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Sethwala A, Hirschfeld CB, O'Sullivan P, Akbarally M, Younger J, Van Pelt N, Randazzo M, Lenturut-Katal D, Vitola JV, Cerci R, Williams MC, Shaw LJ, Karthikeyan G, Villines TC, Dorbala S, Choi AD, Cohen YA, Malkovskiy E, Pascual TNB, Pynda Y, Dondi M, Paez D, Einstein AJ, Better N. Recovery Rates of Diagnostic Cardiac Procedural Volume in Oceania 1 Year Into COVID-19: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID 2). Heart Lung Circ 2024:S1443-9506(23)04471-2. [PMID: 38365497 DOI: 10.1016/j.hlc.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/10/2023] [Accepted: 12/10/2023] [Indexed: 02/18/2024]
Abstract
AIM The aim of this study was to assess the recovery rates of diagnostic cardiac procedure volumes in the Oceania Region, midway through the coronavirus disease 2019 (COVID-19) pandemic. METHODS A survey was performed comparing procedure volumes between March 2019 (pre-pandemic), April 2020 (during first wave of COVID-19 pandemic), and April 2021 (1 year into the COVID-19 pandemic). A total of 31 health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, as well as teaching and non-teaching hospitals. A comparison was made with 549 centres in 96 countries in the rest of the world (RoW) outside of Oceania. The total number and median percentage change in procedure volume were measured between the three timepoints, compared by test type and by facility. RESULTS A total of 11,902 cardiac diagnostic procedures were performed in Oceania in April 2021 as compared with 11,835 pre-pandemic in March 2019 and 5,986 in April 2020; whereas, in the RoW, 499,079 procedures were performed in April 2021 compared with 497,615 pre-pandemic in March 2019 and 179,014 in April 2020. There was no significant difference in the median recovery rates for total procedure volumes between Oceania (-6%) and the RoW (-3%) (p=0.81). While there was no statistically significant difference in percentage recovery been functional ischaemia testing and anatomical coronary testing in Oceania as compared with the RoW, there was, however, a suggestion of poorer recovery in anatomical coronary testing in Oceania as compared with the RoW (CT coronary angiography -16% in Oceania vs -1% in RoW, and invasive coronary angiography -20% in Oceania vs -9% in RoW). There was no statistically significant difference in recovery rates in procedure volume between metropolitan vs regional (p=0.44), public vs private (p=0.92), hospital vs outpatient (p=0.79), or teaching vs non-teaching centres (p=0.73). CONCLUSIONS Total cardiology procedure volumes in Oceania normalised 1 year post-pandemic compared to pre-pandemic levels, with no significant difference compared with the RoW and between the different types of health care facilities.
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Affiliation(s)
| | - Cole B Hirschfeld
- Department of Medicine, Columbia University Irving Medical Center, Weill Cornell Medicine, and NewYork-Presbyterian Hospital, New York, NY, USA
| | | | | | - John Younger
- Royal Brisbane Hospital, Brisbane, Qld, Australia University of Queensland, Brisbane, Qld, Australia
| | | | - Michael Randazzo
- Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | | | | | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Leslee J Shaw
- Blavatnik Family Women's Health Research Institute, Mount Sinai Medical Center, New York, NY, USA
| | - Ganesan Karthikeyan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sharmila Dorbala
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew D Choi
- The George Washington University School of Medicine, Washington, DC, USA
| | - Yosef A Cohen
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA; Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Eli Malkovskiy
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Thomas N B Pascual
- Department of Science and Technology-Philippines, Philippine Nuclear Research Institute, Manila, Philippines
| | - Yaroslav Pynda
- Department of Science and Technology-Philippines, Philippine Nuclear Research Institute, Manila, Philippines
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Andrew J Einstein
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA; Department of Radiology, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | - Nathan Better
- Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of Cardiology, Cabrini Health, Malvern, Vic, Australia; Monash University and University of Melbourne, Melbourne, Vic, Australia
