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Bonfioli G, Tomasoni D, Metra M, Adamo M. Coronavirus disease 2019 and cardiovascular disease: what we have learnt during the last 2 years. J Cardiovasc Med (Hagerstown) 2022; 23:710-714. [DOI: 10.2459/jcm.0000000000001377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Efficacy of extracorporeal membrane oxygenation in pediatric COVID-19 and MIS-C cases: A single-center experience. TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2022; 30:363-371. [PMID: 36303700 PMCID: PMC9580289 DOI: 10.5606/tgkdc.dergisi.2022.23392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/06/2022] [Indexed: 11/21/2022]
Abstract
Background
This study aimed to evaluate the need and the indication of extracorporeal membrane oxygenation (ECMO) in patients diagnosed with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) followed up in the pediatric intensive care unit by the demographic, clinical, and laboratory data and treatment response.
Methods
A total of 79 patients (43 males, 36 females; median age: 138 months; range, 6 to 210 months) with COVID-19 and MIS-C followed up between September 2020 - September 2021 were included in this retrospective study. Demographic and clinical data were retrospectively collected from patient files, and clinical data, laboratory findings, chest X-rays, and echocardiography results of six patients (1 male and 5 female, median age: 159 months, range, 13 to 210 months) who needed ECMO due to poor response to medical treatment were recorded before and after the ECMO therapy.
Results
Extracorporeal membrane oxygenation therapy was performed on one patient with a positive COVID-19 polymerase chain reaction test and five patients with MIS-C in our unit. Five patients were supported with venoarterial (v-a) ECMO, and one patient was supported with venovenous ECMO. Median hospitalization time was 29 (range, 24 to 50) days, median Pediatric Risk of Mortality score was 19.5 (range, 11 to 36), and median length of mechanical ventilation was 23.5 (range, 10 to 45) days. The median vasoactive inotropic score was 55.5 (range, 18 to 110) before ECMO, while the median vasoactive inotropic score was 11 (range, 0 to 34) after ECMO. Four patients were successfully weaned off ECMO, and one of these patients was lost due to brain death 15 days after the weaning. One patient infected with the delta variant of COVID-19, which remained positive during the clinical course, and one patient diagnosed with MIS-C was lost despite the v-a ECMO support. Three of the patients were discharged. Thrombosis developed in the superficial femoral artery of one patient on the cannulated side during v-a ECMO. No death due to complications of ECMO was recorded.
Conclusion
In our study, although the majority of our patients followed up with the diagnosis of COVID-19 and MIS-C showed a mild or moderate clinical course, it was observed that a severe clinical course could develop in a small number of patients and that ECMO treatment may be needed in these patients. In agreement with the ECMO studies with different indications in the literature, we conclude that ECMO therapy may markedly contribute to the prognosis in COVID-19 and MIS-C patients when the initiation and termination timing of therapy is correct.
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Bonalumi G, Giambuzzi I, Buratto B, Barili F, Garatti A, Pilozzi Casado A, Di Mauro M, Parolari A. The day after tomorrow: cardiac surgery and coronavirus disease-2019. J Cardiovasc Med (Hagerstown) 2022; 23:75-83. [PMID: 34958311 DOI: 10.2459/jcm.0000000000001223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The impact of the coronavirus disease-2019 (COVID-19) pandemic forced the governments worldwide to deal with an unprecedented health crisis. The aim of this review is to summarize what happened to cardiac surgery worldwide during the first wave of this pandemic. A literature search was performed to extrapolate key concepts regarding guidelines and reorganization of cardiac surgery wards during COVID-19. Supporting literature was also included to discuss the hot topics related to COVID-19 and cardiac surgery. Hence, both official documents from national scientific societies and single- or multiple-center experiences during the pandemics are reviewed and discussed. In Italy, the first western country hit by the pandemic, two different models were proposed to cope with the need for ICU/ward beds and to reallocate cardiac surgical services: Hub-and-Spoke system ('Hubs', dedicated to perform urgent and nondeferrable surgery, and 'Spokes', turned into COVID centers) and/or a progressive reduction in surgical activity. Worldwide, several guidelines/consensus statements were published, suggesting how to deal with the outbreak. Two different approaches for stratifying surgical indications were proposed: dynamic, based on the number of hospitalized COVID-19 patients; static, based only on the severity of the cardiovascular disease. Moreover, the importance of personal protective equipment was stressed. Several measures should have been adopted to deal with an unprecedented need for healthcare resources allocation to care for COVID-19 patients, putting the healthcare systems under serious stress. Cardiac surgery has, as have most surgical activities, been asked to reduce its own activity, giving priority to emergency and nondeferrable cases.
