ABSTRACT
Background: The relative association between cardiovascular disease (CVD) and mortality in COVID-19 remains unclear. Aim(s): to evaluate the relationship of CVD with in-hospital death among hospitalized patients with Covid-19. Material(s) and Method(s): retrospective cohort study included hospitalized patients aged >= 18 years with confirmed COVID-19 between October and December 2021 in Single COVID -19 department of UMHAT "Alexandrovska". Demographic, clinical and outcome (in-hospital mortality) data were obtained from medical records. All CVD comorbidites were recorded. Multivariate logistic regression models were fitted to quantify the risk and predictors of in-hospital mortality from COVID-19 in patients with these comorbidities. Result(s): 165 patients with a mean age of 64.6+/-15 of whom 44.8% were men were included. In-hospital mortality was 20%. The presence of CVD was associated with increased in-hospital mortality. Mortality risk was higher in patients having hypertension (28.7% vs. 8.7%, p<0.05), coronary artery disease (27.0% vs. 6.5%, p<0.001), previous ischemic stroke (8.1% vs. 1.6%, p< 0.05), valvular heart diasease (16.2% vs. 4.1%), chronic heart failure (29.7% vs. 4.0%, p<0.001). Significant predictors of mortality from COVID-19 in patients with CVD were three vessel disease (HR: 2.04;95% CI 1.42-9.82, p<0.05), previous percutaneous coronary intervention (HR: 5.0;95% CI 2.05-8.56, p<0.05), systolic dysfunction (HR: 5.4;95% CI 1.85-15.76, p<0.05) and advanced heart failure NYHA III-IV (HR: 2.62;95% CI 1.55-4.78, p<0.001). Conclusion(s): COVID-19 patients with CVD comorbidites have a higher risk of in-hospital death. Optimal care and good control of CVD are essential in this patient group.
ABSTRACT
Spontaneous pneumomediastinum is a condition, in which the presence of free air in the mediastinum is established, without previous trauma, surgery or other medical procedure. Due to its relative rarity and difficulty in establishing clinical manifestations, its diagnosis can easily be missed. Pneumomediastinum is rare in viral infections, with only single cases of patients with COVID-19 and pneumomediastinum reported in the literature. The clinical case presented by us is of a 58-year-old man with bilateral inflammatory lung changes associated with COVID-19 infection and development of spontaneous pneumomediastinum. The complication was controlled against the background of oxygen therapy, without the need for intubation and mechanical ventilation. Although pneumomediastinum is a rare complication in patients with COVID-19, there is evidence that its occurrence is a factor associated with disease exacerbation as well as an increased risk of death. Early diagnosis of pneumomediastinum enables better management of the acute respiratory failure with conservative approach, which improves the prognosis in these patients. © 2021, Central Medical Library Medical University – Sofia. All rights reserved.