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Sato H, Yonezu K, Saito S, Abe I, Tawara K, Akioka H, Shinohara T, Teshima Y, Yufu K, Abe R, Takahashi N. Impact of the COVID-19 Pandemic on the Long-Term Prognosis of Acute Myocardial Infarction in Japan. Cureus 2024; 16:e51905. [PMID: 38333491 PMCID: PMC10850441 DOI: 10.7759/cureus.51905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Background During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, a global reduction in hospitalizations for acute myocardial infarction (AMI) was observed. Generally, patients experienced increased severity of AMI with delays in time from symptom onset to treatment during the pandemic. However, the impact of the COVID-19 pandemic on in-hospital mortality among patients with AMI remains unclear. This study aimed to compare the long-term prognosis of patients with AMI during the COVID-19 pandemic to that observed in the pre-pandemic period and to evaluate the influence of the COVID-19 pandemic on the prognosis of patients with AMI. Methods We reviewed the data of patients admitted to our hospital for AMI treatment between April 1, 2018, and March 31, 2021. The time from admission to major adverse cardiac events (MACE), as well as the time from admission to all-cause death, were examined between the pandemic period (April 1, 2020, to March 31, 2021) and the pre-pandemic period (April 1, 2018, to March 31, 2020). Results Eighty patients were included in the study, and those admitted during the pandemic exhibited a higher likelihood of advanced age, lower levels of LDL-cholesterol, and a reduced prevalence of hypertension. The 2.5-year MACE-free survival and overall survival rates between the patients during the pre-pandemic and pandemic periods were not significantly different. Conclusion The long-term prognosis of patients with AMI during the COVID-19 pandemic remains unclear. In this study, we reported that the 2.5-year MACE-free survival and overall survival rates of the patients with AMI admitted during the COVID-19 pandemic were not significantly different from those during the pre-pandemic period. The impact of the COVID-19 pandemic on the prognosis of patients with AMI appears to vary according to the study population.
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Affiliation(s)
- Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Kunio Yufu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
| | - Ryuzo Abe
- Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Yufu, JPN
- Department of Emergency Medicine, Faculty of Medicine, Oita University, Oita, JPN
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, JPN
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Ronco D, Matteucci M, Ravaux JM, Kowalewski M, Massimi G, Torchio F, Trumello C, Naito S, Bonaros N, De Bonis M, Fina D, Kowalówka A, Deja M, Jiritano F, Serraino GF, Kalisnik JM, De Vincentiis C, Ranucci M, Fischlein T, Russo CF, Carrozzini M, Boeken U, Kalampokas N, Golino M, De Ponti R, Pozzi M, Obadia JF, Thielmann M, Scrofani R, Blasi S, Troise G, Antona C, De Martino A, Falcetta G, Actis Dato G, Severgnini P, Musazzi A, Lorusso R. Impact of COVID-19 on incidence and outcomes of post-infarction mechanical complications in Europe. Interdiscip Cardiovasc Thorac Surg 2023; 37:ivad198. [PMID: 38109676 PMCID: PMC10749759 DOI: 10.1093/icvts/ivad198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/07/2023] [Accepted: 12/17/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVES Post-acute myocardial infarction mechanical complications (post-AMI MCs) represent rare but life-threatening conditions, including free-wall rupture, ventricular septal rupture and papillary muscle rupture. During the coronavirus disease-19 (COVID-19) pandemic, an overwhelming pressure on healthcare systems led to delayed and potentially suboptimal treatments for time-dependent conditions. As AMI-related hospitalizations decreased, limited information is available whether higher rates of post-AMI MCs and related deaths occurred in this setting. This study was aimed to assess how COVID-19 in Europe has impacted the incidence, treatment and outcome of MCs. METHODS The CAUTION-COVID19 study is a multicentre retrospective study collecting 175 patients with post-AMI MCs in 18 centres from 6 European countries, aimed to compare the incidence of such events, related patients' characteristics, and outcomes, between the first year of pandemic and the 2 previous years. RESULTS A non-significant increase in MCs was observed [odds ratio (OR) = 1.15, 95% confidence interval (CI) 0.85-1.57; P = 0.364], with stronger growth in ventricular septal rupture diagnoses (OR = 1.43, 95% CI 0.95-2.18; P = 0.090). No significant differences in treatment types and mortality were found between the 2 periods. In-hospital mortality was 50.9% and was higher for conservatively managed cases (90.9%) and lower for surgical patients (44.0%). Patients admitted during COVID-19 more frequently had late-presenting infarction (OR = 2.47, 95% CI 1.24-4.92; P = 0.010), more stable conditions (OR = 2.61, 95% CI 1.27-5.35; P = 0.009) and higher EuroSCORE II (OR = 1.04, 95% CI 1.01-1.06; P = 0.006). CONCLUSIONS A non-significant increase in MCs incidence occurred during the first year of COVID-19, characterized by a significantly higher rate of late-presenting infarction, stable conditions and EuroSCORE-II if compared to pre-pandemic data, without affecting treatment and mortality.