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Affiliation(s)
- Giorgia Bonalumi
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino, IRCCS
| | - Ilaria Giambuzzi
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino, IRCCS
- DISCCO, University of Milan
| | - Beatrice Buratto
- SC Universitary Cardiac Surgery, IRCCS Policlinico S. Donato, University of Milan, Milan
| | - Fabio Barili
- Department of Cardiac Surgery, S. Croce Hospital, Cuneo
| | - Andrea Garatti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
| | | | - Michele Di Mauro
- Cardio-Thoracic Surgery Unit, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Alessandro Parolari
- Unit of Cardiac Surgery and Translational Research, IRCCS Policlinico S. Donato, University of Milan, Milan, Italy
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Venturelli A, Vitolo M, Albini A, Boriani G. How did COVID-19 affect medical and cardiology journals? A pandemic in literature. J Cardiovasc Med (Hagerstown) 2021; 22:840-847. [PMID: 34482327 PMCID: PMC10100635 DOI: 10.2459/jcm.0000000000001245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/28/2021] [Accepted: 08/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The spreading speed of the COVID-19 pandemic forced the medical community to produce efforts in updating and sharing the evidence about this new disease, trying to preserve the accuracy of the data but at the same time avoiding the potentially harmful delay from discovery to implementation. The aim of our analysis was to assess the impact of the COVID-19 pandemic on medical literature in terms of proportion of COVID-19-related published papers and temporal patterns of publications within a sample of general/internal medicine and cardiology journals. METHODS We searched through PubMed scientific papers published from 1 January 2020 to 31 January 2021 about COVID-19 in ten major medical journals, of which five were in general/internal medicine and five in the cardiology field. We analyzed the proportion of COVID-19-related papers, and we examined temporal trends in the number of published papers. RESULTS Overall, the proportion of COVID-19-related papers was 18.5% (1986/10 756). This proportion was higher among the five selected general/internal medicine journals, compared with cardiology journals (23.8% vs 9.5%). The vast majority of papers were not original articles; in particular, in cardiology journals, there were 28% 'original articles', 17% 'review articles' and 55.1% 'miscellaneous', compared with 20.2%, 5.1% and 74.7% in general/internal medicine journals, respectively. CONCLUSIONS Our analysis highlights the big impact of the COVID-19 pandemic on international scientific literature. General and internal medicine journals were mainly involved, with cardiology journals only at a later time.
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Affiliation(s)
- Andrea Venturelli
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Albini
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
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Russo V, Pafundi PC, Rapacciuolo A, de Divitiis M, Volpicelli M, Ruocco A, Rago A, Uran C, Nappi F, Attena E, Chianese R, Esposito F, Del Giorno G, D'Andrea A, Ducceschi V, Russo G, Ammendola E, Carbone A, Covino G, Manzo G, Montella GM, Nigro G, D'Onofrio A. Cardiac pacing procedures during coronavirus disease 2019 lockdown in Southern Italy: insights from Campania Region. J Cardiovasc Med (Hagerstown) 2021; 22:857-859. [PMID: 33399343 DOI: 10.2459/jcm.0000000000001156] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Vincenzo Russo
- Chair of Cardiology, Department of Medical Translational Sciences, University of Campania 'Luigi Vanvitelli' - Monaldi Hospital, Naples
| | - Pia Clara Pafundi
- Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli'
| | - Antonio Rapacciuolo
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II
| | | | - Mario Volpicelli
- Division of Cardiology, San Giovanni Bosco Hospital, Health Authority Naples
| | - Antonio Ruocco
- Interventional Cardiology and Cardiological Care Unit, Cardarelli Hospital
| | - Anna Rago
- Cardiology Unit, AORN dei Colli, Naples
| | - Carlo Uran
- Cardiology Unit, San Giuseppe and Melorio Hospital, Santa Maria Capua Vetere, Caserta
| | - Felice Nappi
- Division of Cardiology, Moscati Hospital, Avellino
| | - Emilio Attena
- Division of Cardiology, San Giuliano Hospital, Giugliano in Campania, Health Authority Naples 2 North
