESULTS Among 1249 hospitalized COVID-19 patients, 216 (17%) had evidence of a second diagnosis in the ED. The second diagnosis of 73 patients (34%) was delayed, with a mean (SD) delay of 1.5 (0.8) days. Medical treatment was deferred in 63 patients (86%) and interventional therapy in 26 (36%). The probability of an ED diagnosis was the lowest for Infection-related diagnoses (56%) and highest for surgical-related diagnoses (89%). Evidence for the second diagnosis by physical examination (adjusted odds ratios [AOR] 2.35, 95% confidence interval [CI] 1.20-4.68) or by imaging (AOR 2.10, 95% CI 1.16-3.79) were predictors for ED diagnosis. Low oxygen saturation (AOR 0.38, 95% CI 0.18-0.79) and cough or dyspnea (AOR 0.48, 95% CI 0.25-0.94) in the ED were predictors of a delayed second diagnosis.
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Affiliation(s)
- Ophir Freund
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lee Azolai
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Neta Sror
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idan Zeeman
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tom Kozlovsky
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon A Greenberg
- Emergency Department, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Tali Epstein Weiss
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Bornstein
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Zvi Tchebiner
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shir Frydman
- Internal Medicine B, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sakata T, Harada K, Aoyama Y, Saito S, Narita K, Kario K. Infective Endocarditis Revealed after Resolution of COVID-19 Infection. Intern Med 2022; 61:3537-3540. [PMID: 36104198 PMCID: PMC9790774 DOI: 10.2169/internalmedicine.0307-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A 34-year-old previously healthy Japanese woman was diagnosed with COVID-19 and treated with remdesivir and dexamethasone. She was discharge but returned the next day due to acute myocardial infarction. Conservative treatment was selected because of an embolic occlusion in the distal portion. Contrast-enhanced computed tomography and brain magnetic resonance imaging revealed a right renal infarction and multiple cerebral embolisms, respectively; she had a fever of 38.9°C that night. Blood culture was positive for methicillin-susceptible Staphylococcus aureus. Transthoracic echocardiography revealed an 11-mm vegetation on the posterior mitral valve leaflet. Native mitral valve infective endocarditis causing multiple embolizations was diagnosed. She underwent surgical mitral valve replacement.
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Affiliation(s)
- Tomohisa Sakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Japan
| | - Kenji Harada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Japan
| | - Yutaka Aoyama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Japan
| | - Shunsuke Saito
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Japan
| | - Keisuke Narita
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Japan
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5
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Torun S, Karaman I. Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report. Front Med (Lausanne) 2022; 9:844609. [PMID: 35360748 PMCID: PMC8960299 DOI: 10.3389/fmed.2022.844609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background Rheumatoid arthritis (RA) is a systemic inflammatory connective tissue disease that affects 1–2% of the population worldwide. Pulmonary manifestations including interstitial lung disease (ILD), airway disease, pleural and vascular disease can be seen in up to 30–40% of patients with RA, which are recognized as the second most frequent cause of death in RA patients. The simultaneous occurrence of COVID-19 in RA patients with or without ILD, and the similarities and differences between RA-related ILD and COVID-19 lung findings have been reported in the literature. However, there was no reported case on differentiation of clinical findings of a patient with RA exacerbation causing a new diagnosis of ILD during the pandemic conditions. Case Presentation Here, we presented a patient with RA who was misdiagnosed as COVID-19 twice due to non-specific respiratory symptoms and ground-glass opacities observed in high-resolution CT. The misdiagnosis led to a delayed diagnosis of ILD and prolonged pulmonary symptoms. Discussion Clinicians must critically review patients throughout the diagnostic workup by thinking other diseases besides COVID-19, particularly in the absence of a confirmatory result. The link between ILD or ILD exacerbation and COVID-19 remains to be determined. While research continues in the field, it is important to consider the importance of COVID-19 in cases of ILD exacerbation, and vice versa. Conclusion Distinguishing lung imaging findings of COVID-19 from ILD is a major concern. Even though the primary manifestation of COVID-19 consists of respiratory symptoms, clinicians should be vigilant for other common conditions having the same symptoms. Clinicians should carefully distinguish a differential diagnosis between COVID-19 and a flare of rheumatic disease.