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Affiliation(s)
- Daniele Ronco
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Congenital Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy
| | - Matteo Matteucci
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
| | - Justine Mafalda Ravaux
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Mariusz Kowalewski
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Giulio Massimi
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy
| | - Federica Torchio
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
- Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Cinzia Trumello
- Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy
| | - Shiho Naito
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - Nikolaos Bonaros
- Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Michele De Bonis
- Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy
| | - Dario Fina
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Cardiology, Città di Lecce Hospital, GVM Care and Research, Lecce, Italy
| | - Adam Kowalówka
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
- Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
| | - Marek Deja
- Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
- Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
| | - Federica Jiritano
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | | | - Jurij Matija Kalisnik
- Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Carlo De Vincentiis
- Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Marco Ranucci
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Theodor Fischlein
- Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | | | | | - Udo Boeken
- Department of Cardiovascular Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Nikolaos Kalampokas
- Department of Cardiovascular Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Michele Golino
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Roberto De Ponti
- Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Matteo Pozzi
- Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Lyon, France
| | | | - Matthias Thielmann
- Department of Thoracic and Cardiovascular Surgery, West-German Heart Center, University of Duisburg-Essen, Essen, Germany
| | - Roberto Scrofani
- Cardiac Surgery Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Blasi
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Giovanni Troise
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Carlo Antona
- Cardiac Surgery Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giosuè Falcetta
- Section of Cardiac Surgery, University Hospital, Pisa, Italy
| | | | - Paolo Severgnini
- Department of Biotechnology and Sciences of Life, Circolo Hospital, University of Insubria, Varese, Italy
| | | | - Roberto Lorusso
- Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands
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3
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de la Torre Fonseca LM, Cedeño RA, Díaz VAJ, Cedeño FIL, Juan-Salvadores P. Cardiovascular Complications in Patients Hospitalized for COVID-19: A Cohort Study in Havana, Cuba. Cardiovasc Revasc Med 2023; 52:10-15. [PMID: 36822976 PMCID: PMC9940473 DOI: 10.1016/j.carrev.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION AND OBJECTIVE At least one in ten patients infected with COVID develop cardiovascular complications during hospitalization, increasing the number of deaths from this cause. However, the determinants of risk are not clearly elucidated. This study aims to determine whether there is a relationship between in-hospital cardiac complications and cardiovascular history and hospital evolution. METHODS Prospective cohort study of 373 patients with a positive diagnosis of SARS-CoV-2 admitted to an Intensive Care Unit between March and October 2021. RESULTS Median age was 69 (IQR: 57-77), 29.2 % of patients presented cardiovascular complications: 21.2 % electrical, 5.9 % acute coronary syndrome and 1.9 % pulmonary thromboembolism. Age RR: 1.02 (95 % CI: 1.00-1.04; p = 0.020) and history of ischemic heart disease RR: 2.23 (95 % CI: 1.27-3.92; p = 0.005) were identified as independent predictors of in-hospital cardiac complications. CONCLUSIONS Age and history of ischemic heart disease were identified as independent predictor variables of cardiovascular complications in patients admitted with severe COVID-19 involvement; being significantly associated with lower survival.
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Affiliation(s)
| | - Robert Alarcón Cedeño
- Interventional Cardiology Unit, Cardiology Department, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Spain
| | - Víctor Alfonso Jiménez Díaz
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain.
| | | | - Pablo Juan-Salvadores
- Cardiovascular Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain.
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4
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Alsaidan AA, Al‐Kuraishy HM, Al‐Gareeb AI, Alexiou A, Papadakis M, Alsayed KA, Saad HM, Batiha GE. The potential role of SARS‐CoV‐2 infection in acute coronary syndrome and type 2 myocardial infarction (T2MI): Intertwining spread. Immun Inflamm Dis 2023; 11:e798. [PMID: 36988260 PMCID: PMC10022425 DOI: 10.1002/iid3.798] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID‐19) is a novel pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). It has been shown that SARS‐CoV‐2 infection‐induced inflammatory and oxidative stress and associated endothelial dysfunction may lead to the development of acute coronary syndrome (ACS). Therefore, this review aimed to ascertain the link between severe SARS‐CoV‐2 infection and ACS. ACS is a spectrum of acute myocardial ischemia due to a sudden decrease in coronary blood flow, ranging from unstable angina to myocardial infarction (MI). Primary or type 1 MI (T1MI) is mainly caused by coronary plaque rupture and/or erosion with subsequent occlusive thrombosis. Secondary or type 2 MI (T2MI) is due to cardiac and systemic disorders without acute coronary atherothrombotic disruption. Acute SARS‐CoV‐2 infection is linked with the development of nonobstructive coronary disorders such as coronary vasospasm, dilated cardiomyopathy, myocardial fibrosis, and myocarditis. Furthermore, SARS‐CoV‐2 infection is associated with systemic inflammation that might affect coronary atherosclerotic plaque stability through augmentation of cardiac preload and afterload. Nevertheless, major coronary vessels with atherosclerotic plaques develop minor inflammation during COVID‐19 since coronary arteries are not initially and primarily targeted by SARS‐CoV‐2 due to low expression of angiotensin‐converting enzyme 2 in coronary vessels. In conclusion, SARS‐CoV‐2 infection through hypercytokinemia, direct cardiomyocyte injury, and dysregulation of the renin‐angiotensin system may aggravate underlying ACS or cause new‐onset T2MI. As well, arrhythmias induced by anti‐COVID‐19 medications could worsen underlying ACS.
