Recurrent Angina in a Patient With Myocardial Infarction With Non-obstructive Coronary Arteries.

The ubiquity of coronary angiography has increased the identification of myocardial infarction with non-obstructive coronary arteries. Currently among cardiologists, there is neither a consensus nor comprehensive diagnostic blueprint for accurate evaluation of patients with myocardial infarction with non-obstructive coronary arteries. We present a case of a patient with recurrent chest pain. A diagnosis of myocardial infarction with non-obstructive coronary arteries secondary to coronary artery vasospasm was determined with the use of multimodality imaging cardiac imaging.

The prevalence of COVID vaccine acceptance among pregnant women: A systematic review and meta-analysis

COVID pandemic has massively hit every nook of the world. Millions of people were infected and lost their lives to the deadly pandemic. This novel virus destroyed the essential healthcare service globally. Mass vaccination is the only option to halt the virus transmission. This study aimed to estimate the acceptance of the COVID vaccine among pregnant women and breastfeeding mothers. Method: We followed Cochrane collaboration guidelines and the PRISMA reporting system. Studies were identified through a systematic search of indexed articles in Medline (PubMed), Clinical key, Google Scholar, Cochrane Library, and CINAHL databases until March 10, 2022, 26,995 articles were identified in the initial search and 24 articles were included in the review. Result: Twenty four studies comprise 22,947 pregnant and 11,022 breastfeeding women. About 54% of pregnant women and 59% of breastfeeding mothers intended to take the COVID vaccination. Among the pregnant mothers, 21% with comorbidities, 14% in the first trimester, 34% in the second trimester, and 51% in the third trimester were willing to take the COVID vaccine. Risks of infections and comorbidities were the reasons for acceptance of the COVID vaccine in pregnant women. Similarly, adverse effects and safety concerns were top indicators for the rejection of the COVID vaccine. Conclusion: The acceptance of COVID vaccination among pregnant women and breastfeeding mothers are not satisfactory. Therefore, timely guidance would help to address the negative perceptions of vaccines among pregnant women.

Subclinical myocardial injury, coagulopathy, and inflammation in COVID-19: A meta-analysis of 41,013 hospitalized patients.

Background: Infection with the SARS-CoV-2 virus can lead to myocardial injury, evidenced by increases in specific biomarkers and imaging. Objective: To quantify the association between biomarkers of myocardial injury, coagulation, and severe COVID-19 and death in hospitalized patients. Methods: Studies were identified through a systematic search of indexed articles in PubMed, Embase, CINAHL, Cochrane, Web of Science, and Scopus, published between December 2019 to August 2021. Effect estimates from individual studies for association between markers of myocardial injury (Troponin), myocardial stretch (N-terminal-pro hormone BNP, NT-proBNP), and coagulopathy (D-Dimer) and death or severe/critical COVID-19 were pooled using inverse variance weighted random-effects model. Odds Ratios (OR), Hazard Ratios (HR), and 95% Confidence Intervals (CI) were pooled separately and reported by outcomes of critical/severe COVID-19 and death. A meta-analysis of proportions was also performed to summarize the pooled prevalence of co-morbidities in patients hospitalized with COVID-19. Results: We included 62 articles, with a total of 41,013 patients. The pooled proportion of patients with history of hypertension was 39% (95% CI: 34-44%); diabetes, 21% (95% CI: 18%-24%); coronary artery disease, 13% (95% CI: 10-16%); chronic obstructive pulmonary disease, 7% (95% CI: 5-8%); and history of cancer, 5% (95% CI: 4-7%). Elevated troponin was associated with higher pooled odds of critical/severe COVID-19 and death [Odds Ratio (OR: 1.76, 95% CI: 1.42-2.16)]; and also separately for death (OR: 1.72, 95% CI: 1.32-2.25), and critical/severe COVID-1919 (OR: 1.93, 95% CI: 1.45-2.40). Elevations in NT-proBNP were also associated with higher severe COVID-19 and death (OR: 3.00, 95% CI: 1.58-5.70). Increases in D-dimer levels was also significantly associated with critical/severe COVID-19 and death (pooled OR: 1.38, 95% CI: 1.07-1.79). Conclusions: This meta-analysis synthesizes existing evidence showing that myocardial injury, and coagulopathy are complications of COVID-19. The durability of these complications and their contributions to long-term cardiac implications of the disease is still being investigated. Patients who have recovered from COVID-19 may benefit from minimally invasive assessment for markers of myocardial injury, stretch and coagulopathy for early risk stratification purposes.