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Affiliation(s)
- Serife Torun
- Department of Pulmonary Diseases, Konya Training and Research Hospital, Konya, Turkey
- *Correspondence: Serife Torun,
| | - Irem Karaman
- School of Medicine, Bahcesehir University, Istanbul, Turkey
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6
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Dueña L, Varona J, Bereciartua E, López L. In the shadow of the pandemic. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:39-41. [PMID: 34764066 DOI: 10.1016/j.eimce.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/04/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Luis Dueña
- Servicio de Medicina Interna, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain.
| | - Jimena Varona
- Servicio de Medicina Interna, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - Elena Bereciartua
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - Leyre López
- Servicio de Microbiología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
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7
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Abdoli A, Falahi S, Kenarkoohi A. COVID-19-associated opportunistic infections: a snapshot on the current reports. Clin Exp Med 2022; 22:327-346. [PMID: 34424451 PMCID: PMC8381864 DOI: 10.1007/s10238-021-00751-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/30/2021] [Indexed: 02/07/2023]
Abstract
Treatment of the novel Coronavirus Disease 2019 (COVID-19) remains a complicated challenge, especially among patients with severe disease. In recent studies, immunosuppressive therapy has shown promising results for control of the cytokine storm syndrome (CSS) in severe cases of COVID-19. However, it is well documented that immunosuppressive agents (e.g., corticosteroids and cytokine blockers) increase the risk of opportunistic infections. On the other hand, several opportunistic infections were reported in COVID-19 patients, including Aspergillus spp., Candida spp., Cryptococcus neoformans, Pneumocystis jiroveci (carinii), mucormycosis, Cytomegalovirus (CMV), Herpes simplex virus (HSV), Strongyloides stercoralis, Mycobacterium tuberculosis, and Toxoplasma gondii. This review is a snapshot about the main opportunistic infections that reported among COVID-19 patients. As such, we summarized information about the main immunosuppressive agents that were used in recent clinical trials for COVID-19 patients and the risk of opportunistic infections following these treatments. We also discussed about the main challenges regarding diagnosis and treatment of COVID-19-associated opportunistic infections (CAOIs).
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Affiliation(s)
- Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran ,Jahrom University of Medical Sciences, Ostad Motahari Ave, POBox 74148-46199, Jahrom, Iran
| | - Shahab Falahi
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Azra Kenarkoohi
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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8
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Araiza-Garaygordobil D, Montalto C, Martinez-Amezcua P, Cabello-Lopez A, Gopar-Nieto R, Alabrese R, Almaghraby A, Catoya-Villa S, Chacon-Diaz M, Kaufmann CC, Corbi-Pascual M, Deharo P, El-Tahlawi M, Elgohari-Abdelwahab A, Guerra F, Jarakovic M, Martinez-Gomez E, Moderato L, Montero S, Morejon-Barragan P, Omar AM, Jorge-Pérez P, Przybyło P, Selim E, Sinan UY, Stratinaki M, Tica O, Trêpa M, Uribarri A, Uzokov J, Wilk K, Czerwińska-Jelonkiewicz K, Sionis A, Gierlotka M, Leonardi S, Krychtiuk KA, Tavazzi G. Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: a multinational study. QJM 2021; 114:642-647. [PMID: 33486512 PMCID: PMC7928691 DOI: 10.1093/qjmed/hcab013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS). AIM To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared. DESIGN Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period. RESULTS A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different. CONCLUSIONS Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.
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Affiliation(s)
- D Araiza-Garaygordobil
- From the Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, México
| | - C Montalto
- Department of Cardiology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - P Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, USA
| | - A Cabello-Lopez
- Occupational Health Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, México
| | - R Gopar-Nieto
- From the Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, México
| | - R Alabrese
- Department of Cardiology, Parma University Hospital, Italy
| | - A Almaghraby
- Department of Cardiology and Angiology, University of Alexandria, Egypt
| | - S Catoya-Villa
- Department of Cardiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M Chacon-Diaz
- Cardiology Clinic and Intensive Cardiac Care, Instituto Nacional Cardiovascular INCOR-Essalud, Lima, Perú
| | - C C Kaufmann
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria
| | - M Corbi-Pascual
- Coronary Care Unit, Cardiology Service, Albacete General Hospital, Albacete
| | - P Deharo
- Aix Marseille University, Inserm, Inra, C2VN, Marseille, France
| | - M El-Tahlawi
- Department of Cardiology, Zagazig University Hospital, Zagazig, Egypt
| | | | - F Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Ospedali Riuniti “Umberto I—Lancisi—Salesi”, Ancona, Italy
| | - M Jarakovic
- Cardiology Intensive Care Unit, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - E Martinez-Gomez
- Acute Cardiovascular Care Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - L Moderato
- Cardiology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - S Montero
