Association of Autonomic Balance With Phone Call Duration in Healthy Individuals.

Background This study aimed to estimate the association of autonomic balance with the duration of phone calls in healthy individuals. Methodology A total of 30 subjects aged between 18 and 30 years without any established systemic disease and using mobile phones for more than five years with minimum daily usage of 30 minutes were included in this analytical study. Heart rate variability (HRV) was recorded using a three-channel physiograph (AD Instruments South Asia (India) Pvt. Ltd., New Delhi, India) with the software LabChart PROV8.1.8 with HRV Module version 2.0.3 for 10 minutes. Time domain parameters were recorded in terms of the standard deviation of normal to normal interval (SDNN), root mean square of successive differences between normal heartbeats (RMSSD), R-R intervals greater than 50 ms (pRR50), and mean heart rate (MHR), and frequency domain parameters were total power, low-frequency power (LF), high-frequency power (HF), and the ratio of low-frequency to high-frequency power (LF/HF). HRV was recorded three times in each subject that included baseline HRV, HRV during the use of a mobile phone, and HRV after the use of a mobile phone. Results A total of 30 subjects (14 males and 16 females) participated in this study. The mean age of participants was 31.93 ± 8.59 years (32.07 ± 9.87 years for males, and 31.81 ± 7.64 years for females). There were no findings of significant arrhythmia in any of the participants. There was a significant difference in pRR50 on comparing all three phases (p = 0.036). However, there was no significant variation in other parameters such as very low frequency (VLF, ms2), VLF (%), LF (ms2), LF (%), HF (ms2), HF (%), LF/HF, SDNN (ms), RMSSD (ms), Poincare plot standard deviation perpendicular to the line of identity (ms), Poincare plot standard deviation along the line of identity (ms), systolic blood pressure (mmHg), and diabolic blood pressure (mmHg) during, before, and after exposure to mobile phone calls. There was no significant difference in the value of all parameters between males and females (p < 0.05). Conclusions Mobile phone calls may influence HRV and autonomic balance. This change may be affected by the electromagnetic field and by speaking as well.

Comparison of clinical and echocardiographic features of first and second waves of COVID-19 at a large, tertiary medical center serving a predominantly African American patient population.

As clinicians have gained experience in treating patients with the novel SARS-CoV-2 (COVID-19) virus, mortality rates for patients with acute COVID-19 infection have decreased. The Centers for Disease Control (CDC) has identified the African American population as having increased risk of COVID-19 associated mortality, however little is known about echocardiographic markers associated with increased mortality in this patient population. We aimed to compare the clinical and echocardiographic features of a predominantly African American patient cohort hospitalized with acute COVID-19 infection during the first (March-June 2020) and second (September-December 2020) waves of the COVID-19 pandemic, and to investigate which parameters are most strongly associated with composite all-cause mortality. We performed consecutive transthoracic echocardiograms (TTEs) on 105 patients admitted with acute COVID-19 infection during the first wave and 129 patients admitted during the second wave. TTE parameters including left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LVGLS), right ventricular global longitudinal strain (RVGLS), right ventricular free-wall strain (RVFWS), and right ventricular basal diameter (RVBD) were compared between the two groups. Clinical and demographic characteristics including underlying co-morbidities, biomarkers, in-hospital treatment regimens, and outcomes were collected and analyzed. Univariable and multivariable analyses were performed to determine variables associated with all-cause mortality. There were no significant differences between the two waves in terms of age, gender, BMI, or race. Overall all-cause mortality was 35.2% for the first wave compared to 14.7% for the second wave (p < 0.001). Previous medical conditions were similar between the two waves with the exception of underlying lung disease (41.9% vs. 29.5%, p = 0.047). Echocardiographic parameters were significantly more abnormal in the first wave compared to the second: LVGLS (- 17.1 ± 5.0 vs. - 18.9 ± 4.8, p = 0.02), RVGLS (- 15.7 ± 5.9% vs. - 19.0 ± 5.9%, p < 0.001), RVFWS (- 19.5 ± 6.8% vs. - 23.2 ± 6.9%, p = 0.001), and RVBD (4.5 ± 0.8 vs. 3.9 ± 0.7 cm, p < 0.001). Stepwise multivariable logistic analysis showed mechanical ventilation, RVFWS, and RVGLS to be independently associated with mortality. In a predominantly African American patient population on the south side of Chicago, the clinical and echocardiographic features of patients hospitalized with acute COVID-19 infection demonstrated marked improvement from the first to the second wave of the pandemic, with a significant decrease in all-cause mortality. Possible explanations include implementation of evidence-based therapies, changes in echocardiographic practices, and behavioral changes in our patient population. Mechanical ventilation and right-sided strain-based markers were independently associated with mortality.

Immune mediating molecules and pathogenesis of COVID-19-associated neurological disease.

BACKGROUND: Long period of SARS-CoV-2 infection has been associated with psychiatric and cognitive disorders in adolescents and children. SARS-CoV-2 remains dormant in the CNS leading to neurological complications. The wide expression of ACE2 in the brain raises concern for its involvement in SARS-CoV-2 infection. Though, the mechanistic insights about blood-brain barriers (BBB) crossing by SARS-CoV-2 and further brain infection are still not clear. Moreover, the mechanism behind dormant SARS-CoV-2 infections leading to chronic neurological disorders needs to be unveiled. There is an urgent need to find out the risk factor involved in COVID-19-associated neurological disease. Therefore, the role of immune-associated genes in the pathogenesis of COVID-19 associated neurological diseases is presented which could contribute to finding associated genetic risk factors. METHOD: The search utilizing multiple databases, specifically, EMBASE, PubMed (Medline), and Google Scholar was performed. Moreover, the literature survey on the involvement of COVID-19, neuropathogenesis, and its consequences was done. DESCRIPTION: Persistent inflammatory stimuli may promote the progression of neurodegenerative diseases. An increased expression level of cytokine, chemokine, and decreased expression level of immune cells has been associated with the COVID-19 patient. Cytokine storm was observed in severe COVID-19 patients. The nature of SARS-CoV-2 infection can be neuroinflammatory. Genes of immune response could be associated with neurodegenerative diseases. CONCLUSION: The present review will provide a useful framework and help in understanding COVID-19-associated neuropathogenesis. Experimental studies on immune-associated genes in COVID-19 patients with neurological manifestations could be helpful to establish its neuropathogenesis.