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Paruchuri SSH, Farwa UE, Jabeen S, Pamecha S, Shan Z, Parekh R, Lakkimsetti M, Alamin E, Sharma V, Haider S, Khan J, Razzaq W. Myocarditis and Myocardial Injury in Long COVID Syndrome: A Comprehensive Review of the Literature. Cureus 2023; 15:e42444. [PMID: 37637608 PMCID: PMC10449234 DOI: 10.7759/cureus.42444] [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: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
The repercussions of coronavirus disease 2019 (COVID-19) have been devastating on a global scale. Long COVID, which affects patients for weeks or even months after their initial infection, is not limited to individuals with severe symptoms and can affect people of all ages. The condition can impact various physiological systems, leading to chronic health conditions and long-term disabilities that present significant challenges for healthcare systems worldwide. This review explores the link between long COVID and cardiovascular complications such as myocardial injury and myocarditis. It also highlights the prevalence of these complications and identifies risk factors for their development in long COVID patients. Myocardial injury occurs due to direct cellular damage and T-cell-mediated cytotoxicity resulting in elevated cardiac biomarkers. Diagnostic techniques like electrocardiogram, troponin level testing, and magnetic resonance imaging can help identify myocarditis, but endomyocardial biopsy is considered the gold-standard diagnostic technique. Guideline-directed medical therapy is recommended for COVID-19 myocarditis patients for better prognosis while being monitored under comprehensive care management approaches. Therefore, it's critical to develop effective screening techniques specifically for vulnerable populations while conducting further research that addresses the effects of long COVID on society's physical health.
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Affiliation(s)
- Sai Sri Hari Paruchuri
- Internal Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND
| | - Umm E Farwa
- Emergency Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Shaista Jabeen
- Medicine, Pakistan Air Force (PAF) Hospital, Islamabad, PAK
| | - Shreyansh Pamecha
- Internal Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Zoofi Shan
- Cardiology, Hero DMC (Dayanand Medical College) Heart Institute, Ludhiana, IND
| | - Ritika Parekh
- Community Health, K. J. (Karamshibhai Jethabhai) Somaiya Medical College and Research Centre, Mumbai, Mumbai, IND
| | | | - Eman Alamin
- Community Health, University of Medical Sciences and Technology, Khartoum, SDN
| | - Vagisha Sharma
- College of Medicine, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Salar Haider
- Physiology, Shifa College of Medicine, Islamabad, PAK
| | - Javeria Khan
- Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Waleed Razzaq
- Internal Medicine, Services Hospital Lahore, Lahore, PAK
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Abstract
Myocarditis and pericarditis are inflammatory conditions of the heart that present a range of symptoms, often including chest pain, fatigue, breathlessness and palpitations that may be irregular due to cardiac rhythm disturbances. Myocarditis has been proposed to account for a fraction of cardiac injury among patients infected with SARS-CoV-2 and associated systemic inflammation; and it might be one of the reasons for the high mortality seen in COVID-19 patients. Furthermore, following vaccination with mRNA COVID-19 vaccines (ie, Comirnaty and Spikevax), myocarditis and pericarditis can develop within a few days of vaccination, particularly following the second dose. Based on recent reviewed data, the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have determined that the risk for both of these conditions is overall ‘very rare’ (~1 in 10 000 vaccinated people may be clinically affected), with the highest risk among younger males. Both EMA and FDA agree that the benefits of all authorised COVID-19 vaccines continue to outweigh their risks, given the threat of serious COVID-19 illness and related complications. Since myocarditis has a very wide clinical spectrum, ranging from mild to fulminant life-threatening disease, we present in this review a sum of the latest findings and considerations for the proper diagnosis and management of affected patients.
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Affiliation(s)
- Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital & Faculty of Medicine, Tel Aviv University, Tel Aviv, Petah Tikva, Israel
| | - Guy Witberg
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital & Faculty of Medicine, Tel Aviv University, Tel Aviv, Petach Tikva, Israel
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