- Acute Cardiovascular Care Unit, Cardiology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - P Morejon-Barragan
- Coronary Care Unit, Cardiology Service, UAI University Hospital, Buenos Aires, Argentina
| | - A M Omar
- Tripoli University Hospital, Tripoli, Libya
| | - P Jorge-Pérez
- Acute Cardiovascular Care Unit, Cardiology Department, Canary Islands University Hospital, Tenerife, Spain
| | - P Przybyło
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - E Selim
- Coronary Care Unit, Emergency Department and Cardiology Clinic, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - U Y Sinan
- Department of Cardiology, PH and ACHD, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkey
| | - M Stratinaki
- Cardiology Department, General Hospital Venizeleio, Heraklion, Crete, Greece
| | - O Tica
- Faculty of Medicine and Pharmacy, University of Oradea; Emergency County Clinical Hospital of Oradea, Romania
| | - M Trêpa
- Cardiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Uribarri
- Cardiovascular Care Unit, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - J Uzokov
- Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | - K Wilk
- Department of Cardiology, Medical University of Białystok, Bialystok, Poland
| | - K Czerwińska-Jelonkiewicz
- Intensive Therapy Unit, Harefield Hospital, Royal Brompton & Harefield NHS Fundation Trust, London, UK
| | - A Sionis
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - S Leonardi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology-Fondazione IRCCS Policlinico San Matteo, and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - K A Krychtiuk
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Austria
| | - G Tavazzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy
- Address correspondence to Dr Guido Tavazzi, MD, PhD, University of Pavia, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences; Anaesthesia, Intensive Care and Pain Therapy, Fondazione IRCCS Policlinico San Matteo, Anestesia e Rianimazione I, DEA Piano-1, Viale Golgi 19, 27100 Pavia, Italy.
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9
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Miyagami T, Uehara Y, Harada T, Watari T, Shimizu T, Nakamura A, Ogura N, Kushiro S, Masuyama K, Kanai Y, Yang KS, Naito T. Delayed treatment of bacteremia during the COVID-19 pandemic. Diagnosis (Berl) 2021; 8:327-332. [PMID: 33470952 DOI: 10.1515/dx-2020-0114] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 12/15/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Coronavirus disease (COVID-19) blindness, that is, the excessive consideration of the disease in diagnosis, has reportedly led to delayed diagnosis of some diseases. We compared several clinical measures between patients admitted for bacteremia during the two months of the COVID-19 pandemic and those admitted during the same period in 2019. We hypothesized that the pandemic has led to delayed treatment of bacteremia. METHODS This retrospective observational study compared several measures undertaken for patients who visited the emergency unit in two hospitals between March 1 and May 31, 2020, during the COVID-19 pandemic and whose blood cultures tested positive for bacteremia with those for corresponding patients treated during the same period in 2019. The primary measure was time from consultation to blood culture/antimicrobials. RESULTS We included 29 eligible patients from 2020 and 26 from 2019. In 2020, the time from consultation to antimicrobial administration was significantly longer than in 2019 (mean [range], 222 [145-309] min vs. 139 [102-179] min, p=0.002). The frequency of chest computed tomography (CT) was significantly higher in 2020 (96.6 vs. 73.1%, p=0.021). Significant differences were not observed in the time to blood culture or chest CT preceding the blood culture between the two periods. CONCLUSIONS Our findings suggested that due to the COVID-19 epidemic/pandemic, focusing on the exclusion of its infection using CT scans leads to an overall delay in the diagnosis and treatment of bacteremia. Medical providers must be aware of COVID-19 blindness and evaluate patients objectively based on rational criteria and take appropriate action.
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Affiliation(s)
- Taiju Miyagami
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuki Uehara
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.,Department of Clinical Laboratory, St Luke's International Hospital, Tokyo, Japan
| | - Taku Harada
- Division of General Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan.,Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Takashi Watari
- Postgraduate Clinical Training Center, Shimane University Hospital, Izumo City, Shimane, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Ayako Nakamura
- Department of Clinical Laboratory, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Naoya Ogura
- Department of Clinical Laboratory, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Seiko Kushiro
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Katsutoshi Masuyama
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshinori Kanai
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kwang-Seok Yang
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
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Abstract
The article highlights the pathogenesis, clinical manifestations of lesions of the central and peripheral nervous system that have arisen or persist in patients in the postcoid period (Long-COVID-19). Their correct assessment, the use of effective methods of complex treatment, targeted neurorehabilitation contribute to the reversibility of functional disorders, prevention, reduction of disability, improvement of quality of life indicators, prevention of the progression of cognitive, emotional, behavioral disorders initiated by SARS-CoV-2.
