Characteristics and outcomes of hospitalized patients with cardiovascular complications of covid-19

Funding Acknowledgements

Type of funding sources: None.

Introduction

Recent reports have indicated that a considerable portion of patients experiences a cardiac injury, ranging from 7.2% to 22.2%, which is linked to higher mortality. Nevertheless, previous studies have exclusively focused on the cardiac injury defined as a raised cardiac marker without a definitive diagnosis. To our knowledge, the present retrospective cohort study is the first study to comprehensively address cardiovascular (CV) complications and related outcomes in COVID-19 patients.

Purpose

To address CV complications and their relationship to clinical outcomes in hospitalized patients with COVID-19.

Methods

A total of 196 adult hospitalized patients admitted to our hospital with a confirmed diagnosis of COVID-19 and a consultation requested from the cardiology department were enrolled in this retrospective single-center cohort study from September 10, 2020, to December 10, 2020, with a median age of 65 years (IQR, 52-77). Cardiac examinations included cardiac biomarkers, electrocardiography, and echocardiography. Data regarding complications during hospitalization were extracted, and patients were categorized into two groups concerning the presence or absence of CV complications. All transthoracic echocardiographic (TTE) assessments were performed by a single cardiologist, who was provided with personal protective gear according to national guidelines. Follow-up continued for 3 months after hospital discharge.

Results

CV complication was observed in 54 (27.6%) patients, with arrhythmia being the most prevalent (14.8%) followed by myocarditis, acute coronary syndromes, ST-elevation myocardial infarction, cerebrovascular accident, and deep vein thrombosis in 15 (7.7%), 12 (6.1%), 10 (5.1%), 8 (4.1%), and 4 (2%) patients, respectively. The proportion of patients with elevated hs-TpI, NT-proBPN, left ventricular diastolic dysfunction, and heart failure with preserved ejection fraction was greater in the CV complication group. Severe forms of COVID-19 comprised nearly two-thirds (64.3%) of our study population and constituted a significantly higher share of the CV complication group members (75.9% vs 59.9%; P = 0.036). Intensive care unit admission (64.8% vs 44.4%; P = 0.011) and stay (5.5 days vs 0 day; P = 0.032) were notably higher in patients with CV complications. Among 196 patients, 50 died during hospitalization and 10 died after discharge, yielding all-cause mortality of 30.8%. However, there were no between-group differences concerning mortality. Heart failure, cancer/autoimmune disease, severity, interferon beta-1a, and arrhythmia were the independent predictors of all-cause mortality during and after hospitalization.

Conclusion

CV complications occurred widely among COVID-19 patients. Moreover, arrhythmia, as the most common complication, was associated with increased mortality. Abstract Figure.

Synthesis, NMR Characterisation, X–ray Crystal Structure and Solution Studies of Ni(II) Complexes of a Pyridine Containing Self–assembling System

X-ray analysis of Ni(II) complexes of the self-assembling system LH2, [pyda.H2][pydc] (pydc.H2 = 2,6-pyridinedicarboxylic acid and pyda = 2,6-pyridinediamine), indicated that two six-coordinated anionic [pyda.H]2[Ni(pydc)2].H2O (I) and neutral [Ni(pydc.H)2].3H2O (II) complexes are formed at different temperature conditions in water; in agreement with the results obtained from potentiometric pH titrations in the pH range 3.5–5.5.

Long-term follow-up of ninety eight Iranian patients with primary immune deficiency in a single tertiary centre

PURPOSE

The aim was to describe the clinical manifestations, complications and long-term outcome of a cohort of Iranian patients with primary immune deficiency (PID).

METHOD

We retrospectively studied the demographic, clinical and immunological characteristics of the PID patients in a single tertiary centre, from January 1989 to July 2014. The patients were classified according to the International Union of Immunological Societies Expert Committee on PID.

RESULTS

98 patients were diagnosed with and followed-up for 15 disorders. The mean age at onset and diagnosis and the diagnostic delay were 8±10, 14.2±13.1 and 6.1±7 years, respectively. Parental consanguinity rate was 57%. Predominantly Antibody Deficiency was the most common diagnosis (n=63), followed by congenital defects of phagocytes (n=16), combined immunodeficiencies (n=12), well defined syndromes (n=4) and defects in innate immunity (n=3). Recurrent sinopulmonary infection was the most common presentation. Active infections were treated appropriately, in addition to prophylactic therapy with IVIG and antimicrobials. Not all the patients were compliant with prophylactic regimens due to cost and unavailability. One SCID patient underwent successful bone marrow transplantation. The total mortality rate was 19% during the follow-up period (7.8±7.6 years). The mean age of living patients at the time of study was 23±11.7 years.