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Affiliation(s)
- Aseel Awad Alsaidan
- Department of Family and Community Medicine, College of MedicineJouf UniversitySakakaSaudi Arabia
| | - Hayder M. Al‐Kuraishy
- Department of Clinical Pharmacology and Medicine, College of MedicineALmustansiriyia UniversityBaghdadIraq
| | - Ali I. Al‐Gareeb
- Department of Clinical Pharmacology and Medicine, College of MedicineALmustansiriyia UniversityBaghdadIraq
| | - Athanasios Alexiou
- Department of Science and EngineeringNovel Global Community Educational FoundationHebershamNew South WalesAustralia,Department of Research and DevelopmentAFNP MedWienAustria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten‐Herdecke, Heusnerstrasse 40University of Witten‐HerdeckeWuppertalGermany
| | - Khalid Adel Alsayed
- Department of Family and Community MedicineSecurity Forces Hospital ProgramRiyadhSaudi Arabia
| | - Hebatallah M. Saad
- Department of Pathology, Faculty of Veterinary MedicineMatrouh UniversityMatrouhEgypt
| | - Gaber El‐Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary MedicineDamanhour UniversityAlBeheiraEgypt
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López-Palop R, Lozano Í, Carrillo P. COVID-19 pandemic: National outbreak and acute coronary syndrome. Collateral damages? Int J Cardiol 2023; 375:144-146. [PMID: 36493929 DOI: 10.1016/j.ijcard.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Ramón López-Palop
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
| | - Íñigo Lozano
- Servicio de Cardiología, Hospital Universitario de Cabueñes, Gijón, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; Universidad de Oviedo, Spain
| | - Pilar Carrillo
- Sección de Cardiología, Hospital Universitario San Juan de Alicante, Spain
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Jeong D, Lee GT, Park JE, Shin TG, Kim K, Jang D, Kim WY, Jo YH, Chung SP, Beom JH, Choi SH, Kwon WY, Suh GJ, Ko BS, Han KS, Shin JH, Cho H, Korean Shock Society KoSS Investigators, Hwang SY. Impact of COVID-19 Pandemic on Management and Outcomes in Patients with Septic Shock in the Emergency Department. J Pers Med 2022; 12. [PMID: 36579517 DOI: 10.3390/jpm12111803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/02/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
This study aimed to determine the impact of modifications in emergency department (ED) practices caused by the coronavirus disease 2019 (COVID-19) pandemic on the clinical outcomes and management of patients with septic shock. We performed a retrospective study. Patients with septic shock who presented to the ED between 1 January 2018 and 19 January 2020 were allocated to the pre-COVID-19 group, whereas those who presented between 20 January 2020 and 31 December 2020 were assigned to the post-COVID-19 group. We used propensity score matching to compare the sepsis-related interventions and clinical outcomes. The primary outcome measure was in-hospital mortality. Of the 3697 patients included, 2254 were classified as pre-COVID-19 and 1143 as post-COVID-19. A total of 1140 propensity score-matched pairings were created. Overall, the in-hospital mortality rate was 25.5%, with no statistical difference between the pre- and post-COVID-19 groups (p = 0.92). In a matched cohort, the post-COVID-19 group had delayed lactate measurement, blood culture test, and infection source control (all p < 0.05). There was no significant difference in time to antibiotics (p = 0.19) or vasopressor administration (p = 0.09) between the groups. Although sepsis-related interventions were delayed during the COVID-19 pandemic, there was no significant difference in the in-hospital mortality between the pre- and post-COVID-19 groups.
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7
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Spadaccio C, Pisani A, Salsano A, Nenna A, Fardman A, D’Alessandro D, Santini F, Gaudino MFL, Sundt TM, Rose D. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis. Open Med (Wars) 2022; 17:1412-1416. [PMID: 36128445 PMCID: PMC9449689 DOI: 10.1515/med-2022-0545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022] Open
Abstract
This study aims to compare treatments and outcomes of mechanical complications of acute myocardial infarction (MI) during the Covid-19 and in the pre-Covid-19 era. Electronic databases have been searched for MI mechanical complications during the Covid-19 era and in the previous period from January 1998 to January 2020 (pre-Covid-19 era), until October 2021. To perform a quantitative analysis of non-comparative series, a meta-analysis of proportion has been conducted. Early mortality after surgical treatment was 15.0% while it was significantly higher after conservative treatment (62.4%) (P = 0.026). Early mortality after surgical treatment was seemingly higher in the pre-Covid-19 era but the difference did not reach statistical significance (15.0% vs 38.9%; P = 0.13). Mortality in patients treated conservatively, or turned down for surgery, was lower during the Covid-19 pandemic (62.4% vs 97.7%; P = 0.001). The crude mean prevalence of the use rate of conservative or surgical treatment across the studies during Covid-19 and in the pre-Covid-19 era was comparable. The current increased incidence of MI mechanical complications might be a consequence of delayed presentation or restricted access to hospital facilities. Despite the general negative impact of Covid-19 on cardiac surgery volumes and outcomes and the apparent increase of the incidence of MI complications, the outcomes of their surgical and clinical treatment seem not to have been affected during the pandemic.