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11
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Kusumawardhani N, Dewi IP, Dharmadjati BB. Extracorporeal Membrane Oxygenation Used in Acute Respiratory Distress Syndrome with COVID-19: A Systematic Review and Meta-Analysis. J Saudi Heart Assoc 2021; 33:177-185. [PMID: 34307014 PMCID: PMC8294133 DOI: 10.37616/2212-5043.1261] [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: 05/26/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction Protective pulmonary mechanical ventilation, higher positive end-expiratory pressure, neuromuscular blockade, prone positioning, and pulmonary recruitment procedures are all strategies in severe COVID-19 cases. Extracorporeal Membrane Oxygenation (ECMO) can be seen as an alternative to traditional treatment in certain patients when conventional therapy fails. We present a study that intends to systematically review and meta-analysis ECMO use in COVID-19 patients. Methods We search major medical databases (Cochrane Library, PubMed, EMBASE, MedRxiv) for clinical trials that were released between January 2020 until February 2021, had full-text availability, were written in English, and humans studies. We used National Heart, Lung, and Blood Institute (NHLBI) quality evaluation methods for retrospective cohort and cross-sectional studies to evaluate the quality of the articles. In addition, we used the Mantel–Haenszel random-effects meta-analysis of using RevMan 5.4. Results A total of 33 studies involving 3090 patients were included in the systematic review and six studies in the meta-analysis. There were 828 patients admitted to the ICU, of which 779 patients had ARDS (94%). Of the total study, 527 patients received ECMO therapy (17%). ARDS incidence was associated with complications during ICU care compared to non-ICU care (OR 107.98; 95% CI 55.51–210.03; p < 0.00001). Indirect comparisons, the incidence of mortality was associated with ECMO compared with non-ECMO (OR 15.79; 95% CI 4.21–59.28; p < 0.0001). Conclusion The incidence of ARDS was associated with complications during ICU stay, and the incidence of mortality was associated with ECMO. Further study about mechanisms involving illness and death of patients from COVID-19 is needed.
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Affiliation(s)
- Novia Kusumawardhani
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University-Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Ivana Purnama Dewi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University-Dr. Soetomo General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia
| | - Budi Baktijasa Dharmadjati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University-Dr. Soetomo General Hospital, Surabaya, Indonesia
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12
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Dueña L, Varona J, Bereciartua E, López L. In the shadow of the pandemic. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00071-9. [PMID: 33867190 DOI: 10.1016/j.eimc.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Luis Dueña
- Servicio de Medicina Interna, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
| | - Jimena Varona
- Servicio de Medicina Interna, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España
| | - Elena Bereciartua
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España
| | - Leyre López
- Servicio de Microbiología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España
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13
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Lapostolle F, Vianu I, Petrovic T, Adnet F. COVID-19 epidemic: anticoagulants treatments, another victim. Acta Cardiol 2021; 76:222-223. [PMID: 33308093 DOI: 10.1080/00015385.2020.1810916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Frédéric Lapostolle
- SAMU 93 – UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, Bobigny, France
| | - Isabelle Vianu
- SAMU 93 – UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, Bobigny, France
| | - Tomislav Petrovic
- SAMU 93 – UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, Bobigny, France
| | - Frédéric Adnet
- SAMU 93 – UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, Bobigny, France
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14
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Rodriguez-Ramos MA. Effect of COVID-19 Pandemic on Performance Measures in Acute Myocardial Infarction. ACTA ACUST UNITED AC 2021; 61:52-56. [PMID: 33849419 DOI: 10.18087/cardio.2021.3.n1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 02/16/2021] [Indexed: 11/18/2022]
Abstract
Objective To assess performance measures of attention of STEMI in Coronary Intensive Care Unit in General Hospital Camilo Cienfuegos.Methods Admitted patients with STEMI, from February-April 2020, were compared with patients from similar period from 2015-2019, and patients from January 2019 to January 2020. Primary endpoint were performance measures according to the 2017 AHA / ACC Clinical Performance and Quality Measures for Adults with STEMI document, and secondary endpoint were all-cause in-hospital mortality and major acute coronary events.Results Only 35 patients were admitted from February-April 2020. When comparing with similar periods from recent years, in-hospital death (8.3 % vs. 20 %; p=0.03), major complications (38.7 % vs. 57.1 %; p=0.03), and cardiogenic shock (6.9 % vs. 17.4 %; p=0.04) were significantly higher. When comparing with 2019 and January 2020, in-hospital death (9.6 %; p=0.04), and major complications (35.8 % p=0.03) were significantly higher in February-April 2020; however, there was no difference in prevalence of cardiogenic shock (8 %; p=0.12).Conclusion COVID-19 pandemic had decreased prevalence of STEMI, as well as some performance measures of attention in this center.