| | - Raffaele Chianese
- Division of Cardiology, San Leonardo Hospital, Castellammare di Stabia, Health Authority Naples 3 South, Naples
| | - Francesca Esposito
- Division of Cardiology, San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | | | | | | | - Giovanni Russo
- Division of Cardiology, San Leonardo Hospital, Castellammare di Stabia, Health Authority Naples 3 South, Naples
| | | | | | - Gregorio Covino
- Division of Cardiology, San Giovanni Bosco Hospital, Health Authority Naples
| | | | | | - Gerardo Nigro
- Chair of Cardiology, Department of Medical Translational Sciences, University of Campania 'Luigi Vanvitelli' - Monaldi Hospital, Naples
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Giamberti A, Caldaroni F, Varrica A, Pace Napoleone C, Marianeschi SM, Uricchio N, Vanini V, Santoro F, Luciani GB, Stellin G, Gargiulo G, Murzi B, Filippelli S, Oppido G, Agati S, Galletti L, Frigiola A. Impact of COVID-19 Pandemic on the Italian Humanitarian Congenital Cardiac Surgery Activity: What No One Tells You. Front Cardiovasc Med 2021; 8:705029. [PMID: 34395564 PMCID: PMC8355370 DOI: 10.3389/fcvm.2021.705029] [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: 05/04/2021] [Accepted: 07/05/2021] [Indexed: 01/25/2023] Open
Abstract
More than 4 millions of children with congenital heart disease (CHD) are waiting for cardiac surgery around the world. Few of these patients are treated only thanks to the support of many non-governmental organizations (NGOs). Starting in December 2019, the so-called coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic and has dramatically impacted on all the international humanitarian activities for congenital heart disease. We analyzed data from all the Italian congenital cardiac surgery centers with the aim to quantify the impact of the pandemic on their charities. Fifteen Italian centers participated in the study and contributed to data collection. We analyzed and compared data regarding humanitarian activities carried out abroad and on site from two periods: year 2019 (pre-COVID-19) and year 2020 (COVID-19 pandemic). In 2019, 53 international missions were carried out by Italian congenital cardiac surgeons, resulting in the treatment of 471 CHD patients. In the same period 11 Italian cardiac centers operated on 251 foreign patients in Italy. In 2020, the pandemic led to a reduction of this activity by 96% for the surgery performed overseas and 86% for the interventions carried out in Italy. In conclusion our study shows the important quantitative impact of the pandemic on the Italian humanitarian cardiac surgical activity overseas and in Italy. This shocking result highlights the failure of the systems adopted so far to solve the problem of CHD in developing countries.
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Affiliation(s)
- Alessandro Giamberti
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Association "Bambini cardiopatici nel Mondo" Non-Governmental Organization (NGO), Milan, Italy
| | - Federica Caldaroni
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alessandro Varrica
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | | | - Nicola Uricchio
- Cardiac Surgery, Aziende Socio Sanitarie Territoriali (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | | | - Francesco Santoro
- Missioni Cardio Chirurgiche Internazionali, Gaslini Pediatric Hospital, Genova, Italy
| | - Giovanni Battista Luciani
- Pediatric and Congenital Cardiac Surgery Unit, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
| | - Giovanni Stellin
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Gaetano Gargiulo
- Pediatric and Grown-up Congenital Cardiac Surgery, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Bruno Murzi
- Pediatric Cardiac Surgery Unit, Heart Hospital, G. Monasterio Foundation, Massa, Italy
| | - Sergio Filippelli
- Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, Rome, Italy
| | - Guido Oppido
- Congenital Cardiac Surgery Unit, Monaldi Hospital, Naples, Italy
| | - Salvatore Agati
- Centro Cardiologico Pediatrico del Mediterraneo - Bambino Gesù, "San Vincenzo" Hospital, Taormina, Italy
| | - Lorenzo Galletti
- Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandro Frigiola
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Association "Bambini cardiopatici nel Mondo" Non-Governmental Organization (NGO), Milan, Italy
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