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Affiliation(s)
- Cristiano Spadaccio
- Cardiac Surgery, Massachusetts General Hospital (MGH), Harvard Medical School , Boston , United States of America
| | - Angelo Pisani
- Cardiac Surgery, Pineta Grande Hospital, Castel Volturno , Naples , Italy
| | - Antonio Salsano
- Division of Cardiac Surgery, IRCCS Ospedale Policlinico San Martino , Genoa , Italy
- DISC Department, University of Genoa , L.go Rosanna Benzi, 10, 16143 , Genoa , Italy
| | - Antonio Nenna
- Division of Cardiac Surgery, Università Campus Bio-Medico di Roma , Rome , Italy
| | - Alexander Fardman
- Lev Leviev Heart and Vascular Center, Sheba Medical Center , Tel Hashomer , Israel
- Sackler School of Medicine, Tel Aviv University , Tel Aviv , Israel
| | - David D’Alessandro
- Cardiac Surgery, Massachusetts General Hospital (MGH), Harvard Medical School , Boston , United States of America
| | - Francesco Santini
- Division of Cardiac Surgery, IRCCS Ospedale Policlinico San Martino , Genoa , Italy
- DISC Department, University of Genoa , L.go Rosanna Benzi, 10, 16143 , Genoa , Italy
| | | | - Thoralf M. Sundt
- Cardiac Surgery, Massachusetts General Hospital (MGH), Harvard Medical School , Boston , United States of America
| | - David Rose
- Cardiac Surgery, Lancashire Cardiac Centre, Blackpool Victoria Hospital , Blackpool , United Kingdom
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8
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Sharma YP, Panda P, Kaur N, Prasad K, Vinay G. How lessons from past helped in shaping management plans for COVID patients: Tertiary care experience translated to primary care application. J Family Med Prim Care 2022; 11:5712-5713. [PMID: 36505607 PMCID: PMC9730953 DOI: 10.4103/jfmpc.jfmpc_2312_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
- Yash Paul Sharma
- Department of Cardiology, PGIMER, Chandigarh, India,Address for correspondence: Yash Paul Sharma, Department of Cardiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. E-mail:
| | | | - Navjot Kaur
- Department of Cardiology, PGIMER, Chandigarh, India
| | - Krishna Prasad
- Department of Cardiology, AIIMS, Raipur, Chhattisgarh, India
| | - Gautam Vinay
- Department of Gastroenterology, AIIMS, Rishikesh, Uttarakhand, India
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9
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Chashchin MG, Gorshkov AY, Strelkova AV, Drapkina OM. Features of the pathogenesis and course of myocardial infarction in COVID-19 patients: a descriptive review. Cardiovasc Ther Prev 2022. [DOI: 10.15829/1728-8800-2022-3270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic remains one of the most urgent problems for healthcare professionals due to the variety of non-pulmonary manifestations. Along with the respiratory syndrome in a significant proportion of patients, the disease course is accompanied by pronounced systemic inflammatory response and hemostasis changes. This is associated with a high risk of complications, especially in patients with concomitant cardiovascular pathology. The aim of the study was to analyze and systematize the literature data on the pathogenesis, clinical course, and outcomes of myocardial infarction (MI) in patients with COVID-19. For review, publications indexed in the PubMed, Google Scholar, Web of Science, and Cyberleninka databases were used. The search depth was 2 years, starting from 2020. The review is based on summarized data from the most relevant clinical studies, reports and systematic reviews. The literature analysis made it possible to conclude that the published data on MI in patients with COVID-19 are currently contradictory. Multiple thrombosis, sepsis, macrophage activation, increasing hypoxemia, imbalance between myocardial oxygen supply and demand in patients with severe COVID-19 have led to a high incidence of type 1 and type 2 MI. It should be especially noted that in a number of cases, MI with COVID-19 occurs in patients with intact coronary arteries, and its course is associated with a high incidence of complications, which, in turn, leads to a significant increase in short- and mid-term mortality.
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Affiliation(s)
- M. G. Chashchin
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. Yu. Gorshkov
- National Medical Research Center for Therapy and Preventive Medicine
| | | | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Yoon S, Noh H, Jin H, Lee S, Han S, Kim SH, Kim J, Seo JS, Kim JJ, Park IH, Oh J, Bae JY, Lee GE, Woo SJ, Seo SM, Kim NW, Lee YW, Jang HJ, Hong SM, An SH, Lyoo KS, Yeom M, Lee H, Jung B, Yoon SW, Kang JA, Seok SH, Lee YJ, Kim SY, Kim YB, Hwang JY, On D, Lim SY, Kim SP, Jang JY, Lee H, Kim K, Lee HJ, Kim HB, Park JW, Jeong DG, Song D, Choi KS, Lee HY, Choi YK, Choi JA, Song M, Park MS, Seo JY, Nam KT, Shin JS, Won S, Yun JW, Seong JK. Laboratory information management system for COVID-19 non-clinical efficacy trial data. Lab Anim Res 2022; 38:17. [PMID: 35765097 PMCID: PMC9238008 DOI: 10.1186/s42826-022-00127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/09/2022] [Indexed: 12/01/2022] Open
Abstract
Background As the number of large-scale studies involving multiple organizations producing data has steadily increased, an integrated system for a common interoperable format is needed. In response to the coronavirus disease 2019 (COVID-19) pandemic, a number of global efforts are underway to develop vaccines and therapeutics. We are therefore observing an explosion in the proliferation of COVID-19 data, and interoperability is highly requested in multiple institutions participating simultaneously in COVID-19 pandemic research.
Results In this study, a laboratory information management system (LIMS) approach has been adopted to systemically manage various COVID-19 non-clinical trial data, including mortality, clinical signs, body weight, body temperature, organ weights, viral titer (viral replication and viral RNA), and multiorgan histopathology, from multiple institutions based on a web interface. The main aim of the implemented system is to integrate, standardize, and organize data collected from laboratories in multiple institutes for COVID-19 non-clinical efficacy testings. Six animal biosafety level 3 institutions proved the feasibility of our system. Substantial benefits were shown by maximizing collaborative high-quality non-clinical research.
Conclusions This LIMS platform can be used for future outbreaks, leading to accelerated medical product development through the systematic management of extensive data from non-clinical animal studies.