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15
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Tomar BS, Singh M, Nathiya D, Sharma A, Sharma E, Bareth H, Suman S, Ruparelia DP, Patel JB, Gajera VK. Prevalence of Symptoms in Patients Discharged from COVID Care Facility of NIMS Hospital: Is RT PCR Negativity Truly Reflecting Recovery? A Single-Centre Observational Study. Int J Gen Med 2021; 14:1069-1078. [PMID: 33790636 PMCID: PMC8006813 DOI: 10.2147/ijgm.s295499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To assess the prevalence of post-COVID symptoms in patients with recovered COVID-19 (nasopharyngeal RT PCR negative) who were discharged from an acute COVID care facility at a tertiary care teaching hospital in North India. METHODS This study was an observational study with retrospective data collection, conducted in the COVID follow-up clinic, a combined clinic of medicine and endocrinology. Patients discharged from the acute COVID care facility were recruited after 14 days of discharge if they fulfilled inclusion and exclusion criteria. The retrospective data was collected from the hospital records/EMR and analysed by the SPSSv23. RESULTS Fifty patients, who fulfilled the inclusion and exclusion criteria, were included in the study. The Mean age of patients was 53.4±13.8 years (range 28-77). Seventy six percent were male, and 38% had type 2 diabetes. Fever (94%), cough (78%) and breathlessness (68%), were the most common symptoms at presentation to acute care facility. Oxygen saturation at presentation had a negative correlation with D-Dimer, age, and C reactive protein. When patients were evaluated clinically, after 14 days (range 15 to 50 days) of the discharge, 82% of patients had at least one persistent symptom. Fatigue (74%) was the most common symptoms in follow-up followed by breathlessness (44%), and muscle weakness (36%). Two patients had persistent fever, even after negative RT PCR status. CONCLUSION Patients discharged from the acute COVID care facility had a high prevalence of post-COVID symptoms even after 14 days.
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Affiliation(s)
- Balvir S Tomar
- Institute of Gastroenterology, Hepatology & Transplant, Nims University Rajasthan, Jaipur, India
| | - Mahaveer Singh
- Department of Endocrinology, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, 303121, India
| | - Deepak Nathiya
- Department of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, India
| | - Abhishek Sharma
- Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, India
| | - Eshan Sharma
- Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, India
| | - Hemant Bareth
- Department of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, India
| | - Supriya Suman
- Department of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, India
| | - Darshan Purshotambhai Ruparelia
- Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, India
| | - Jaykumar Bharatbhai Patel
- Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, India
| | - Vikrant Kantilal Gajera
- Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, India
| | - On Behalf of the NIMS COVID 19 Investigator Group
- Institute of Gastroenterology, Hepatology & Transplant, Nims University Rajasthan, Jaipur, India
- Department of Endocrinology, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, 303121, India
- Department of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, India
- Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, India
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16
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Bontempi L, Cerini M, Salghetti F, Fabbricatore D, Nozza C, Campari M, Valsecchi S, Curnis A. Use of a novel implantable cardioverter-defibrillator multisensor algorithm for heart failure monitoring in a COVID-19 patient: A case report. Clin Case Rep 2021; 9:1178-1182. [PMID: 33768806 PMCID: PMC7981691 DOI: 10.1002/ccr3.3721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
We report the case of a patient implanted with an implantable defibrillator endowed with a multisensor algorithm for heart failure monitoring. Automatic measurement of multiple clinical variables allowed to detect impending heart failure decompensation and showed its ability to facilitate differential diagnosis in the context of the current COVID-19 pandemic.