Subclinical Myocardial Injury, Coagulopathy, and Inflammation in COVID-19: A Meta-Analysis of 41,013 Hospitalized Patients (preprint)

Background: Infection with SARS-CoV-2 virus can lead to myocardial injury, with cardiac biomarker elevations. Objective: To quantify association between biomarkers of myocardial injury, coagulation, and severe COVID-19 and death in hospitalized patients. Methods: Studies were identified from electronic databases, published between December 2019 to August 2021. Effect estimates for association between markers of myocardial injury (Troponin), myocardial stretch (N-terminal-pro hormone BNP, NT-proBNP), and coagulopathy (D-Dimer) and death or severe/critical COVID-19 were pooled using random-effects models. Odds Ratios (OR), Hazard Ratios (HR), were pooled separately and reported by outcomes of critical/severe COVID-19 and death. A meta-analysis of proportions summarized pooled prevalence of co-morbidities. Results: We included 62 articles, with a total of 41,013 patients. The pooled proportion of patients with history of hypertension was 39% (95% CI: 34-44%); diabetes, 21% (95% CI: 18%-24%); coronary artery disease, 13% (95% CI: 10-16%); chronic obstructive pulmonary disease, 7% (95% CI: 5-8%), and history of cancer, 5% (95% CI: 4-7%). Elevated troponin was associated with higher pooled odds of critical/severe COVID-19 and death [Odds Ratio (OR: 1.76, 95% CI: 1.42-2.16)]; and also separately for death (OR: 1.72, 95% CI: 1.32-2.25), and critical/severe COVID-1919 (OR: 1.93, 95% CI: 1.45-2.40). Elevations in NT-proBNP were also associated with higher severe COVID-19 and death (OR: 3.00, 95% CI: 1.58-5.70). Conclusions : This meta-analysis synthesizes evidence showing that myocardial injury, and coagulopathy are complications of COVID-19. Patients who have recovered from COVID-19 may benefit from minimally invasive assessment for markers of myocardial injury, stretch and coagulopathy for early risk stratification.Funding: There was no funding for the study.Declaration of Interests: The authors report no relationships that could be construed as a conflict of interest.

Assessment of Water Quality Along the Southeast Coast of India During COVID-19 Lockdown

The COVID-19 has jeopardized the entire world and this pandemic has had a devastating impact on both lives and livelihoods in India. In order to defeat this mammoth wide spreading, the only way is to shut down the socio-economic activities and maintaining the minimal human interaction with LOCKDOWN. This lockdown has manifested in a pollution curtailment in almost all the spheres of the Planet and marine pollution is one amongst them. Quantifying this decrease in pollution levels enables the scientific community to assess the sole contribution of anthropogenic (especially non-essential) activities to global/regional pollution levels. This paper aims to study the impact of stringent lockdown period (phase 1&2) on coastal water quality along the Chennai coast of India, by analyzing suspended matter concentration (SPM), a key element of water quality and diffuse attenuation coefficient, Kd(490) by using LANDSAT-8 Operational Land Imager (OLI) data. LANDSAT-8/OLI, L1TP scenes were subjected to radiometric calibration and atmospheric correction to derive surface reflectance values from raw digital numbers using ACOLITE software and a brief insight has been given for Dark Spectrum Fitting algorithm used in ACOLITE. SPM concentration decreased by 15.48%, and 37.50% due to minimal vessel movement and cargo handling in Chennai and Ennore ports, respectively. The stringent lockdown led to the operation of fewer thermal plant units, emanated less amount of fly ash, resulted in 28.05% reduction in SPM levels over Ennore creek. As the industrial and commercial activities were subsided, the city’s water bodies are clearer than they were a fortnight ago, with a reduction of 22.26% of SPM in Adyar and 33.97% in Cooum riverine estuaries. Decrease in Kd(490) showed a positive relationship with SPM thus proved improved coastal water quality by the reduction of SPM during this period. The variations in PM2.5 and PM10 concentrations were studied using National Air Quality Monitoring Programme (NAMP) data and observed reduced levels in particulate matter concentration (PM2.5&PM10) for Adyar residential area (24.38% & 28.43%) and for Nungampakkam commercial area (36.09% & 67.18%). Significant reduction in PM2.5 concentration (45.63%) was observed at Ennore-Manali Industrial region.