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Affiliation(s)
- Suhyeon Yoon
- Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea
| | - Hyuna Noh
- Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea
| | - Heejin Jin
- Institute of Health and Environment, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sungyoung Lee
- Department of Genomic Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea.,Department of Medicine, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Soyul Han
- RexSoft Corp, Seoul, 08826, Republic of Korea
| | - Sung-Hee Kim
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jiseon Kim
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jung Seon Seo
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jeong Jin Kim
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - In Ho Park
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.,Institute of Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jooyeon Oh
- Department of Microbiology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Joon-Yong Bae
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Gee Eun Lee
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Sun-Je Woo
- Science Unit, International Vaccine Institute, Seoul, 08826, Republic of Korea
| | - Sun-Min Seo
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, 05029, Republic of Korea
| | - Na-Won Kim
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, 05029, Republic of Korea
| | - Youn Woo Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea
| | - Hui Jeong Jang
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea
| | - Seung-Min Hong
- Laboratory of Avian Diseases, BK21 Plus Program for Veterinary Science and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea
| | - Se-Hee An
- Laboratory of Avian Diseases, BK21 Plus Program for Veterinary Science and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea
| | - Kwang-Soo Lyoo
- Korea Zoonosis Research Institute, Chonbuk National University, Iksan, 54531, Republic of Korea
| | - Minjoo Yeom
- Department of Pharmacy, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Hanbyeul Lee
- Department of Pharmacy, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Bud Jung
- Department of Pharmacy, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Sun-Woo Yoon
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, 34141, Republic of Korea
| | - Jung-Ah Kang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, 34141, Republic of Korea
| | - Sang-Hyuk Seok
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, ChunCheon, 24341, Republic of Korea
| | - Yu Jin Lee
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, ChunCheon, 24341, Republic of Korea
| | - Seo Yeon Kim
- Preclinical Research Center, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea
| | - Young Been Kim
- Preclinical Research Center, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea
| | - Ji-Yeon Hwang
- Preclinical Research Center, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea
| | - Dain On
- Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea.,Laboratory of Developmental Biology and Genomics, Research Institute for Veterinary Science, BK21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea
| | - Soo-Yeon Lim
- Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sol Pin Kim
- Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ji Yun Jang
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, 10408, Republic of Korea.,College of Pharmacy, Dongguk University, Seoul, 04620, Republic of Korea
| | - Ho Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, 10408, Republic of Korea
| | - Kyoungmi Kim
- Department of Biomedical Sciences and Department of Physiology, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, 13620, Republic of Korea
| | - Jun Won Park
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, ChunCheon, 24341, Republic of Korea
| | - Dae Gwin Jeong
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, 34141, Republic of Korea
| | - Daesub Song
- Department of Pharmacy, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Kang-Seuk Choi
- Laboratory of Avian Diseases, BK21 Plus Program for Veterinary Science and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea
| | - Yang-Kyu Choi
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, 05029, Republic of Korea
| | - Jung-Ah Choi
- Science Unit, International Vaccine Institute, Seoul, 08826, Republic of Korea
| | - Manki Song
- Science Unit, International Vaccine Institute, Seoul, 08826, Republic of Korea
| | - Man-Seong Park
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Jun-Young Seo
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ki Taek Nam
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jeon-Soo Shin
- Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.,Institute of Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.,Department of Microbiology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Sungho Won
- Institute of Health and Environment, Seoul National University, Seoul, 08826, Republic of Korea. .,RexSoft Corp, Seoul, 08826, Republic of Korea. .,Department of Public Health Sciences, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Jun-Won Yun
- Laboratory of Veterinary Toxicology, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Je Kyung Seong
- Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea. .,Laboratory of Developmental Biology and Genomics, Research Institute for Veterinary Science, BK21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea. .,Interdisciplinary Program for Bioinformatics, Program for Cancer Biology, BIO-MAX/N-Bio Institute, Seoul National University, Seoul, 08826, Republic of Korea.
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11
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Altobelli E, Angeletti PM, Marzi F, D’Ascenzo F, Petrocelli R, Patti G. Impact of SARS-CoV-2 Outbreak on Emergency Department Presentation and Prognosis of Patients with Acute Myocardial Infarction: A Systematic Review and Updated Meta-Analysis. J Clin Med 2022; 11:jcm11092323. [PMID: 35566450 PMCID: PMC9102296 DOI: 10.3390/jcm11092323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/23/2022] Open
Abstract
We performed an updated meta-analysis to robustly quantify admission trends of patients with ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) during the first wave of the pandemic and to characterize on a large basis the risk profile and early prognosis. Studies having the same observation period for the comparison between SARS-CoV-2 outbreak in 2020 versus control period in 2019 were included. Primary endpoints were the relative variation of hospital admissions, the difference of in-hospital mortality for STEMI and NSTEMI. Secondary were: mortality according to countries, income levels and data quality; cardiogenic shock, mechanical complications, door-to-balloon time, time from symptom onset to first medical contact, left ventricular ejection fraction (LVEF) and troponin. In total, 61 observational studies with 125,346 patients were included. Compared with 2019, during the pandemic for STEMI were observed: a 24% reduction of hospitalizations with an impact on early survival (OR = 1.33 in-hospital mortality); the time from symptom onset to first medical contact was 91.31 min longer, whereas door-to-balloon time was increased (+5.44 min); after STEMI, the rate of cardiogenic shock was 33% higher; LVEF at discharge was decreased (−3.46); elevated high-sensitivity troponin levels (1.52) on admission. For NSTEMI, in the COVID-19 period, we observed a 31% reduction of hospitalizations and higher in-hospital deaths (OR = 1.34). The highest mortality rates among countries were: Italy OR = 3.71 (high income), Serbia OR = 2.15 (upper middle) and Pakistan OR = 1.69 (lower middle). Later hospital presentation was associated with larger infarctions, as well as with increased cardiogenic shock and in-hospital mortality.
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Affiliation(s)
- Emma Altobelli
- Department of Life, Public Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.M.A.); (F.M.)
- Correspondence: ; Tel.: +39-0862-434-666
| | - Paolo Matteo Angeletti
- Department of Life, Public Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.M.A.); (F.M.)
