Managing Covid-19 in patients with heart failure: current status and future prospects.

INTRODUCTION: COVID-19 may contribute to decompensation of previously stable chronic HF or cause a de-novo heart failure, which may come from the hyperinflammatory response and subsequent increase in metabolic demand. AREAS COVERED: Two independent investigators searched MEDLINE (via PubMed), Europe PMC, and ScienceDirect databases with the following search terms: COVID-19, heart failure, COVID-19 drugs, heart failure drugs, and device therapy. All of the included full-text articles were rigorously evaluated by both authors in case there was disagreement about whether research should be included or not. In total, 157 studies were included and underwent extensive reading by the authors. EXPERT OPINION: The World Health Organization (WHO) and the National Institute of Health (NIH) have published COVID-19 drug recommendations, although recommendations for HF-specific drug choices in COVID-19 are still lacking. We hope that this review can answer the void of comprehensive research data regarding the management options of HF in the COVID-19 condition so that clinicians can at least choose a more beneficial therapy or avoid combination therapies that have a high burden of side effects on HF; thus, morbidity and mortality in COVID-19 patients with HF may be reduced.

Rekomendasi Penyekat Raas Di Tengah-Tengah Pandemi Coronavirus

With a rapidly growing pandemic of coronavirus disease of 2019 (COVID-19), a public health emergency of international concern, the medical communities and national health systems are being tested for their preparedness. The culprit that is responsible for this viral respiratory disease, is a novel type of coronavirus, now identified as severe acute respiratory syndrome coronavirus - 2 (SARS-CoV-2). At the present time, there are gaps in the knowledge regarding the safety of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for COVID-19 patients due to concern of ACE2, which is critical for viral entry and their levels are upregulated when using these (Renin Angiotensin Aldosterone System) RAAS blockers. ACE2 is a glycoprotein metalloprotease that plays an essential role in physiologic and pathological states and it is ubiquitously found in human organs. Despite sharing homology, ACE is different from ACE2, and while the former cleaves angiotensin 1 to angiotensin 2, the latter cleaves angiotensin two to angiotensin 1-7. Extrapolated from experimental animal studies, ACE2 and angiotensin 1-7 are important and protective for the lung physiology based on mice model of acute lung injury by various causes. Other evidence also demonstrates harm over benefits when stopping RAAS blockers, particularly in patients with cardiovascular disease, in which using these drugs are proven to be life-saving. In the light of the paucity of evidence derived from well-designed study, societies and colleges recommend continuing RAAS blockers until new evidence says otherwise.

Cardiac manifestations, treatment characteristics, and outcomes of paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus-2: A systematic review.

BACKGROUND: Paediatric inflammatory multisystem syndrome (PIMS) temporally associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (PIMS-TS) is a rare clinical syndrome associated with a multiorgan system dysfunction, especially acute cardiac injury, and mandates a higher level of care. AIM OF REVIEW: To investigate cardiac manifestations, treatment characteristics, and outcomes of PIMS-TS. KEY SCIENTIFIC CONCEPTS OF REVIEW: Twenty-six studies were included with 1228 pooled subjects, with a mean age of 8.6 years, which were dominated by male gender (53%), and African ethnicity (31%). 732 (38%) patients were reactive on a serological test, and 457 patients (45%) were positive on SARS-CoV-2 RT-PCR. ST-segment abnormalities were the most common ECG findings (16%, n/N: 34/212). Various markers of troponin and the pooled mean of BNP and NT-pro-BNP levels were elevated. Cardiomegaly and pericardial effusion (21.8%, n/N: 164/751) were the most common chest X-ray findings. In echocardiography, the majority of patients' left ventricular ejection fraction was reduced (59.0%, n/N: 180/305), with pericardial effusion/ pericarditis seen the most (17.44%, n/N: 221/1267), and Z score ≥ 2 in 28% (n/N: 42/139). Cardiac MRI findings were consistent with acute myocarditis. Intravenous immunoglobulin, corticosteroids, and vasoactive drugs were frequently utilized. The mean length of stay was 6 days, with most patients (71%, n/N: 834/1163) were admitted to the ICU. However, the overall prognosis was favorable, with 98% alive (n/N: 1235/1260), and more than 50% of patients experienced recovery of left ventricular systolic functions at discharge (116 out of 206 patients).

Coronavirus Disease of 2019: a Mimicker of Dengue Infection?

At the beginning of 2020, the national health system and medical communities are faced with unprecedented public health challenges. A novel strain of coronavirus, later identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread globally, marking another pandemic of coronaviruses. This viral disease is responsible for devastating pneumonia, named coronavirus disease of 2019 (COVID-19), and projected to persist until the end of the year. In tropical countries, however, concerns arise regarding the similarities of COVID-19 with other infectious diseases due to the same chief complaint, which is fever. One of the infectious disease of a primary concern is dengue infection, which its peak season is approaching. Others report that there are cases of serological cross-reaction of COVID-19 and dengue infection. In this comprehensive review, we underscore the importance of knowing similar clinical presentations of both diseases and emphasize why excluding COVID-19 in the differentials in the setting of a pandemic is imprudent.