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Servato ML, Valente FX, García-Moreno LG, Casas G, Fernández-Galera R, Burcet G, Teixidó-Tura G, Calabria HC, González IF, Rodríguez-Palomares JF. Intraventricular Conundrum in a SARS-CoV-2-Positive Patient With Elevated Biomarkers of Myocardial Injury. JACC Case Rep 2021; 3:566-572. [PMID: 33821246 PMCID: PMC8011590 DOI: 10.1016/j.jaccas.2021.01.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/16/2020] [Revised: 01/14/2021] [Accepted: 01/22/2021] [Indexed: 12/11/2022]
Abstract
We present a case of acute myocarditis with left ventricular dysfunction and intracavitary thrombosis in a 55-year-old man with severe acute respiratory syndrome coronavirus 2 infection (coronavirus disease 2019) who was admitted with bilateral atypical pneumonia. The patient was treated with anticoagulation and optimal heart failure therapy and had an improvement of left ventricular function and thrombus resolution. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- María L. Servato
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
| | - Filipa X. Valente
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
| | - Laura Gutiérrez García-Moreno
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
| | - Guillem Casas
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
| | - Rubén Fernández-Galera
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
| | - Gemma Burcet
- Radiology Service, Institute for Diagnostic Imaging, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Gisela Teixidó-Tura
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
| | - Hug Cuéllar Calabria
- Radiology Service, Institute for Diagnostic Imaging, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Ignacio Ferreira González
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Epidemiology and Public Health Consortium, Madrid, Spain
| | - José F. Rodríguez-Palomares
- Department of Cardiology, Vall d’Hebron University Hospital, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Investigation Cardiovascular Consortium, Madrid, Spain
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Franchini M, Glingani C, Morandi M, Corghi G, Cerzosimo S, Beduzzi G, Storti A, Di Stasi V, Rastrelli G, Vignozzi L, Mengoli C, Garuti M, Beccaria M, Inglese F, Caruso B, Petilino RA, Amato M, Nicchio M, Pagani M, Bellani A, Castelli G, Casari S, De Donno G. Safety and Efficacy of Convalescent Plasma in Elderly COVID-19 Patients: The RESCUE Trial. Mayo Clin Proc Innov Qual Outcomes 2021; 5:403-412. [PMID: 33585799 PMCID: PMC7869678 DOI: 10.1016/j.mayocpiqo.2021.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Indexed: 12/15/2022] Open
Abstract
Objective To assess the safety and efficacy of convalescent plasma (CP) transfusion in elderly people with moderate to severe coronavirus disease 2019 (COVID-19) living in a long-term care facility (LTCF). Patients and Methods Twenty-two consecutive elderly patients with COVID-19 infection living in an LTCF in Lombardy, Italy, who were given CP during May 15 to July 31, 2020, were enrolled in a prospective cohort study. Their clinical, instrumental, and laboratory parameters were assessed following the CP treatment. The overall mortality rate in this group was compared with that recorded in other LTCFs in Lombardy during the 3-month period from March to May 2020. Results Of the 22 patients enrolled, 68.2% (n=15) received 1 CP unit, 27.3% (n=6) received 2 units, and 4.5% (n=1) received 3 units. Of the CP units transfused, 76.7% (23/30) had a neutralizing antibody titer of 1:160 or greater. No adverse reactions were recorded during or after CP administration. Improvements in clinical, functional, radiologic, and laboratory parameters during the 14 days after CP transfusion were observed in all 19 patients who survived. Viral clearance was achieved in all patients by the end of follow-up (median, 66 days; interquartile range, 48-80 days). The overall mortality rate was 13.6% (3/22), which compared favorably with that in the control group (38.3% [281/733]; P=.02) and corresponded to a 65% reduction in mortality risk. Conclusion Early administration of CP with an adequate anti-severe acute respiratory syndrome coronavirus 2 antibody titer to elderly symptomatic patients with COVID-19 infection in an LTCF was safe and effective in eliminating the virus, restoring patients' immunity, and blocking the progression of COVID-19 infection, thereby improving patients' survival. Trial Registration ClinicalTrials.gov: NCT04569188.