- Cardiac Surgical Intensive Care Unit, Giuseppe Mazzini Hospital, 64100 Teramo, Italy
| | - Francesca Marzi
- Department of Life, Public Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.M.A.); (F.M.)
| | - Fabrizio D’Ascenzo
- Cardiovascular and Thoracic Department, Division of Cardiology, University of Turin, 10126 Turin, Italy;
| | | | - Giuseppe Patti
- Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, 28100 Novara, Italy;
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12
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Lavie G, Wolff Sagy Y, Hoshen M, Saliba W, Flugelman MY. Continuous Decline in Myocardial Infarction and Heart Failure Hospitalizations during the First 12 Months of the COVID-19 Pandemic in Israel. J Clin Med 2022; 11:jcm11061577. [PMID: 35329902 PMCID: PMC8949334 DOI: 10.3390/jcm11061577] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 12/15/2022] Open
Abstract
Background: A decline in cardiovascular hospitalizations was observed during the initial phases of the COVID-19 pandemic. We examine the continuous effect of the COVID-19 pandemic in reducing cardiovascular hospitalization and associated mortality rates during the first year of the pandemic in Israel. Methods: We conduct a retrospective cohort study using the data of Clalit Health Services, the largest healthcare organization in Israel. We divide the Corona year into six periods (three lockdowns and three post-lockdowns) and compare the incidence rates of cardiovascular hospitalizations and 30-day all-cause mortality during each period to the previous three years. Results: The number of non-STEMI hospitalizations during the first year of the pandemic was 13.7% lower than the average of the previous three years (95% CI 11–17%); STEMI hospitalizations were 15.7% lower (95% CI 13–19%); CHF (Congestive heart failure) hospitalizations were 23.9% lower (95%, CI 21–27%). No significant differences in 30-day all-cause mortality rates were observed among AMI (acute myocardial infarction) patients during most of the periods, whereas the annual 30-day all-cause mortality rate among CHF patients was 23% higher. Conclusions: AMI and CHF hospitalizations were significantly lower during the first year of the pandemic relative to 2017–9. Mortality rates were higher in the case of CHF patients but not in the case of AMI patients, possibly due to a change in the clinical acuity of patients arriving at the hospitals. We conclude that targeted public health messaging should be implemented together with proactive monitoring, in order to identify residual disability in patients who may have received non-optimal treatment during the pandemic.
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Affiliation(s)
- Gil Lavie
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel; (Y.W.S.); (M.H.)
- Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 31096, Israel; (W.S.); (M.Y.F.)
- Correspondence: or ; Tel.: +972-52-5582800
| | - Yael Wolff Sagy
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel; (Y.W.S.); (M.H.)
| | - Moshe Hoshen
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel; (Y.W.S.); (M.H.)
| | - Walid Saliba
- Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 31096, Israel; (W.S.); (M.Y.F.)
- Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa 3436212, Israel
| | - Moshe Y. Flugelman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 31096, Israel; (W.S.); (M.Y.F.)
- Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa 3436212, Israel
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13
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Denegri A, Sola M, Morelli M, Farioli F, Alberto T, D'Arienzo M, Savorani F, Pezzuto GS, Boriani G, Szarpak L, Magnani G. Arrhythmias in COVID-19/SARS-CoV-2 Pneumonia Infection: Prevalence and Implication for Outcomes. J Clin Med 2022; 11. [PMID: 35268554 DOI: 10.3390/jcm11051463] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/23/2022] [Accepted: 03/04/2022] [Indexed: 02/01/2023] Open
Abstract
Arrhythmias (ARs) are potential cardiovascular complication of COVID-19 but may also have a prognostic role. The aim of this study was to explore the prevalence and impact of cardiac ARs in hospitalized COVID-19 patients. All-comer patients admitted to the emergency department of Modena University Hospital from 16 March to 31 December 2020 and diagnosed with COVID-19 pneumonia infection were included in the study. The primary endpoint was 30-day mortality. Out of 902 patients, 637 (70.6%) presented a baseline 12-lead ECG registration; of these, 122 (19.2%) were diagnosed with ARs. Atrial fibrillation (AF, 40.2%) was the most frequent AR detected. The primary endpoint (30-day mortality) occurred in 33.6% (p < 0.001). AR-patients presented an almost 3-fold risk of mortality compared to non-AR-patients at 30d (Adj. OR = 2.8, 95%CI: 1.8−4.3, p < 0.001). After adjustment for significant baseline characteristics selected by a stepwise backward selection, AR-patients remained at increased risk of mortality (Adj. HR = 2.0, 95%CI: 1.9−2.3, p < 0.001). Sub-group analysis revealed that among ARs patients, those with AF at admission presented the highest risk of 30-day mortality (Adj. HR = 3.1, 95%CI: 2.0−4.9, p < 0.001). In conclusion, ARs are a quite common manifestation in COVID-19 patients, who are burdened by even worse prognosis. AR patients with AF presented the highest risk of mortality; thus, these patients may benefit from a more aggressive secondary preventive therapy and a closer follow up.
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Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review. Front Public Health 2022; 9:760795. [PMID: 34976922 PMCID: PMC8716399 DOI: 10.3389/fpubh.2021.760795] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023] Open
Abstract
Background: COVID-19 pandemic caused by SARS-CoV2 has seriously impacted the global economy. Medical facilities around the world were not prepared for the enormous challenges posed by the growing number of patients each day, the shortage of personal protective equipment, and insufficient numbers of medical staff. Governments have tried to counteract the impact of the pandemic, but the measures taken have not always been sufficient to maintain access to and quality of health services at the same level as before the pandemic. The disruption of health services has resulted in more and more research reports from different parts of the world on the accessibility of health services during the COVID-19 pandemic. Methodology: This review article presents 21 selected scientific studies on access to health services in different regions of the world. Articles were found in PubMed, GoogleScholar, Medline, and ScienceDirect databases, then grouped, and significant data were extracted from each article. The results were summarized in a table. Results: The range of limited health services included a variety of specialties, including primary care, psychiatry, orthopedics, cardiology, neurosurgery, and more. Methods used in the studies were based on retrospective analysis or on the subjective assessment of patients in the form of a questionnaire or interview. Most authors claimed a decrease in accessibility to health services during the COVID-19 pandemic compared to the pre-pandemic period, including a decrease in planned surgeries, doctor appointments, patient admission to hospital or ER, and access to medicines. Additionally, some authors observed an increase in the mortality rate. One of the few medical services that have expanded rapidly during the pandemic was online appointments. Conclusions: The COVID-19 pandemic has most certainly affected the accessibility of health services worldwide. Lessons should be learned to prevent inaccessibility to medical services, especially as experts predict another wave of COVID-19 cases.
