ABSTRACT
A patient presented with COVID-19-induced enteritis and colitis associated with a high D-dimer. Serotonin released by activated platelets can lead to inflammation and multiorgan failure in COVID-19 infection. Cyproheptadine blocks serotonin receptors. In light of a prior report that showed that cyproheptadine successfully treated neurologic sequelae in COVID-19, we applied this treatment to this patient. Rapid clinical improvement and reduction of D-dimer occurred after 3 doses of cyproheptadine. This inexpensive, well-Tolerated, oral medication may be applicable to treat hyperinflammatory sequelae of COVID-19 infection.Copyright © 2023 American College of Gastroent. All rights reserved.
ABSTRACT
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 allcause 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
COVID-19 and its associated disease control measures have greatly altered everyday life. The burden of these challenges has fallen disproportionately on women. Drawing on qualitative inquiry in agrarian north India and Nepal, this research note analyzes how South Asian COVID-19 lockdowns have affected women's labor responsibilities in sometimes surprising ways. We find increased responsibilities for caregiving within the household, substantial stress in responding to food insecurity, and growing expectations to fulfill public roles in disease response measures. However, we also find that the return of male migrants and youth has, in some cases, reduced women's farming responsibilities and created opportunities for household togetherness at a time of great uncertainty. We conclude that more research is needed to examine the nuanced aspects of COVID-19's gendered labor impacts to create comprehensive policy responses to address the multiple and sometimes conflicting effects the lockdown has had on agrarian women's informal labor and well-being.