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Affiliation(s)
- Luca Bontempi
- Chair and Unit of CardiologyUniversity of BresciaSpedali Civili HospitalBresciaItaly
| | - Manuel Cerini
- Chair and Unit of CardiologyUniversity of BresciaSpedali Civili HospitalBresciaItaly
| | - Francesca Salghetti
- Chair and Unit of CardiologyUniversity of BresciaSpedali Civili HospitalBresciaItaly
| | - Davide Fabbricatore
- Chair and Unit of CardiologyUniversity of BresciaSpedali Civili HospitalBresciaItaly
| | | | | | | | - Antonio Curnis
- Chair and Unit of CardiologyUniversity of BresciaSpedali Civili HospitalBresciaItaly
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17
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Endara SA, Dávalos GA, Molina GA, Zavala AB, Ponton PM, Brito M, Nieto C, Ullauri VE. COVID-19 infection and cardiac angiosarcoma: a dangerous combination-a case report. THE CARDIOTHORACIC SURGEON 2021; 29:5. [PMID: 38624715 PMCID: PMC7903407 DOI: 10.1186/s43057-021-00042-7] [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: 12/23/2020] [Accepted: 02/09/2021] [Indexed: 11/12/2022] Open
Abstract
Background The COVID-19 pandemic has strained all medical systems, especially in countries like Ecuador, where health services were already limited. These conditions, combined with a deadly and unusual disease, like primary heart angiosarcoma, can lead to severe outcomes. Angiosarcomas represent the most common and aggressive primary malignant heart tumor; regretfully, its clinical manifestations are vague and can be easily missed. Most patients become symptomatic when there is local invasion, embolization, or metastases, leading to late diagnosis and poor survival. High clinical awareness, adequate diagnosis, and prompt treatment are vital in these rare diseases, in which time is of paramount importance. Case presentation We report the case of a 28-year-old female who had cough, hemoptysis, and ground-glass opacities in the CT (computed tomography). Since Ecuador is in the middle of this pandemic, she was misdiagnosed and mistreated. Primary heart angiosarcoma was diagnosed, and regretfully, the patient suffered multiple complications due to diagnosis and died. Conclusion To this day, most cardiac angiosarcomas are found in a late-stage with distal metastasis and advanced local invasion. Sadly, this tumor is frequently missed due to its incidence and broad-spectrum of clinical symptoms. Considering that its manifestations can be misleading, misdiagnosis can occur, especially in pandemic times. Therefore, knowledge of other pathologies prevents COVID-19 from overshadowing other diagnoses, hence preventing delayed diagnosis or even misdiagnosis and consequent adverse outcomes for patients. Supplementary Information The online version contains supplementary material available at 10.1186/s43057-021-00042-7.
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Affiliation(s)
- Santiago A. Endara
- Department of Surgery Division of Cardiothoracic Surgery, Hospital Metropolitano, Av. Mariana de Jesús Oe7/47 y Conclina, Edificio Diagnóstico 2000 tercer piso 3/3, Quito, Ecuador
| | - Gerardo A. Dávalos
- Department of Surgery Division of Cardiothoracic Surgery, Hospital Metropolitano, Av. Mariana de Jesús Oe7/47 y Conclina, Edificio Diagnóstico 2000 tercer piso 3/3, Quito, Ecuador
| | - Gabriel A. Molina
- Universidad San Francisco de Quito (USFQ) & Department of General Surgery, IESS Quito Sur, Quito, Ecuador
| | | | - Patricia M. Ponton
- Department of Internal Medicine, Division of Pathology, Hospital Metropolitano, Quito, Ecuador
| | - Maribel Brito
- Department of Internal Medicine, Division of Pathology, Hospital Metropolitano, Quito, Ecuador
| | - Carlos Nieto
- Department of Internal Medicine, Division of Cardiology, Hospital Metropolitano, Quito, Ecuador
| | - Vladimir E. Ullauri
- Department of Internal Medicine, Division of Cardiology, Hospital Metropolitano, Quito, Ecuador
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18
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Cameli M, Pastore MC, Mandoli GE, D'Ascenzi F, Focardi M, Biagioni G, Cameli P, Patti G, Franchi F, Mondillo S, Valente S. COVID-19 and Acute Coronary Syndromes: Current Data and Future Implications. Front Cardiovasc Med 2021; 7:593496. [PMID: 33585577 PMCID: PMC7876078 DOI: 10.3389/fcvm.2020.593496] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19) pandemic is a global healthcare burden, characterized by high mortality and morbidity rates all over the world. During the outbreak period, the topic of acute coronary syndromes (ACS) has raised several clinical issues, due to the risks of COVID-19 induced myocardial injury and to the uncertainties about the management of these cardiologic emergency conditions, which should be organized optimizing the diagnostic and therapeutic resources and ensuring the maximum protection to healthcare personnel and hospital environment. COVID-19 status should be assessed as soon as possible. Moreover, considerably lower rates of hospitalization for ACS have been reported all over the world, due to patients' hesitations to refer to hospital and to missed diagnosis. As a result, short- and long-term complications of myocardial infarction are expected in the near future; therefore, great efforts of healthcare providers will be required to limit the effects of this issue. In the present review we discuss the impact of COVID-19 pandemic on ACS diagnosis and management, with possible incoming consequences, providing an overview of the available evidence and suggesting future changes in social and clinical approach to ACS.