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Affiliation(s)
- Magdalena Tuczyńska
- Student Scientific Circle of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
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15
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Alhejily W. Impact of the COVID-19 Pandemic on Patients With Acute Coronary Syndrome: A Tertiary Center Experience With Primary Percutaneous Intervention and Early Invasive Strategy. Cureus 2021; 13:e20747. [PMID: 34976551 PMCID: PMC8711577 DOI: 10.7759/cureus.20747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on patients with acute coronary syndrome (ACS). Methods: This retrospective longitudinal cohort study analysed ACS patients admitted in a large tertiary center in 2019 (pre-pandemic) and 2020 (pandemic). The primary endpoint was mortality from myocardial infarction; secondary endpoints were death from any causes, including COVID-related complications, stroke, and coronary artery bypass graft surgery. Results: There were 489 ACS patients admitted in 2020, and 614 in 2019, representing a 21% reduction (p=0.001). Male patients comprised 73% of the patients. Only eight were polymerase chain reaction (PCR)-confirmed positive COVID-19 patients. The mean time to presentation from the time of onset of symptoms in acute ST-elevation myocardial infarction cases was 48±16 in 2020 (vs. 4±3 h in 2019); this significant delay was observed in more than 50% of patients (p=0.0001). Mortality due to ACS in 2020 doubled, with eight patients confirmed dead during or within 30 days of admission, with none of the deaths related to COVID-19. The incidence of stroke (p=0.01) and coronary artery (p=0.0001) bypass was also high in 2020. Conclusion: We found a statistically significant increase in the mortality related to myocardial infarction. Despite timely interventions, patients presented late and were worse than in the non-pandemic period.
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Pasqualetto MC, Tuttolomondo D, Gaibazzi N, Baratella MC, Casolino P, Stefani M, Reato S, Tattan E, Sorbo MD, Bigon L, Giada F, Nizzetto M, Ferrara C, Galiotto A, Scevola M, Rigo F. Safety of surgical masks during phisical activity evaluated with graded cycle ergometry test. J Sports Med Phys Fitness 2021; 62:846-850. [PMID: 34651611 DOI: 10.23736/s0022-4707.21.12814-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIMS At the time of the coronavirus disease 2019 (COVID-19) pandemic wearing surgical mask (SM) is recommended for the prevention of contracting or exposing others to airborne transmission of COVID-19. It is somewhat controversial whether wearing SM during exercise affects performance and health status and/or may influence the results. In order to give an answer we planned a prospective, randomized, crossover study to evaluate the effects of wearing a SM or no-SM in 33 (17 male) physically active helthy subjects during a graded exercise cycle ergometry test. METHODS The two tests were performed in random order in the same subjects. The participants were all tested the same day, after a recovery time of at least of one hour, in order to avoid interferences on physical performances. Arterial oxygen saturation, heart rate and arterial blood pressure were assessed throughout the exercise tests every step of two minutes, at the end of exercise, performed at the same time with and without mask. RESULTS AND CONCLUSIONS Wearing SM had no effect on performance, since the duration of cycle ergometry test with SM and without SM median, respectively, was 14.2, [lower-upper quartile 13.9-14.8] versus 14.3 [13.9-15.5] minutes, p=0.094, and median peak power was 150 W [150-180] versus 150 W [120-180] p=0.754. When expressed relative to peak exercise performance, no differences were found between wearing or not wearing SM regarding arterial oxygen saturation, or heart rate at any time during the exercise tests. Wearing SM during vigorous exercise had no detrimental effect on cardiovascular parameters, as well as on exercise metrics in all participants. No ventricular repolarization abnormalities and no arrhythmias were reported on the electrocardiograms.
