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Rathore SS, Atulkar A, Remala K, Corrales VV, Farrukh AM, Puar RK, Yao SJN, Ganipineni VDP, Patel N, Thota N, Kumar A, Deshmukh A. A systematic review and meta-analysis of new-onset atrial fibrillation in the context of COVID-19 infection. J Cardiovasc Electrophysiol 2024; 35:478-487. [PMID: 38185923 DOI: 10.1111/jce.16169] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/09/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
New-onset atrial fibrillation (NOAF) in COVID-19 raises significant clinical and public health issues. This systematic review and meta-analysis aims to compile and analyze the current literature on NOAF in COVID-19 and give a more comprehensive understanding of the prevalence and outcomes of NOAF in COVID-19. A comprehensive literature search was carried out using several databases. The random effect model using inverse variance method and DerSimonian and Laird estimator of Tua2 was used to calculate the pooled prevalence and associated 95% confidence interval (CI). Results for outcome analysis were presented as odds ratios (ORs) with 95% CI and pooled using the Mantel-Haenszel random-effects model. The pooled prevalence of NOAF in COVID-19 was 7.8% (95% CI: 6.54%-9.32%),a pooled estimate from 30 articles (81 929 COVID-19 patients). Furthermore, our analysis reported that COVID-19 patients with NOAF had a higher risk of developing severe disease compared with COVID-19 patients without a history of atrial fibrillation (OR = 4.78, 95% CI: 3.75-6.09) and COVID-19 patients with a history of pre-existing atrial fibrillation (OR = 2.75, 95% CI: 2.10-3.59). Similarly, our analysis also indicated that COVID-19 patients with NOAF had a higher risk of all-cause mortality compared with, COVID-19 patients without a history of atrial fibrillation (OR = 3.83, 95% CI: 2.99-4.92) and COVID-19 patients with a history of pre-existing atrial fibrillation (OR = 2.32, 95% CI: 1.35-3.96). The meta-analysis did not reveal any significant publication bias. The results indicate a strong correlation between NOAF and a higher risk of severe illness and mortality. These results emphasize the importance of careful surveillance, early detection, and customized NOAF management strategies to improve clinical outcomes for COVID-19 patients.
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Affiliation(s)
- Sawai Singh Rathore
- Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India
| | - Akanksha Atulkar
- Department of Internal Medicine, Global Remote Research Scholars Program, St. Paul, Minnesota, USA
| | - Kavya Remala
- Department of Internal Medicine, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
| | | | - Ameer Mustafa Farrukh
- Department of Internal Medicine, University of Galway School of Medicine, Galway, Ireland
| | - Ravinderjeet Kaur Puar
- Department of Internal Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Sem Josue Nsanh Yao
- Department of Internal Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Nirmal Patel
- Department of Internal Medicine, St. George's University School of Medicine, True Blue, Grenada
| | - Naganath Thota
- Department of Internal Medicine, Baptist Memorial Hospital, Memphis, Tennessee, USA
| | - Ashish Kumar
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, Ohio, USA
| | - Abhishek Deshmukh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Farrukh AM, Ganipineni VDP, Jindal U, Chaudhary A, Puar RK, Ghazarian K, Corrales VV, Alarcón SE, Remala K, Thota N, Vijayan S, Rathore SS. Unveiling the Dual Threat: Myocarditis in the Spectrum of Dengue Fever. Curr Probl Cardiol 2024; 49:102029. [PMID: 37567490 DOI: 10.1016/j.cpcardiol.2023.102029] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
This meta-analysis aims to systematically review and analyze available studies on the association between myocarditis and dengue viral fever. A comprehensive literature search was carried out using several databases. Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size using random effect models. Besides, random effects models were used to calculate the overall pooled prevalence. Data from 26 articles (6622 dengue patients) showed that pooled estimate of myocarditis in dengue fever was 12.4% (95% CI, 8.41-17.08). Higher prevalence was seen in reports from Asia (15.2%) compared to that from Latin America (3.6%). Besides, the pooled prevalence of severity and mortality was 34% (95% CI, 20.49-49.04) and 26.44% (95% CI, 18.07-35.78) respectively. Significantly higher prevalence rates of severe disease in the pediatric population (52.4%) and studies with a higher percentage of females (52.1%) were also observed. However, higher mortality rates were seen in the adult population (34.8%) compared with the pediatric age group. Further, myocarditis in dengue patients was associated with increased risk of severity (RR = 2.44, 95% CI 1.007-5.93, P = 0.048) and mortality (RR = 19.41, 95% CI 7.19-52.38, P < 0.001) compared with dengue patients without myocarditis. No significant publication bias was evident in the meta-analysis. The findings highlight the clinical significance of early identification and management of myocarditis in patients with dengue fever.
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Affiliation(s)
| | | | - Urmi Jindal
- KJ Somaiya Medical College and Research Centre, Mumbai, Maharashtra, India
| | | | | | | | | | | | - Kavya Remala
- Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
| | - Naganath Thota
- Department of Internal Medicine, Baptist Memorial Hospital, Memphis, TN
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Abstract
Lingual tonsillitis can cause various signs and symptoms including nocturnal or supine cough, constant discomfort in the throat, glossal pain, and otalgia. Most patients with lingual tonsillitis have already had palatine tonsillectomy. A lingual tonsil may be visible only by using a laryngeal mirror. An embedded foreign body can cause recurrent tonsillitis with abscess formation, and life-threatening airway obstruction may result. Aberrant lingual thyroid may be the only functioning thyroid tissue. Cryosurgery and the CO2 laser have made lingual tonsillectomy a safe and simple procedure. An abscess of a lingual tonsil should be drained under general anesthesia, and lingual thyroid should be treated conservatively unless it produces obstructive symptoms.
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