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Affiliation(s)
- Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.,University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Giulia Biagioni
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Paolo Cameli
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Giuseppe Patti
- University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Federico Franchi
- Department of Medical Biotechnologies, Anesthesia and Intensive Care, University of Siena, Siena, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Serafina Valente
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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19
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Chang WT, Toh HS, Liao CT, Yu WL. Cardiac Involvement of COVID-19: A Comprehensive Review. Am J Med Sci 2021; 361:14-22. [PMID: 33187633 PMCID: PMC7536131 DOI: 10.1016/j.amjms.2020.10.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/16/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. SARS-CoV-2 caused COVID-19 has reached a pandemic level. COVID-19 can significantly affect patients' cardiovascular systems. First, those with COVID-19 and preexisting cardiovascular disease have an increased risk of severe disease and death. Mortality from COVID-19 is strongly associated with cardiovascular disease, diabetes, and hypertension. Second, therapies under investigation for COVID-19 may have cardiovascular side effects of arrhythmia. Third, COVID-19 is associated with multiple direct and indirect cardiovascular complications. Associated with a high inflammatory burden related to cytokine release, COVID-19 can induce vascular inflammation, acute myocardial injury, myocarditis, arrhythmias, venous thromboembolism, metabolic syndrome and Kawasaki disease. Understanding the effects of COVID-19 on the cardiovascular system is essential for providing comprehensive medical care for cardiac and/or COVID-19 patients. We hereby review the literature on COVID-19 regarding cardiovascular virus involvement.
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Affiliation(s)
- Wei-Ting Chang
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Han Siong Toh
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Te Liao
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Liang Yu
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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20
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Pediatric Sepsis in the Time of Coronavirus Disease 2019. Pediatr Crit Care Med 2020; 21:1020-1021. [PMID: 32941294 PMCID: PMC7597757 DOI: 10.1097/pcc.0000000000002586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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21
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Lauridsen MD, Butt JH, Østergaard L, Møller JE, Hassager C, Gerds T, Kragholm K, Phelps M, Schou M, Torp-Pedersen C, Gislason G, Køber L, Fosbøl EL. Incidence of acute myocardial infarction-related cardiogenic shock during corona virus disease 19 (COVID-19) pandemic. IJC HEART & VASCULATURE 2020; 31:100659. [PMID: 33072848 PMCID: PMC7553065 DOI: 10.1016/j.ijcha.2020.100659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/03/2020] [Indexed: 12/13/2022]
Abstract
Aims The hospitalization of patients with MI has decreased during global lockdown due to the COVID-19 pandemic. Whether this decrease is associated with more severe MI, e.g. MI-CS, is unknown. We aimed to examine the association of Corona virus disease (COVID-19) pandemic and incidence of acute myocardial infarction with cardiogenic shock (MI-CS). Methods On March 11, 2020, the Danish government announced national lock-down. Using Danish nationwide registries, we identified patients hospitalized with MI-CS. Incidence rates (IR) and incidence rate ratios (IRR) were used to compare MI-CS before and after March 11 in 2015–2019 and in 2020. Results We identified 11,769 patients with MI of whom 696 (5.9%) had cardiogenic shock in 2015–2019. In 2020, 2132 MI patients were identified of whom 119 had cardiogenic shock (5.6%). The IR per 100,000 person years before March 11 in 2015–2019 was 9.2 (95% CI: 8.3–10.2) and after 8.9 (95% CI: 8.0–9.9). In 2020, the IR was 7.5 (95% CI: 5.8–9.7) before March 11 and 7.7 (95% CI: 6.0–9.9) after. The IRRs comparing the 2020-period with the 2015–2019 period before and after March 11 (lockdown) were 0.81 (95% CI: 0.59–1.12) and 0.87 (95% CI: 0.57–1.32), respectively. The IRR comparing the 2020-period during and before lockdown was 1.02 (95% CI: 0.74–1.41). No difference in 7-day mortality or in-hospital management was observed between study periods. Conclusion We could not identify a significant association of the national lockdown on the incidence of MI-CS, along with similar in-hospital management and mortality in patients with MI-CS.