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Affiliation(s)
| | | | - Nicola Gaibazzi
- Cardiology and Cardiac Imaging Department, Parma University Hospital, Parma, Italy
| | | | - Pietro Casolino
- Division of Cardiology, Dolo Hospital AULSS 3, Venice, Italy
| | - Maria Stefani
- Division of Cardiology, Dolo Hospital AULSS 3, Venice, Italy
| | - Stefania Reato
- Division of Cardiology, Dolo Hospital AULSS 3, Venice, Italy
| | - Elisa Tattan
- Division of Cardiology, Dolo Hospital AULSS 3, Venice, Italy
| | - Maria D Sorbo
- Division of Cardiology, Dolo Hospital AULSS 3, Venice, Italy
| | - Lucio Bigon
- Sport Medicine Division, Dolo Hospital AULSS 3, Venice, Italy
| | - Franco Giada
- Sport Medicine Division, Dolo Hospital AULSS 3, Venice, Italy
| | - Manuele Nizzetto
- Sub-Intensive Care COVID Unit in Pneumology, Dolo Hospital AULSS 3, Venice, Italy
| | - Chiara Ferrara
- Dolo Hospital AULSS 3 Venice, Non-critical COVID Area in Internal Medicine, Venice, Italy
| | - Alessandra Galiotto
- Dolo Hospital AULSS 3 Venice, Non-critical COVID Area in Internal Medicine, Venice, Italy
| | - Moreno Scevola
- Dolo Hospital AULSS 3 Venice, Non-critical COVID Area in Internal Medicine, Venice, Italy
| | - Fausto Rigo
- Division of Cardiology, Dolo Hospital AULSS 3, Venice, Italy
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17
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Tarantino N, Della Rocca DG, Zou F, Lin A, Natale A, Di Biase L. Prevalence, Outcomes, and Management of Ventricular Arrhythmias in COVID-19 Patients. Card Electrophysiol Clin 2021. [PMID: 35221078 PMCID: PMC8554003 DOI: 10.1016/j.ccep.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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18
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Pothineni NVK, Santangeli P. Electrophysiology and Interventional Cardiology Procedure Volumes During the Coronavirus Disease 2019 Pandemic. Card Electrophysiol Clin 2021; 14:105-110. [PMID: 35221077 PMCID: PMC8556575 DOI: 10.1016/j.ccep.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has imposed an unprecedented health care crisis across the globe. Health care efforts across the world have been diverted to tackling the pandemic since early 2020. Hospitals and health care systems have undertaken major restructuring in an effort to deliver health care to an increasing number of patients affected by COVID-19. Although great focus has been placed on treating those individuals suffering from COVID-19, clinicians must simultaneously balance caring for patients who are not actively infected. In anticipation of an exponential increase in COVID-19 cases, health care systems developed strategies to channel available resources to meet the rapidly rising demands of COVID-19. This change was noticed significantly in the field of invasive cardiology as well. Many cardiac catheterization and electrophysiology (EP) laboratories canceled elective procedures to limit the burden on hospital resources and preserve personal protective equipment (PPE). Major societies published guidance statements delineating patient selection for procedures during the exponential phase of the pandemic growth. Patient care was triaged and those waiting for elective procedures were managed with expectant care or noninvasive approaches to preserve hospital resources and personnel. In the current article, we review the impact of the COVID-19 pandemic and its response to the volume of interventional cardiology (IC) and EP procedures across the world.
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Affiliation(s)
- Naga Venkata K Pothineni
- Section of Electrophysiology, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Pasquale Santangeli
- Section of Electrophysiology, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Palazzuoli A, Giustozzi M, Ruocco G, Tramonte F, Gronda E, Agnelli G. Thromboembolic Complications in Covid-19: From Clinical Scenario to Laboratory Evidence. Life (Basel) 2021; 11:life11050395. [PMID: 33925334 PMCID: PMC8145351 DOI: 10.3390/life11050395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/20/2022] Open
Abstract
SARS-Cov-2 infection, a pandemic disease since March 2020, is associated with a high percentage of cardiovascular complications mainly of a thromboembolic (TE) nature. Although clinical patterns have been described for the assessment of patients with increased risk, many TE complications occur in patients with apparently moderate risk. Notably, a recent statement from the European Society of Cardiology (ESC) atherosclerosis and vascular biology working group pointed out the key role of vascular endothelium for the recruitment of inflammatory and thrombotic pathways responsible for both disseminated intravascular coagulation and cardiovascular complications. Therefore, a better understanding of the pathophysiological process linking infection to increased TE risk is needed in order to understand the pathways of this dangerous liaison and possibly interrupt it with appropriate treatment. In this review, we describe the histological lesions and the related blood coagulation mechanisms involved in COVID-19, we define the laboratory parameters and clinical risk factors associated with TE events, and propose a prophylactic anticoagulation treatment in relation to the risk category. Finally, we highlight the concept that a solid risk assessment based on prospective multi-center data would be the challenge for a more precise risk stratification and more appropriate treatment.
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Affiliation(s)
- Alberto Palazzuoli
- Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy; (G.R.); (F.T.)
- Correspondence: ; Tel.: +39-577-585-363 or +39-577-585-461; Fax: +39-577-233-480
| | - Michela Giustozzi
- Internal Vascular and Emergency Medicine and Stroke Unit, University of Perugia, 06121 Perugia, Italy; (M.G.); (G.A.)
| | - Gaetano Ruocco
- Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy; (G.R.); (F.T.)
| | - Francesco Tramonte
- Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy; (G.R.); (F.T.)
| | - Edoardo Gronda
- Department of Medicine and Medical Specialties, IRCCS Foundation Ca’ Granda Hospital, 20126 Milan, Italy;
| | - Giancarlo Agnelli
- Internal Vascular and Emergency Medicine and Stroke Unit, University of Perugia, 06121 Perugia, Italy; (M.G.); (G.A.)
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Pepe M, Frati G, Biondi-Zoccai G, Corcione N, Giordano A. Direct and indirect effects of COVID-19 on acute coronary syndromes: Can we pick the worst? Int J Cardiol 2021; 335:19-20. [PMID: 33901561 PMCID: PMC8064824 DOI: 10.1016/j.ijcard.2021.04.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Martino Pepe
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; IRCCS NEUROMED, Pozzilli, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Naples, Italy.
| | - Nicola Corcione
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy; Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy
| | - Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy; Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy
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Fedorowski A, Erlinge D. How much is good enough? Insights from myocardial infarction incidence during COVID-19 pandemic. Int J Cardiol 2021; 334:24-25. [PMID: 33857541 PMCID: PMC8053482 DOI: 10.1016/j.ijcard.2021.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Artur Fedorowski
- Department of Cardiology, Skåne University Hospital, Lund - Malmö, Sweden; Department of Clinical Sciences, Lund University, Lund - Malmö, Sweden.
| | - David Erlinge
- Department of Cardiology, Skåne University Hospital, Lund - Malmö, Sweden; Department of Clinical Sciences, Lund University, Lund - Malmö, Sweden
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