ABSTRACT
Since the emergence of novel coronavirus and the disease named as COVID-19 in late December of 2019 in Wuhan, Hubei province, China, many aspects of this disease have been reported in the literature (mainly pulmonary manifestations). In patients with COVID-19, rheumatic and cardiovascular manifestations and interactions were reported separately, but they were all very rare. This is the report of a 14-year-old teenager with GPA (previously known as Wegner's granulomatosis) who was in remission with immunosuppressive therapy. Post COVID-19 infection, she developed exacerbation of her disease. Besides the rheumatologic manifestations, she developed epigastric pain found to be acute myocardial infarction (MI) that needed primary percutaneous coronary intervention (PCI).
Subject(s)
COVID-19/complications , COVID-19/diagnosis , Granulomatosis with Polyangiitis/complications , Myocardial Infarction/diagnosis , Myocardial Infarction/etiology , Adolescent , COVID-19/therapy , Female , Humans , Myocardial Infarction/therapyABSTRACT
[Figure: see text].
Subject(s)
Arrhythmias, Cardiac/epidemiology , COVID-19/epidemiology , Global Health/trends , Aged , Arrhythmias, Cardiac/mortality , Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/therapy , COVID-19/mortality , COVID-19/therapy , Cardiac Electrophysiology/trends , Comorbidity , Electrophysiologic Techniques, Cardiac/trends , Female , Health Care Surveys , Healthcare Disparities , Humans , Incidence , Male , Middle Aged , Practice Patterns, Physicians'/trends , Prevalence , Prognosis , Retrospective Studies , Risk Assessment , Time FactorsABSTRACT
To assess imaging data in COVID-19 patients and its association with clinical course and survival and 86 consecutive patients (52 males, 34 females, mean age = 58.8 year) with documented COVID-19 infection were included. Seventy-eight patients (91%) were in severe stage of the disease. All patients underwent transthoracic echocardiography. Mean LVEF was 48.1% and mean estimated systolic pulmonary artery pressure (sPAP) was 27.9 mmHg. LV diastolic dysfunction was mildly abnormal in 49 patients (57.6%) and moderately abnormal in 7 cases (8.2%). Pericardial effusion was present in 5/86 (minimal in size in 3 cases and mild- moderate in 2). In 32/86 cases (37.2%), the severity of infection progressed from "severe" to "critical". Eleven patients (12.8%) died. sPAP and computed tomography score were associated with disease progression (P value = 0.002, 0.002 respectively). Tricuspid annular plane systolic excursion (TAPSE) was significantly higher in patients with no disease progression compared with those who deteriorated (P value = 0.005). Pericardial effusion (minimal, mild or moderate) was detected more often in progressive disease (P = 0.03). sPAP was significantly lower among survivors (P value = 0.007). Echocardiographic findings (including systolic PAP, TAPSE and pericardial effusion), total CT score may have prognostic and therapeutic implication in COVID-19 patients.