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Key Words
- CABG, Coronary artery bypass grafting
- CAG, Coronary angiography
- COVID-19
- COVID-19, Corona Virus disease
- Cardiogenic shock
- Corona virus
- ECMO, Extra-corporeal membrane oxygenation
- IABP, Intra-aortic balloon pump
- ICD, International Classification of Diseases
- Incidence
- MI, Acute myocardial infarction
- MI-CS, Acute myocardial infarction-related cardiogenic shock
- Myocardial infarction
- PCI, Percutaneous coronary intervention
- STEMI, ST-segment elevation myocardial infarction
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Affiliation(s)
- M D Lauridsen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J H Butt
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - L Østergaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J E Møller
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - C Hassager
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - T Gerds
- Department of Biostatistics, Copenhagen University, Copenhagen, Denmark.,The Danish Heart Foundation, Copenhagen, Denmark
| | - K Kragholm
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - M Phelps
- The Danish Heart Foundation, Copenhagen, Denmark
| | - M Schou
- Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
| | - C Torp-Pedersen
- Department of Cardiology and Clinical Research, Nordsjaellands Hospital, Hillerød, Denmark
| | - G Gislason
- The Danish Heart Foundation, Copenhagen, Denmark.,Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
| | - L Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - E L Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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22
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Affiliation(s)
- Sukhjinder Singh Nijjer
- Cardiology, Chelsea & Westminster NHS Foundation Trust, London, United Kingdom
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Ricardo Petraco
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Sayan Sen
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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23
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Budhram B, Kobza AO, Mohammed N. Misdiagnosis related to premature diagnostic closure during the COVID-19 pandemic. CMAJ 2020; 192:E1129-E1131. [PMID: 32989025 DOI: 10.1503/cmaj.201426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Brandon Budhram
- Division of General Internal Medicine, McMaster University, Hamilton, Ont.
| | - Alexandra O Kobza
- Division of General Internal Medicine, McMaster University, Hamilton, Ont
| | - Naufal Mohammed
- Division of General Internal Medicine, McMaster University, Hamilton, Ont
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24
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Riley RF, Kereiakes DJ, Mahmud E, Smith TD, Grines C, Henry TD. "Back to the Future" for STEMI?: The COVID-19 Experience. JACC Case Rep 2020; 2:1651-1653. [PMID: 32839761 PMCID: PMC7438036 DOI: 10.1016/j.jaccas.2020.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Robert F. Riley
- Carl and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati, Ohio
| | - Dean J. Kereiakes
- Carl and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati, Ohio
| | - Ehtisham Mahmud
- Division of Cardiovascular Medicine, University of California-San Diego, San Diego, California
| | - Timothy D. Smith
- Carl and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati, Ohio
| | - Cindy Grines
- Northside Hospital Cardiovascular Institute, Atlanta, Georgia
| | - Timothy D. Henry
- Carl and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati, Ohio
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Custodio-Sánchez P, Miranda D, Murillo L. [Impact of the COVID-19 pandemic on ST- elevation myocardial infarction care in Peru]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2020; 1:67-74. [PMID: 38572337 PMCID: PMC10986344 DOI: 10.47487/apcyccv.v1i2.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/25/2020] [Indexed: 04/05/2024]
Abstract
Purpose To compare the number of admissions, clinical features and therapeutic outcomes of patients treated for acute ST-segment elevation myocardial infarction (STEMI), before and after the COVID-19 pandemic state of emergency in Peru. Methods Observational analytical study of retrospective cohorts, derivated from the PEruvian Registry of ST-segment Elevation Myocardial Infarction II (PERSTEMI II). We compared the patients treated for STEMI, between 45 days before and during the first 45 days of the COVID-19 state of emergency in Peru. Results During the first 45 days of the COVID-19 state of emergency, the team found a 59% decrease on the number of admissions for STEMI. There was a larger proportion of patients with high blood pressure and dyslipidemia. We noticed a decreasing trend in the access to reperfusion therapies (73% vs. 66.6%); the fibrinolysis was the most commonly used therapy. The most frequent reason for no reperfusion was the late onset >24 hours (41.7%, p=0.004). There was a trend of time reduction to first medical contact and less ischemia time to reperfusion. A lower incidence of post-infarction heart failure was registered. The mortality was similar in both groups (3.4% vs. 2.7%). Conclusions COVID-19 pandemic in Peru has generated a significant reduction of STEMI admissions and a trend in less use of reperfusion therapies. The late onset of patients was the most common reason of not reperfusion.
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Affiliation(s)
- Piero Custodio-Sánchez
- Servicio de Cardiología. Unidad de Cardiología Intervencionista. Hospital Nacional Almanzor Aguinaga Asenjo Essalud, Chiclayo, Perú. Servicio de CardiologíaUnidad de Cardiología IntervencionistaHospital Nacional Almanzor Aguinaga Asenjo EssaludChiclayoPerú
| | - David Miranda
- Servicio de Cardiología Clínica. Instituto Nacional Cardiovascular INCOR. Lima, Perú.Servicio de Cardiología ClínicaInstituto Nacional Cardiovascular INCORLimaPerú
| | - Luis Murillo
- Médico residente de Cardiología. Instituto Nacional Cardiovascular INCOR. Lima, Perú.Médico residente de CardiologíaInstituto Nacional Cardiovascular INCORLimaPerú
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