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Key Words
- COVID-19, coronavirus disease 2019
- CP, convalescent plasma
- CRP, C-reactive protein
- Fio2, fraction of inspired oxygen
- IL-6, interleukin 6
- IQR, interquartile range
- ISS, Italian National Institute of Health
- LTCF, long-term care facility
- NNT, number needed to treat
- NS, not significant
- PCR, polymerase chain reaction
- RESCUE, Real-time Evaluation of Safety and Efficacy of Convalescent Plasma Units Transfused to Elderly Patients With COVID-19
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
- Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - Claudia Glingani
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - Mario Morandi
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | | | - Sara Cerzosimo
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | - Gloria Beduzzi
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | - Andrea Storti
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | - Vincenza Di Stasi
- "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence-Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, Florence, Italy
| | - Giulia Rastrelli
- "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence-Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, Florence, Italy
| | - Linda Vignozzi
- "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence-Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, Florence, Italy
| | - Carlo Mengoli
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | | | | | | | | | | | - Massimo Amato
- Emergency Department, Carlo Poma Hospital, Mantova, Italy
| | | | - Mauro Pagani
- Department of Medicine, Ospedale Destra Secchia, Carlo Poma Hospital, Mantova, Italy
| | - Angela Bellani
- Department of Frailty, Carlo Poma Hospital, Mantova, Italy
| | - Gianpaolo Castelli
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Mantova, Italy
| | - Salvatore Casari
- Unit of Infectious Diseases, Carlo Poma Hospital, Mantova, Italy
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Huette P, Beyls C, Guilbart M, Haye G, Najid FZ, Mestan B, Roger PA, Dupont H, Abou-Arab O, Mahjoub Y. Acute Cor Pulmonale in COVID-19-Related ARDS: Improvement With Almitrine Infusion. JACC Case Rep 2020; 2:1311-1314. [PMID: 32835274 PMCID: PMC7296301 DOI: 10.1016/j.jaccas.2020.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/20/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 12/19/2022]
Abstract
Coronavirus disease-19 (COVID-19)-related severe acute respiratory distress syndrome can lead to acute cor pulmonale. We report a case of acute cor pulmonale secondary to severe COVID-19 acute respiratory distress syndrome diagnosed with transesophageal echocardiography. Almitrine infusion allowed rapid enhancement of right ventricular function as well as improvement in oxygenation. (Level of Difficulty: Intermediate.)
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Key Words
- ACE2, angiotensin-converting enzyme 2
- ACP, acute cor pulmonale
- ARDS
- ARDS, acute respiratory distress syndrome
- CI, cardiac index
- COVID-19
- COVID-19, coronavirus disease-19
- CT, computed tomography
- Fio2, fraction of inspired oxygen
- Pao2, partial pressure of oxygen
- RV, right ventricle
- RVSWI, right ventricular stroke work index
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2
- TEE, transesophageal echocardiography
- acute cor pulmonale
- almitrine
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Affiliation(s)
- Pierre Huette
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Mathieu Guilbart
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Guillaume Haye
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Fatim-Zahra Najid
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Benjamin Mestan
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Pierre-Alexandre Roger
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
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Coyle J, Igbinomwanhia E, Sanchez-Nadales A, Danciu S, Chu C, Shah N. A Recovered Case of COVID-19 Myocarditis and ARDS Treated With Corticosteroids, Tocilizumab, and Experimental AT-001. JACC Case Rep 2020; 2:1331-1336. [PMID: 32368755 PMCID: PMC7196388 DOI: 10.1016/j.jaccas.2020.04.025] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [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: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 12/13/2022]
Abstract
We describes a case of a critically ill patient with myocarditis and severe acute respiratory distress syndrome related to coronavirus disease-2019. This case highlights management strategies, including the use of corticosteroids, an interleukin-6 inhibitor, and an aldose reductase inhibitor, resulting in complete clinical recovery. (Level of Difficulty: Intermediate.)
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Key Words
- 2019-nCoV
- ACS, acute coronary syndrome
- ARDS
- ARDS, acute respiratory distress syndrome
- ARI, aldose reductase inhibitor
- CMR, cardiac magnetic resonance
- COVID-19
- COVID-19, coronavirus disease-2019
- CT, computed tomography
- ECG, electrocardiogram
- Fio2, fraction of inspired oxygen
- LGE, late gadolinium enhancement
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2
- aldose reductase inhibitor
- cardiac magnetic resonance
- cardiogenic shock
- corticosteroids
- myocarditis
- tocilizumab
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Affiliation(s)
- Justin Coyle
- Department of Cardiovascular Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois
| | - Efehi Igbinomwanhia
- Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois
| | | | - Sorin Danciu
- Department of Cardiovascular Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois
| | - Chae Chu
- Department of Pulmonology and Critical Care Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois
| | - Nishit Shah
- Department of Cardiovascular Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois
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