CONCLUSIONS

Physicians awareness of PID has been rising dramatically in Iran, ensuring an increasing number of patients being diagnosed and treated. More effective treatment services, including health insurance coverage and drug availability are needed to improve the outcome of PID patients.

Potentiometric determination of trace amounts of amantadine using a modified carbon-paste electrode

A chemically modified carbon-paste electrode has been described for the sensitive and selective determination of amantadine. Beta-cyclodextrin was used as modifier. The electrode shows a sub-Nernstian response of 51.0 +/- 1.0 mV decade(-1) for amantadine in the concentration range of 6.3 x 10(-10)-7.1 x 10(-7) M at 25 degrees C. The optimum pH value was maintained at 4.5 using a 0.02 M acetate buffer. The limit of detection of the electrode was 6.3 x 10(-10) M of amantadine. The electrode responded very rapidly (<60 s) to changes in the concentration of amantadine, and its lifetime was more than three months. The relative standard deviation of measurements for a 2.0 x 10(-7) M of amantadine was 0.68% (n = 7). The application of a modified carbon-paste electrode to the determination of amantadine in its pharmaceutical preparations showed a relative error of 2%. The recovery of amantadine (2.5 x 10(-8) M) from a blood-serum sample was 94%.

Synthesis, characterization, and X-ray crystal structures of Co(II) and La(III) complexes of a pyridine containing self-assembling system and solution studies of the Co(II) complex

The complexes [pyda.H]2[Co(pydc)2]·H2O (I) and [pyda·H]2[La2(pydc)4(H2O)4].2H2O (II) were prepared from the complexation of a novel pyridine containing self-assembling system LH2, ([pyda·H2]2+[pydc]2–) (pyda = 2,6-pyridinediamine and pydc·H2 = 2,6-pyridinedicarboxylic acid), with cobalt(II) and lanthanum(III) salts in 82% and 74% yields, respectively. The characterizations were performed using elemental analysis, ESI mass spectroscopy as well as 1H and 13C solution NMR spectroscopy, and X-ray crystallography. The crystal systems I and II are monoclinic and triclinic with space groups P21/n and P[Formula: see text] respectively. Coordination number around each Co atom is six with distorted octahedral geometry, while coordination number around each La atom is nine with highly distorted tricapped trigonal prism geometry. The paramagnetic Co(II) and diamagnetic La(III) complexes show 1H NMR resonances of both anionic [pydc]2- and cationic counter ion [pyda·H]+ in DMSO-d6. The complexation reactions of the complex I in aqueous solution were investigated by potentiometric pH titrations and the equilibrium constants for all major complexes formed are described. The results are presented in the form of distribution diagrams revealing the concentrations of individual complex species as a function of pH. The results revealed that at a pH range 4.0–4.5 the major complex species is [(pyda·H)]2[Co(pydc)2].Key words: self-assembly, X-ray crystal structure, Co(II) complex, La(III) complex, 2,6- pyridinedicarboxylic acid, 2,6-pyridinediamine, hydrogen bonding.

Isolation of adenylate cyclase gene-specific sequences from Ophiostoma novo-ulmi, Candida albicans, and Agaricus bisporus by PCR

Degenerate primers corresponding to consensus sequences in the catalytic domains of known fungal adenylate cyclases were used to isolate gene-specific homologs from the Dutch elm disease pathogen Ophiostoma novo-ulmi, the dimorphic human pathogen Candida albicans, and the commercial mushroom Agaricus bisporus. All three fungi gave the expected PCR product of about 390 bp. Computer searches of the databases revealed that the products generated from O. novo-ulmi and C. albicans were highly similar to the adenylate cyclase gene of Magnaporthe grisea, the rice blast fungus (91% and 79%, respectively). The PCR product from the homobasidiomycete A. bisporus, on the other hand, showed 78% similarity to the uac1 gene of the heterobasidiomycete smut fungus, Ustilago maydis. Southern hybridization indicated that all three fungi contain a single adenylate cyclase gene. Our data suggest that PCR will be highly successful for the isolation of adenylate cyclase sequences from other fungi.