Short and long-term survival in patients hospitalized due to COVID-19 in relation to cardiovascular risk factors and established cardiovascular diseases: the Cor-Cardio Study.

INTRODUCTION: We aimed to analyze the influence of cardiovascular risk factors, established cardiovascular diseases and its treatment with cardiovascular drugs on short term and long term survival in patients hospitalized due to COVID-19. PATIENTS AND METHODS: We retrospectively analyzed data of patients hospitalized in thirteen COVID - 19 hospitals in Poland (between March 2020 and October 2020). Individual deaths were recorded during follow-up until March 2021. RESULTS: Overall 2346 COVID-19 patients were included (mean age 61 years, 50.2% women). 341 patients (14.5%) died during hospitalization and 95 (4.7%) died during follow-up. Independent predictors for in-hospital death were: older age, history of established cardiovascular disease, heart failure (HF), chronic kidney disease (CKD), while treatment with renin-angiotensin-aldosterone system (RAAS) blockers and statins were related with lower risk of death during hospitalization. The independent predictors of death during follow-up were older age, history of established cardiovascular disease, CKD and history of cancer. Presence of cardiovascular risk factors did not increase odds of death either in hospital or during follow-up. Of note, higher systolic blood pressure and oxygen blood saturation on admission were assessed with better short and long term prognosis. CONCLUSION: Established cardiovascular disease and chronic kidney disease are the main predictors of mortality during hospitalization and during follow-up in patients hospitalized due to COVID-19, while the use of cardiovascular drugs during hospitalization is associated with better prognosis. The presence of cardiovascular risk factors did not increase odds of in-hospital and follow-up death.

Blood Pressure and Arterial Stiffness in Association With Aircraft Noise Exposure:Long-Term Observation and Potential Effect of COVID-19 Lockdown.

In a cross-sectional analysis of a case-control study in 2015, we revealed the association between increased arterial stiffness (pulse wave velocity) and aircraft noise exposure. In June 2020, we evaluated the long-term effects, and the impact of a sudden decline in noise exposure during the coronavirus disease 2019 (COVID-19) lockdown, on blood pressure and pulse wave velocity, comparing 74 participants exposed to long-term day-evening-night aircraft noise level >60 dB and 75 unexposed individuals. During the 5-year follow-up, the prevalence of hypertension increased in the exposed (42% versus 59%, P=0.048) but not in the unexposed group. The decline in noise exposure since April 2020 was accompanied with a significant decrease of noise annoyance, 24-hour systolic (121.2 versus 117.9 mm Hg; P=0.034) and diastolic (75.1 versus 72.0 mm Hg; P=0.003) blood pressure, and pulse wave velocity (10.2 versus 8.8 m/s; P=0.001) in the exposed group. Less profound decreases of these parameters were noticed in the unexposed group. Significant between group differences were observed for declines in office and night-time diastolic blood pressure and pulse wave velocity. Importantly, the difference in the reduction of pulse wave velocity between exposed and unexposed participants remained significant after adjustment for covariates (-1.49 versus -0.35 m/s; P=0.017). The observed difference in insomnia prevalence between exposed and unexposed individuals at baseline was no more significant at follow-up. Thus, long-term aircraft noise exposure may increase the prevalence of hypertension and accelerate arterial stiffening. However, even short-term noise reduction, as experienced during the COVID-19 lockdown, may reverse those unfavorable effects.

Literature-based considerations regarding organizing and performing cardiac surgery against the backdrop of the coronavirus pandemic.

BACKGROUND: The ongoing coronavirus disease 2019 (Covid-19) pandemic presents challenges for surgeons of all disciplines, including cardiologists. The volume of cardiac surgery cases has to comply with the mandatory constraints of healthcare capacities. The treatment of Covid-19-positive patients must also be considered. Unfortunately, no scientific evidence is available on this issue. Therefore, this study aimed to offer some consensus-based considerations, derived from available scientific papers, regarding the organization and performance of cardiac surgery against the backdrop of the Covid-19 pandemic. METHODS: Key recommendations were extracted from recent literature concerning cardiac surgery. RESULTSː Reducing elective cardiac procedures should be based on frequent clinical assessment of patients on the waiting list (every one or two weeks) and the current local status of the Covid-19 pandemic. Screening tests at admission for every patient are broadly recommended. Where appropriate, alternative treatment methods can be considered, including percutaneous techniques and minimally invasive surgery, if performed by experienced cardiac surgery teams. CONCLUSIONS: There is little evidence on the strategies to organize cardiac surgery in the Covid-19 pandemic. Most authors agree on reducing elective operations based on patients' clinical condition and the status of the Covid-19 pandemic. Admission screenings and the use of percutaneous or minimally invasive approaches should be preferred to reduce in-hospital stays.

Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society.

The coronavirus disease 2019 (COVID-19) pandemic affects anticoagulation not only in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but also in most patients who require daily anticoagulant therapy and are facing substantial limitations in medical care these days. Concomitant venous thromboembolism (VTE), a potential cause of unexplained deaths, has frequently been reported in patients with COVID-19, but its management is still challenging due to the complexity between antithrombotic therapy and hematological alterations. In the era of COVID-19 pandemic, it is highly recommended for patients who require chronic anticoagulation to continue therapy to prevent thromboembolic events. To avoid regular and frequent blood tests and unnecessary exposure to SARS-CoV-2 during contacts with medical personnel, direct oral anticoagulants should be strongly preferred whenever possible. Current evidence is insufficient to recommend routine pharmacological antithrombotic prophylaxis in all hospitalized patients with COVID-19. In patients with COVID-19 who are suspected of VTE or in whom the diagnosis is confirmed, parenteral therapy with low-molecular-weight heparin should be initiated in the absence of contraindications. If heparin-induced thrombocytopenia is suspected, nonheparin anticoagulants should be used such as bivalirudin or fondaparinux. In case of confirmed acute pulmonary embolism, treatment should be guided by risk stratification as defined in the current guidelines.