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Schoene D, Schnekenberg LG, Pallesen LP, Barlinn J, Puetz V, Barlinn K, Siepmann T. Pathophysiology of Cardiac Injury in COVID-19 Patients with Acute Ischaemic Stroke: What Do We Know So Far?-A Review of the Current Literature. LIFE (BASEL, SWITZERLAND) 2022; 12:life12010075. [PMID: 35054468 PMCID: PMC8778241 DOI: 10.3390/life12010075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/22/2021] [Accepted: 12/30/2021] [Indexed: 02/06/2023]
Abstract
With the onset of the COVID-19 pandemic, it became apparent that, in addition to pulmonary infection, extrapulmonary manifestations such as cardiac injury and acute cerebrovascular events are frequent in patients infected with SARS-CoV-2, worsening clinical outcome. We reviewed the current literature on the pathophysiology of cardiac injury and its association with acute ischaemic stroke. Several hypotheses on heart and brain axis pathology in the context of stroke related to COVID-19 were identified. Taken together, a combination of disease-related coagulopathy and systemic inflammation might cause endothelial damage and microvascular thrombosis, which in turn leads to structural myocardial damage. Cardiac complications of this damage such as tachyarrhythmia, myocardial infarction or cardiomyopathy, together with changes in hemodynamics and the coagulation system, may play a causal role in the increased stroke risk observed in COVID-19 patients. These hypotheses are supported by a growing body of evidence, but further research is necessary to fully understand the underlying pathophysiology and allow for the design of cardioprotective and neuroprotective strategies in this at risk population.
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Chetboul V, Foulex P, Kartout K, Klein AM, Sailleau C, Dumarest M, Delaplace M, Gouilh MA, Mortier J, Le Poder S. Myocarditis and Subclinical-Like Infection Associated With SARS-CoV-2 in Two Cats Living in the Same Household in France: A Case Report With Literature Review. Front Vet Sci 2021; 8:748869. [PMID: 34746286 PMCID: PMC8566889 DOI: 10.3389/fvets.2021.748869] [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: 07/28/2021] [Accepted: 09/13/2021] [Indexed: 12/15/2022] Open
Abstract
This report provides the first clinical, radiographic, echocardiographic, and biological description of SARS-CoV-2-associated myocarditis with a 6-month follow-up in a 5-year-old obese male domestic shorthair cat (Cat-1) presented for refractory congestive heart failure, with high cardiac troponin-I level (5.24 ng/ml), and a large lingual ulcer. The animal was SARS-CoV-2 positive on serology. The other cat living in the same household (Cat-2) never showed any clinical sign but was also confirmed SARS-CoV-2 positive on serology. Both cats were SARS-CoV-2 PCR negative. Cat-1 had closer contact than Cat-2 with their owner, who had been in close contact with a coworker tested PCR positive for COVID-19 (Alpha (B.1.1.7) variant) 4 weeks before Cat-1's first episode of congestive heart failure. A focused point-of-care echocardiography at presentation revealed for Cat-1 numerous B-lines, pleural effusion, severe left atrial dilation and dysfunction, and hypertrophic cardiomyopathy phenotype associated with focal pulmonary consolidations. Both myocarditis and pneumonia were suspected, leading to the prescription of cardiac medications and antibiotics. One month later, Cat-1 recovered, with normalization of left atrial size and function, and radiographic and echocardiography disappearance of heart failure signs and pulmonary lesions. An extensive literature review of SARS-CoV-2-related cardiac injury in pets in comparison with human pathology is discussed.
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Affiliation(s)
- Valérie Chetboul
- École Nationale Vétérinaire d'Alfort, CHUVA, Unité de Cardiologie d'Alfort (UCA), Maisons-Alfort, France.,Université Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Pierre Foulex
- École Nationale Vétérinaire d'Alfort, CHUVA, Unité de Cardiologie d'Alfort (UCA), Maisons-Alfort, France
| | - Kahina Kartout
- École Nationale Vétérinaire d'Alfort, CHUVA, Unité de Cardiologie d'Alfort (UCA), Maisons-Alfort, France
| | | | - Corinne Sailleau
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| | - Marine Dumarest
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| | - Manon Delaplace
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| | - Meriadeg Ar Gouilh
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, UNICAEN, 13 UNIROUEN, Caen, France
| | - Jeremy Mortier
- École Nationale Vétérinaire d'Alfort, CHUVA, Service d'Imagerie Médicale, Maisons-Alfort, France
| | - Sophie Le Poder
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
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